What is HHS?

HHS is a life-threatening complication of diabetes characterized by extremely high blood sugar (often >600 mg/dL) and severe dehydration, but WITHOUT ketones (unlike DKA).

Who gets it?

Primarily older adults with Type 2 Diabetes. It develops slowly over days to weeks.

Triggers:

• Infection (pneumonia, UTI).
• Illness or stress.
• Not drinking enough fluids.
• Certain medications (steroids, diuretics).

Symptoms:

• Extreme thirst and dry mouth.
• Frequent urination (eventually stops when severely dehydrated).
• Weakness, confusion, or altered mental state.
• Seizures or coma.
• NO fruity breath (no ketones).

Why is itdangerous?

The blood becomes "syrup-like" from extreme sugar concentration. This can cause blood clots (stroke, heart attack) and organ failure. Mortality rate is 10-20%.

Treatment:

Requires ICU admission.

• Massive IV Fluids: The priority is rehydration.
• IV Insulin: To gradually lower blood sugar (must be done slowly to avoid brain swelling).
• Electrolytes: Replacing potassium and sodium.

Prevention:

• Monitor blood sugar during illness.
• Stay hydrated (especially in hot weather or when sick).
• Seek medical attention if blood sugar is consistently >300 mg/dL.