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What is hyperosmolar hyperglycemic syndrome (HHS) in diabetes?

Hyperosmolar hyperglycemic syndrome (HHS) is a complication of type 2 diabetes that can occur when blood glucose levels exceed 600 mg/dl (33.3 mmol/l), but ketosis (ketone bodies in the blood) is small or not present. With such high blood sugars, the body becomes severely dehydrated. HHS occurs most often in the elderly, who are either newly diagnosed with diabetes or are unaware of having high blood glucose levels, and those who are not able to tell they are thirsty (impaired thirst mechanism). Elderly people or those with a decreased thirst mechanism should always have water within reach and should drink plenty of fluids. Impaired kidney function and infections are also risk factors.
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is an emergency condition in which one's blood glucose level is very high and ketones are not present in the blood or urine. If HHNS is not treated, it can lead to coma or death.

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