People with type 2 diabetes are at risk for a problem called hyperosmolar hyperglycemic nonketotic syndrome (HHNS).
It is very rare in people with type 1 diabetes.
Your risk of developing diabetic hyperosmolar syndrome might be higher if you:
1.Have type 2 diabetes. If you don’t monitor your blood sugar or you don’t yet know you have type 2 diabetes, your risk is higher.
2.Are older than age 65.
3.Have another chronic health condition, such as congestive heart failure or kidney disease.
4.Have an infection, such as pneumonia, a urinary tract infection or a virus, which causes your blood sugar levels to rise.
5.Take certain medications. Some drugs — such as corticosteroids (prednisone), diuretics (hydrochlorothiazide and chlorthalidone) and the anti-seizure medication phenytoin (Dilantin).
HHNS is an emergency caused by very high blood sugar, often over 600 mg/dL. Your kidneys try to get rid of the extra blood sugar by putting more sugar into the urine. This makes you urinate more and you lose too much body fluid, causing dehydration.
As you lose fluids, your blood becomes thicker and your blood sugar level gets too high for the kidneys to be able to fix.
With the high blood sugar and dehydration there is also an imbalance of minerals, especially sodium and potassium in the blood.
The imbalance of fluids, glucose, and minerals in the body can lead to severe problems, such as brain swelling, abnormal heart rhythms, seizures, coma, or organ failure. Without rapid treatment, HHNS can cause death.
You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the HHNS.
Signs and Symptoms Of Hyperosmolar Hyperglycemic Non-ketotic Syndrome (HHNS)
Diabetic hyperosmolar syndrome can take days or weeks to develop. Possible signs and symptoms include:
1.Blood sugar level of 600 milligrams per deciliter (mg/dL) or 33.3 millimoles per liter (mmol/L) or higher
5.Warm, dry skin
Diabetic hyperosmolar syndrome may be triggered by:
1.Illness or infection
2.Not following a diabetes treatment plan or having an inadequate treatment plan
3.Certain medications, such as water pills (diuretics)
4.Sometimes undiagnosed diabetes results in diabetic hyperosmolar syndrome.
Seek emergency care immediately if:
1.Your blood sugar level is 400 mg/dL (22.2 mmol/L) or higher and doesn’t improve despite following your doctor’s instructions for treatment. Don’t wait until your blood sugar is high enough to cause diabetic hyperosmolar syndrome.
2.You have confusion, vision changes or other signs of dehydration.
Treatment for Hyperosmolar Hyperglycemic Non-ketotic Syndrome (HHNS)
The treatment for HHNS depends on the cause and how well you respond to treatment. The goal of treatment is to return your blood sugar to a normal level and keep it in a normal range. Treatment may include:
1.You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
2.Your Health provider may prescribe medicines to:
Keep your blood sugar controlled
Treat other medical problems that may have been caused by or made worse because of diabetes
Treat or prevent an infection
Prevent blood clots
Prevent side effects, such as nausea or constipation, from other treatments
Replace vitamins and minerals
3.You may receive oxygen through a small tube placed under your nose or through a mask placed over your face.
4.If you develop blood clots, you may need surgery to remove them.
5.You may need kidney dialysis to help filter your blood if your kidneys are not working properly.
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