Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) can occur when blood glucose levels exceed 600 mg/dl (33.3 mmol/l), but ketosis (ketone bodies in the blood) is not present. With such high blood sugars, the body becomes severely dehydrated. HHNS occurs most often in the elderly and people who are on medications that raise blood glucose levels. Impaired kidney function is also a risk factor.

HHNS is a life-threatening condition. If you experience any of the following symptoms of the syndrome, seek emergency medical care immediately:

  • Excessive thirst and dehydration
  • Nausea and vomiting
  • Disorientation and confusion
  • Sudden hypotension, or low blood pressure (as evidenced by faintness)
  • Visual problems
  • Extreme, unexplained fatigue
  • Fever
  • In advanced cases, coma, seizure, and/or hemiplegia (paralysis on one side of the body)

Treatment for HHNS involves administering intravenous fluids (i.e., saline and sometimes electrolyte solutions) to restore fluid balance. Insulin therapy may also be required.

Reviewed by Francine Kaufman, MD. 4/08

Last Modified Date: November 28, 2012

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