Hyperosmolar hyperglycaemic state

Consider a diagnosis of hyperosmolar hyperglycaemic state (HHS) in any patient who is unwell and has a raised blood glucose. There are no specific diagnostic criteria for HHS, but the following may be used to differentiate HHS from other hyperglycaemic states such as diabetic ketoacidosis:[6]Joint British Diabetes Societies for Inpatient Care Group. The management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes. Feb 2022 [internet publication]. https://abcd.care/resource/jbds-06-management-hyperosmolar-hyperglycaemic-state-hhs-adults-diabetes

• Hypovolaemia

• Marked hyperglycaemia (≥30 mmol/L [≥540 mg/dL]) without significant hyperketonaemia (≤3 mmol/L) or significant acidosis (pH ≥7.3, bicarbonate ≥15 mmol/L [≥15 mEq/L])

• High serum osmolality (usually ≥320 mOsm/kg [≥320 mmol/kg]).