hyperosmolar hyperglycaemic state

Question 1

what is hyperosmolar hyperglycaemic state

Answer 1

hyperglycaemia results in osmotic diuresis, severe dehydration and electrolyte deficiencies
presents: elderly with T2DM

Question 2

pathophysiology of hyperosmolar hyperglycaemic state

Answer 2

hyperglycaemia -> raised serum osmolality -> osmotic diuresis -> severe volume depletion

Question 3

precipitating factors for hyperosmolar hyperglycaemic state

Answer 3

intercurrent illness
dementia
sedative drugs

Question 4

clinical features of hyperosmolar hyperglycaemic state

Answer 4

comes on over many days
dehydration, polyuria, polydipsia
lethargy, nausea and vomiting
altered level of consciousness
hyperviscosity

Question 5

management of hyperosmolar hyperglycaemic state

Answer 5

fluid replacement: IV sodium chloride solution
insulin: should not be given unless blood glucose stops falling with IV fluids
VTE prophylaxis