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Journal of Education, Health and Sport

Hyperosmolar hyperglycemic syndrome: A comprehensive review of clinical presentation, diagnosis, and treatment strategies in hyperglycemic crises
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Hyperosmolar hyperglycemic syndrome: A comprehensive review of clinical presentation, diagnosis, and treatment strategies in hyperglycemic crises

Authors

  • Dominika Orłowska Chair and Department of Neonatology and Neonatal Intensive Care, Medical University of Warsaw https://orcid.org/0009-0001-9104-0459
  • Wojciech Kapłan Chair and Department of Psychology, Medical University of Lublin https://orcid.org/0000-0003-2270-0318
  • Jan Ostański 1st Military Clinical Hospital with Polyclinic SPZOZ in Lublin https://orcid.org/0009-0008-6634-7740
  • Karolina Zalewa Independent Public Hospital No. 4 in Lublin https://orcid.org/0009-0004-0610-6866
  • Lidia Bartoszek National Medical Institute of the Ministry of the Interior and Administration https://orcid.org/0009-0000-1656-7325
  • Rafał Świdziński Chair and Department of Psychology, Medical University of Lublin https://orcid.org/0000-0002-8535-0936
  • Bartosz Skorupski Chair and Department of Psychology, Medical University of Lublin https://orcid.org/0009-0003-3314-983X
  • Jakub Lipiec Chair and Department of Psychology, Medical University of Lublin https://orcid.org/0000-0001-6711-4684
  • Monika Rogowska Chair and Department of Paediatric Radiology, Medical University of Lublin https://orcid.org/0000-0002-9617-7307
  • Joanna Olszak Independent Public Hospital No. 4 in Lublin https://orcid.org/0009-0004-0211-1449

DOI:

https://doi.org/10.12775/JEHS.2024.55.014

Keywords

hyperglycemic hyperosmolar state, HHS, diabetes mellitus, hyperglycemia

Abstract

Introduction and Purpose Hyperosmolar Hyperglycemic State (HHS), a severe type 2 diabetes complication, presents with profound hyperglycemia, hyperosmolality, and dehydration sans ketosis, posing distinct challenges in diagnosis and treatment compared to diabetic ketoacidosis (DKA). This article aims to enhance medical community awareness by examining HHS features, prevalence, and associated risk factors, contributing to improved clinical management. Emphasizing tailored treatment strategies for dehydration, coexisting illnesses, and metabolic decompensation, it ultimately seeks to enhance outcomes for type 2 diabetes individuals.

Material and methods Conducting a systematic review of medical articles from 1972 to 2023 using PubMed, this study analyzed keywords such as hyperglycemic hyperosmolar state, HHS, diabetes mellitus, hyperglycemia, and dehydration. Inclusion of pertinent articles ensured a comprehensive exploration of Hyperosmolar Hyperglycemic State (HHS) literature during the specified timeframe.

Brief description of the state of knowledge. Hyperosmolar Hyperglycemic Syndrome (HHS) predominantly affects elderly type 2 diabetes individuals, often triggered by infections like pneumonia or urinary tract infections. Clinical presentation includes fatigue, weakness, polydipsia, polyuria, nausea, and altered consciousness. Diagnosis relies on criteria such as elevated blood glucose levels and increased osmolality. HHS management involves a multidisciplinary approach, addressing fluid depletion, compromised cerebral perfusion, and achieving gradual normalization of osmolality and blood glucose levels to prevent complications.

Summary Hyperosmolar Hyperglycemic Syndrome (HHS), a severe metabolic disorder linked to diabetes, extends beyond hyperglycemia, necessitating a comprehensive understanding. This review sheds light on HHS etiology, clinical manifestations, diagnostic criteria, and treatment modalities, emphasizing its critical nature in diabetes care.

References

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Zubkiewicz‐Kucharska A, Chrzanowska J, Noczyńska A. Hyperosmolar hyperglycaemic state (HHS) as the first manifestation of type 2 diabetes in a child. Pediatr Endocrinol Diabetes Metab. 2019;25(2):85‐89. doi: 10.5114/pedm.2019.85819

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Published

2024-01-30

How to Cite

1.
ORŁOWSKA, Dominika, KAPŁAN, Wojciech, OSTAŃSKI, Jan, ZALEWA, Karolina, BARTOSZEK, Lidia, ŚWIDZIŃSKI, Rafał, SKORUPSKI, Bartosz, LIPIEC, Jakub, ROGOWSKA, Monika and OLSZAK, Joanna. Hyperosmolar hyperglycemic syndrome: A comprehensive review of clinical presentation, diagnosis, and treatment strategies in hyperglycemic crises. Journal of Education, Health and Sport. Online. 30 January 2024. Vol. 55, pp. 217-230. [Accessed 25 December 2025]. DOI 10.12775/JEHS.2024.55.014.
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Vol. 55 (2024)

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Review Articles

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Copyright (c) 2024 Dominika Orłowska, Wojciech Kapłan, Jan Ostański, Karolina Zalewa, Lidia Bartoszek, Rafał Świdziński, Bartosz Skorupski, Jakub Lipiec, Monika Rogowska, Joanna Olszak

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

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