Hyperosmolar Hyperglycaemic State

Question 1

Patient demographic of HHS

Answer 1

T2DM
Older
Long history (eg. 1 wk)

Question 2

hi

Answer 2

hello there

Question 3

Pathophysiology of HHS

Answer 3

Dehydration
Hyperglycaemia > 35 mM
Osmolality > 340 mosmol/kg
No acidosis (no ketogenesis)

Question 4

Complications of HHS

Answer 4

Occlusive events - DVT, Stroke

Give LMWH

Question 5

Mx of HHS

Answer 5

Saline over 48 hrs - may need 9L
Wait 1 hr before starting insulin - may not be needed, start slow
Look for precipitant - MI, infection, bowel infarct