|
Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus (predominantly type 2) in which high blood sugars cause severe dehydration, increases in osmolarity (relative concentration of solute) and a high risk of complications, coma and death. It is diagnosed with blood tests. It is related to diabetic ketoacidosis (DKA), another complication of diabetes more often (but not exclusively) encountered in people with type 1 diabetes; they are differentiated with measurement of ketone bodies, organic molecules that are the underlying driver for DKA but are usually not detectable in HHS. The treatment of HHS consists of correction of the dehydration with intravenous fluids, reduction of the blood sugar levels with insulin, and management of any underlying conditions that might have precipitated the illness, such as an acute infection. Older names for HHS are hyperosmolar non-ketotic coma (HONK), nonketotic hyperosmolar coma, hyperosmolar hyperglycemic nonketotic syndrome (HHNS, favoured by the American Diabetes Association). ==Signs and symptoms== According to the consensus statement published by the American Diabetes Association, diagnostic features of HHS may include the following:〔 〕 * Plasma glucose level >600 mg/dL (>30 mmol/L) * Serum osmolality >320 mOsm/kg * Profound dehydration, up to an average of 9L (and therefore substantial thirst (polydipsia)) * Serum pH >7.30 * Bicarbonate >15 mEq/L * Small ketonuria (~+ on dipstick) and absent-to-low ketonemia (<3 mmol/L) * Some alteration in consciousness Additionally it may also lead to: * Neurologic signs including focal signs such as sensory or motor impairments or focal seizures or motor abnormalities, including flaccidity, depressed reflexes, tremors or fasciculations. * Hyperviscosity and increased risk of blood clot formation 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Hyperosmolar hyperglycemic state」の詳細全文を読む スポンサード リンク
|