Hyperglycemic Hyperosmolar Syndrome

  • HHS is defined by hyperglycemia and hyperosmolarity due to volume depletion with resultant altered mental status
  • Profound hypokalemia is common as a result of osmotic diuresis. Replete aggressively
  • Hypokalemia = hypomagnesemia. Replete both of these electrolytes simultaneously
  • Fluid repletion is the key point in management but careful repletion is vital as patients may not tolerate aggressive administration
  • All patients should have an exhaustive investigation of the cause of their decompensation. Look for signs of infection, ischemia, trauma etc.

 

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