Case study: hyperosmolar hyperglycaemic state

Hyperosmolar Hyperglycaemic State (HHS) typically affects known type 2 diabetic patients who suffer from a precipitating illness which impedes the persons fluid balance leading to dehydration accompanied by high blood glucose levels (over 30mmol/L, more frequently over 40mmol/L). 1 Infection is the most common precipitating illness, but many other conditions, such as trauma or stroke, can cause this state. 2,3 Although HHS accounts for less than 1% of diabetic associated admissions, it carries a high mortality rate of 5-20%. 4-5 Previously called hyperosmolar hyperglycaemic nonketotic coma (HHNC); HHS more often presents without altered consciousness however there is a correlation between