Recognizing hyperglycemic hyperosmolar state (HSS) in diabetic people

High blood sugar levels in diabetes mellitus can cause serious life-threatening complications. If blood sugar levels are left high for a long time, diabetics (diabetics) can experience it Hyperosmolar Hyperglycemic State (HHS) or nonketotic hyperosmolar hyperglycemia. This condition is characterized by symptoms of continuous bowel movements until severe dehydration requires emergency medical help.

Cause diabetics experience HHS

HHS or nonketotic hyperosmolar hyperglycemia is a complication that occurs in type 2 diabetes. However, HHS is a complication that actually occurs less frequently than other complications of diabetes.

Hyperosmolar Hyperglycemic State occurs when the level of sugar in the blood of a diabetic is too high. In HHS conditions, blood sugar has usually risen to an extreme up to 600 mg / dL (33.3 mmol / L). Even though normal blood sugar levels are below 100 mg / dL or less than 140 mg / dL after eating.

Although marked by high blood sugar levels, the cause of HHS in diabetes is not solely due to negligence in maintaining blood sugar from adopting a healthy lifestyle.

According to studies from journals American Family Phisician There are various other factors that can trigger an increase in blood sugar in diabetics to be very extreme, such as:

• Infectious diseases, such as pneumonia, urinary tract infections, and sepsis
• Diuretic medicines that decrease sugar tolerance in the body or remove fluids from the body
• A diabetes condition that was not diagnosed in a long time
• The presence of other chronic diseases, such as stroke, heart disease, and impaired kidney function
• Not undergoing diabetes treatment as recommended by the doctor
• Type 2 diabetics who are over 65 years of age

When the sugar in the blood is too high, the kidneys will try to remove excess sugar that has accumulated through urine.

In the HHS condition, the removal of blood sugar through urine too often causes the body to lose a lot of fluids so that it becomes dehydrated.

Instead of lowering blood sugar levels, dehydration causes an imbalance of fluids in the body so that the blood becomes too thick (hyperosmolarity). Subsequent blood clots can cause swelling of the blood vessels (edema) in the brain.

Signs and symptoms of HHS

Hyperosmolar Hyperglycemic State it is indeed a condition of severe dehydration that requires emergency treatment, but you can still be aware of it through several symptoms.

HHS usually develops within days to weeks. The symptoms of HHS will get worse from day to day, such as:

• High blood sugar levels up to 600 mg / dL
• Excessive thirst
• Dry mouth
• Continuous urination
• Dry skin and feels warm
• Fever
• Fatigue and weakness
• Hallucinations
• Decreased vision
• Loss of consciousness

The difference between HHS and diabetic ketoacidosis

The condition of HHS and its symptoms is similar to that of other diabetes complications such as diabetic ketoacidosis. Both of them cause symptoms of frequent urination and dehydration.

However, diabetic ketoacidosis is a common complication in type 1 diabetes. In this condition, the excretion of blood sugar through urine causes a buildup of ketones (blood acids) from burning fat due to a lack of the hormone insulin.

In type 2 diabetes, what happens is the opposite, the hormone insulin is excess in the blood because insulin does not work optimally (insulin resistance) so it does not cause ketone buildup. Therefore Hyperosmolar Hyperglycemic State this is also known as Nonketotic Hyperosmolar Hyperglycemia (HHNK).

When is it necessary to see a doctor?

You should consult your doctor immediately when your blood sugar level continues to be high or rises from the target blood sugar level. Especially if you experience some of the symptoms of HHS as already mentioned.

Meanwhile, immediately seek help to the emergency room if you experience signs and symptoms of HHS such as:

• Blood sugar levels reach 400 mg / dL even though you have taken medication as recommended by your doctor
• Decreased vision
• Convulsions
• Loss of consciousness

HHS can cause diabetic coma

Hyperglycemia that is neglected without treatment can cause central nervous system damage. Moreover, HHS also causes dehydration which causes a drastic decrease in body fluids.

In a scientific review from researchers at The Brooklyn Hospital Center, it was explained that severe dehydration makes body fluids thick and can lead to swelling in the brain (brain edema). In children, the condition of brain edema can be fatal, causing diabetic coma.

How to treat Nonketotic Hyperosmolar Hyperglycemia

HHS is a diabetes complication that requires emergency medical attention. To treat HHS, the doctor will do:

• Entering large amounts of fluids intravenously to treat dehydration.
• Provides insulin to lower or stabilize blood sugar levels.
• Providing electrolytes in the form of potassium, phosphate, or sodium through a vein or infusion to restore the function of cells in the body.

If there is interference with other organs, such as impaired kidney and heart function, the doctor will provide treatment to treat the condition.

How to prevent complications of HHS in diabetes

The most important thing that needs to be done to prevent complications of HHS from diabetes is to keep blood sugar levels normal, especially when sick and experiencing infectious diseases.

You can do the following things to prevent this:

• Get regular diabetes medication.
• Follow the recommended healthy diet for diabetes.
• Get regular exercise.
• Always follow the diabetes condition control schedule to the doctor.
• Watch for the early symptoms of HHS
• Check your blood sugar regularly, especially if you feel sick.
• See a doctor immediately when he finds out that blood sugar levels are too high.
• Tell your family, friends, coworkers, or those closest to you about the signs of HHS and ask them to seek medical help as soon as possible.

Nonketotic Hyperosmolar Hyperglycemia is a complication of type 2 diabetes that causes severe dehydration. HHS can lead to life-threatening conditions such as diabetic coma.

Like other diabetes complications, this condition can still be prevented. However, you need to recognize the symptoms well so that you can be more aware of these complications.

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