What is Hyperglycemic Hyperosmolar Nonketotic Syndrome?

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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 28 November 2019
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Hyperglycemic hyperosmolar nonketotic syndrome is a potentially serious health problem that can affect type 2 diabetes patients. Complications occur whenever blood sugar levels are very high due to an illness, infection, or poor management of a diabetes treatment regimen. The condition is characterized by extreme dehydration symptoms, fever, weakness, and changes in cognition and vision. Within a few hours or days, a person can experience shock or slip into a diabetic coma. Emergency treatment with intravenous (IV) fluids and insulin is vital to prevent life-threatening complications.

Type 2 diabetes impairs the body's ability to extract and process glucose sugars from the bloodstream. When blood sugar levels become significantly elevated, the blood thickens and loses water. Concentrations of salts, potassium, and other minerals become very high in the blood as more and more water is removed and excreted by the kidneys. The result is severe dehydration and the onset of hyperglycemic hyperosmolar nonketotic syndrome.

Most diabetic people are able to manage their blood sugar levels with insulin, medications, and careful diet and exercise habits. When the body is under a great deal of stress, however, levels can rise sharply and suddenly. Severe illnesses, viral infections, and extreme anxiety can all potentially trigger hyperglycemic hyperosmolar nonketotic syndrome. Middle-aged and elderly diabetics are at a higher risk of developing symptoms of very high blood sugar than younger people.


In most cases, the first symptoms of hyperglycemic hyperosmolar nonketotic syndrome include dry mouth, excessive thirst, weakness, and frequent urges to urinate. A person may also develop a fever and feel very warm to the touch. He or she might begin to feel very sleepy and confused, and start having audible or visual hallucinations. Vision loss, extreme mental sluggishness, and full-body convulsions are possible complications as well. Without treatment, an individual can enter a comatose state.

A person who shows possible signs of hyperglycemic hyperosmolar nonketotic syndrome needs to be hospitalized and treated immediately. A health-care team can provide IV fluids to rehydrate the body and insulin to bring blood sugar levels back into the normal range. Additional treatment in the form of oxygen therapy and kidney dialysis may be needed. Blood and urine samples are collected during treatment so laboratory personnel can confirm the diagnosis of hyperglycemic hyperosmolar nonketotic syndrome.

Once the patient is stable, he or she is usually kept in the hospital for several days for careful monitoring. Additional tests may be needed to check for underlying infections and other health problems that might have triggered the onset of symptoms. It is important for hyperglycemic hyperosmolar nonketotic syndrome patients to attend regular checkups and carefully manage their blood sugar levels at home to reduce the chances of future episodes.


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