Hyperglycemic hyperosmolar state
Abstract
Introduction: Hyperosmolar hyperglycemic state is a severe complication of diabetes mellitus characterized by extreme hyperglycemia, severe dehydration and hyperosmolality, without significant ketoacidosis.
Objective: To describe the pathophysiology, triggering factors, diagnostic criteria and current therapeutic strategies.
Methods: A literature review of the last 5 years, available in full text without restrictions by type of article, was performed in PubMed and ScienceDirect with the English descriptor "hyperosmolar hyperglycemic state".
Development: Hyperosmolar hyperglycemic state is a severe acute complication of diabetes mellitus, due to a relative deficit of insulin capable of regulating ketogenesis and unable to control hyperglycemia, resulting in severe dehydration, elevated serum osmolality and electrolyte disturbances. The main triggering factors are infections, drugs and non-adherence to treatment. Early diagnosis allows effective treatment in intensive care units with fluid replacement, glycemic control with insulin and correction of electrolyte disturbances and underlying causes.
Conclusions: Early detection and an appropriate therapeutic approach are essential to improve prognosis. A continuous monitoring and prevention strategy is recommended in patients with risk factors. Treatment pathways target three main areas: fluids, insulin and electrolytes.
Keywords: hyperosmolar hyperglycemic state, hyperosmolar hyperglycemic state, hyperosmolar nonketotic coma, diabetes mellitusDownloads
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