Epidemiology

The precise prevalence and incidence of HHS is difficult to determine because of the lack of population-based studies and the multiple comorbidities often found in these patients. However, the overall prevalence is estimated at less than 1% of all diabetes-related hospital admissions.[6][15]​​[16]​ 

HHS is seen most commonly in older patients with poorly controlled type 2 diabetes.[3][4]​​ Mortality rates in HHS have been reported to be 5% to 20%, a rate that is 10-fold higher than that reported for diabetic ketoacidosis.[2]​​[3]​​ Mortality increases significantly when the patient is above the age of 70 years.[17] A combined state of severe hyperglycemia, hyperosmolality, and metabolic acidosis is seen in approximately 24% to 33% of all hyperglycemic emergencies.​[6][18][19]​​

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