Hyperosmolar Hyperglycemic State (HHS)

Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of type 2 diabetes characterized by extremely high blood sugar, severe dehydration, and altered mental status. Unlike DKA, ketones are usually minimal.

Table of Contents

Quick Facts

  • ICD-10: E11.00
  • Mortality: Significant if untreated

Call 911

Call 911 for a person with diabetes with:
  • Extreme thirst and frequent urination
  • Very high blood sugar (often >600 mg/dL)
  • Severe weakness or confusion
  • Dry skin, sunken eyes, rapid heart rate
  • Seizure or loss of consciousness

Treatment

  • Hospital ICU care
  • Aggressive IV fluid replacement
  • Insulin (after initial fluids)
  • Electrolyte correction (especially potassium)
  • Treat underlying trigger (infection, medications, missed insulin)
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Diabetes Association. Standards of Care.