Diabetic hyperglycemic hyperosmolar syndrome - Treatment

Alternative Names

Hyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK)

Treatment:

The goal of treatment is to correct the dehydration. This will improve the blood pressure, urine output, and circulation.

Fluids and potassium will be given through a vein (intravenously). High glucose levels are treated with intravenous insulin.

Expectations (prognosis):

Patients who develop this syndrome are often already ill. The death rate with this condition is as high as 40%.

Complications:

Acute circulatory collapse (shock)
Blood clot formation
Brain swelling (cerebral edema)
Increased blood acid levels (lactic acidosis)

Calling your health care provider:

This condition is a medical emergency. Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of diabetic hyperglycemic hyperosmolar syndrome.

Food and insulin release

Reviewed last on: 5/10/2010
Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29:2739-2748.

Cydulka RK, Maloney Jr. GE. Diabetes mellitus and disorders of glucose homeostasis. In: Marx J, Hockberger R, Walls R, eds. Rosen's Emergency Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier;2009.

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