Hyperosmolar syndrome or diabetic hyperosmolar syndrome is a medical emergency caused by a high blood glucose level.

The “hyper” means – high and osmolarity is a measures of the concentration of active particles in a solution , so it’s simply called high concentration of glucose in the blood.

Hyperosmolar syndrome may take a long duration – days and weeks to develop.

Some of the signs including the following :

(a) Excessive thirst despite frequently taking water/other liquids.

(b) Skin becomesd dry and warm and there is no sweating.

(c) Continued high level of blood sugar.

(d) Sleepiness and a condition of confusion.

(e) Pulsed rate becomes rapid.

(f) Dry mouth and Frequency of urination increases.

Hyperglycaemic Hyperosmolar Nonketotic Coma (HONK)

Early diagnosis for ( diabetic ) hyperosmolar syndrome is crucial .

Firstly physically tests will likely include the collection of blood and urine samples to measure your blood sugar level as well as the functioning of your kidneys. If high ketone count is found in the urine samples means that the body is sourcing its energy through the burning of fat at a fast rate, High blood sugar levels may cause a decrease in sodium levels, which is another potential indicator of hyperosmolar syndrome.

Emergency treatment can come into effect within hours in case of diabetic hyperosmolar syndrome.

Intravenous insulin treatment suggest to lower blood sugar level, and intravenous Potassium and sodium to replace the lost electrolytes which are essential for cell function.

Following the administration of intravenous insulin, dextrose should be added once glucose levels reach the 250-300 mg/dl(target level). A potassium replacement should be administered if sodium levels are maintained.


Hyperosmolar hyperglycemic state (HSS) is a complication of diabetes mellitus.

The symptoms shows signs of dehydration, weakness, leg cramps, vision problems and an altered level of consciousness, and also may include seizures, disseminated intravascular coagulopathy, mesenteric artery occlusion , or rhabdomyolysis.

Hyperosmolar hyperglycemia state is also known as hyperosmolar hyperglycemic non ketotic coma (HHNC), hyperosmolar non-ketotic come (HONK) and hyperosmolar hyperglycemic non-ketotic syndrome ( HHNS ).

Hyperosmolar Hyperglycemic State: A Health Risk Of Type 2 Diabetes

The main risk factor is a history of diabetes mellitus type 2. Diagnosis is based on blood tests finding a blood sugar greater than 30mm ol/l(600mg/dl),osmolarity greater than 320 mosm/kg, and a ph above 7.3.

The initial treatment generally consists of intravenous fluids to manage dehydration.Intravenous insulin in those with significant ketones, low molecular weight heparin to decrease the risk of blood clotting and antibiotics among those whom there is concerns of infections.

Potassium replacement is also required as the metabolic problems are corrected.

Older people are most commonly affected. The risk of death among those affected is about 15%. Efforts to prevent diabetic foot ulcers are also important. It takes a few days for the person to return to baseline.

Commonly questions answered on diabetes .


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