Hyperosmolar Hyperglycaemic State Flashcards

1
Q

what type of diabetes does hyperosmolar hyperglycaemic state occur in

A

Type 2

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2
Q

what is the difference between HHS and DKA

A

DKA has ketoacidosis and hyperglycaemia whereas in HHS, there is hyperglycaemia without ketoacidosis

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3
Q

characteristics of HHS

A

hyperosmolarity

hyperglycaemia (>30 mmol/L)

volume depletion

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4
Q

what causes HHS

A

insulin deficiency with increased counter-acting hormones such as cortisol, glucagon, adrenaline and GH

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5
Q

what are insulins counter-acting hormones

A

cortisol, glucagon, adrenaline and GH (growth hormone)

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6
Q

how would a patient with HHS present (symptoms and signs on physical examination)

A

acute cognitive impairment,

polyuria, polydipsia,

weight loss,

nausea,

vomitting,

weakness,

tachycardia,

hypotension

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7
Q

why would a patient in HHS present with hypotension (SBP <90mmHg)

A

due to hypovolaemia

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8
Q

investigations for suspected HHS

A

blood glucose (>30),

blood ketones (low),

Venous blood gas,

serum osmolality (high),

U&E’s

FBC (leucocytosis) and ECG (hypo/er kalaemic changes)

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9
Q

what does the management of hyperosmolar hyperglycaemic state depend on

A

SERUM POTASSIUM (low, normal, high)

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10
Q

management of HHS

A

IV fluids, IV potassium replacement (IF HYPOKALAEMIC) IV insulin, refer to ICU, monitor biomarkers

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11
Q

prognosis of HHS

A

mortality is usually quite low, seen more in elder people

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12
Q

risk factors for HHS

A

infections, inadequate insulin administration, corticosteroids etc.

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