Hyperglycaemic Hyperosmolar State HHS

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Hyperglycaemic Hyperosmolar State HHS!
July 2006
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Hyperglycaemic Hyperosmolar State

• Session outline
• What happens
• What causes it
• Management
• Prevention

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What happens in HHS
Can be gradual
Very high BGL (body tries to get rid of the
glucose via the kidneys - urinating a lot, very
thirsty) Electrolyte imbalance and
dehydration (every time the body gets rid of
excess glucose it sucks out more fluid and
this disrupts electrolytes like potassium in the
body) Impaired conscious state (The body is
unable to replace all the fluids lost and the
person is now in danger of severe
dehydration) Coma and possible DEATH
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Signs of HHS
Fluid movement from the cell and dehydration lead
to

• Decreased skin elasticity
• Low blood pressure
• Fever
• Drowsiness
• Confusion
• Convulsion and coma.

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Causes and contributing factors

• Prolonged hyperglycaemia (high blood glucose).
• Intercurrent illness - eg infection, systemic
  illness.
• Medication - such as high dose corticosteroids.
• Acute events - myocardial infarct, respiratory
  problems.

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Management of HHS

• Hospitalisation.
• Rehydration (because of dehydration).
• Insulin therapy (because of high BGL).
• Monitor glucose and electrolyte balance.
• Continue observation of vital signs.
• Identify precipitating factors.

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Prevention of HHS

• Identify those at high risk.
• Ensure person is well hydrated.
• Teach the person and their families about warning
  signs and symptoms.
• Education about sick day management.