What is Hyperglycemic Hyperosmolar State

Hyperglycemic hyperosmolar state is a serious condition in which you experience an extreme increase in your blood sugar (glucose) level. This makes your body become extremely dehydrated, which can be life-threatening.

This condition is a result of uncontrolled or undiagnosed diabetes. It occurs most often in people who have type 2 diabetes (type 2 diabetes mellitus).

Certain hormones (insulin and glucagon) control the level of glucose that is in the blood. Insulin lowers blood glucose, and glucagon increases blood glucose. Hyperglycemia can result from having too little insulin in the bloodstream, or from the body not responding normally to insulin. Normally, the body gets rid of excess glucose through urine. If you do not drink enough fluids, or if you drink fluids that contain sugar, your body cannot get rid of excess glucose. This can result in hyperglycemic hyperosmolar state.

What are the causes?

This condition may be caused by:

• Infection.
• Medicines that cause you to become dehydrated or cause you to lose fluid.
• Certain illnesses.
• Not taking your diabetes medicine.
• New onset or diagnosis of diabetes.
• Cardiovascular disease (CVD).

What increases the risk?

The following factors make you more likely to develop this condition:

• Older age.
• Poor management of diabetes.
• Inability to eat or drink normally.
• Heart failure.
• Infection.
• Surgery.
• Illness.

What are the signs or symptoms?

Symptoms of this condition include:

• Extreme or increased thirst. This symptom may gradually disappear.
• Needing to urinate more often than usual.
• Dry mouth.
• Warm, dry skin that does not sweat even in high temperatures.
• High fever.
• Sleepiness or confusion.
• Vision problems or vision loss.
• Seeing, hearing, tasting, smelling, or feeling things that are not real (hallucinations).
• Weakness.
• Weight loss.
• Vomiting.

How is this diagnosed?

Hyperglycemic hyperosmolar state is diagnosed based on your medical history, your symptoms, and a blood test to measure your blood glucose level.

How is this treated?

This condition is treated in the hospital. The goals of treatment are:

• To correct dehydration by replacing fluids that you have lost. Fluids will be given through an IV tube.
• To improve blood sugar levels using insulin or other medicines as needed.
• To treat the cause of hyperglycemia, such as an infection, illness, or newly diagnosed diabetes.

Follow these instructions at home:

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
• Stay hydrated, especially when you exercise, when you get sick, or when you spend time in hot temperatures.
• Learn to manage stress. If you need help with this, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Eating and drinking

• Maintain a healthy weight.
• Exercise regularly, as directed by your health care provider.
• Eat healthy foods, such as:
  • Lean proteins.
  • Complex carbohydrates.
  • Fresh fruits and vegetables.
  • Low-fat dairy products.
  • Healthy fats.
• Drink enough fluid to keep your urine clear or pale yellow.

If You Have Diabetes:

• Make sure you know the early signs and symptoms of hyperglycemia.
• Follow your diabetes management plan, as told by your health care provider. Make sure you:
  • Take your insulin and medicines as directed.
  • Follow your exercise plan.
  • Follow your meal plan. Eat on time, and do not skip meals.
  • Check your blood glucose as often as directed. Make sure to check your blood glucose before and after exercise. If you exercise longer or in a different way than usual, check your blood glucose more often.
  • Follow your sick day plan whenever you cannot eat or drink normally. Make this plan in advance with your health care provider.
• Share your diabetes management plan with people in your workplace, school, and household.
• Check your urine for ketones when you are ill and as often as told by your health care provider.
• Carry a medical alert card or wear medical alert jewelry.

Contact a health care provider if:

• You cannot eat or drink without throwing up.
• You develop a fever.

Get help right away if:

• You develop symptoms of hyperglycemic hyperosmolar state.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Hyperglycemic hyperosmolar state is a serious condition in which you experience an extreme increase in your blood sugar (glucose) level. This makes your body become extremely dehydrated, which can be life-threatening.
• This condition is a result of uncontrolled or undiagnosed diabetes. It occurs most often in people who have type 2 diabetes (type 2 diabetes mellitus).
• This condition is treated in the hospital. Treatment may include fluids given through an IV tube and other medicines.
• Make sure you know the early signs and symptoms of hyperglycemia.
• Follow your diabetes management plan, as told by your health care provider.