HYPEROSMOLAR HYPERGLYCEMIC NONKETOTIC COMA

Course overview

HYPEROSMOLAR HYPERGLYCEMIC SYNDROME (HHS) IS A CLINICAL CONDITION THAT ARISES FROM A COMPLICATION OF DIABETES MELLITUS. TYPE 2 DIABETES ACCOUNTS FOR ABOUT 90% TO 95% OF DIABETES CASES. IT IS MOST COMMONLY SEEN IN PATIENTS WITH OBESITY. AS A CONSEQUENCE OF THE OBESITY AND HIGH BODY MASS INDEX (BMI), THERE IS THE RESISTANCE OF THE PERIPHERAL TISSUE TO THE ACTION OF INSULIN. THE BETA-CELL IN THE PANCREAS CONTINUES TO PRODUCE INSULIN, BUT THE AMOUNT IS NOT ENOUGH TO COUNTER THE EFFECT OF THE RESISTANCE OF THE END ORGAN TO ITS EFFECT. HHS IS A SERIOUS AND POTENTIALLY FATAL COMPLICATION OF TYPE 2 DIABETES. THE MORTALITY RATE IN HHS CAN BE AS HIGH AS 20% WHICH IS ABOUT 10 TIMES HIGHER THAN THE MORTALITY SEEN IN DIABETIC KETOACIDOSIS. THIS ACTIVITY REVIEWS THE PATHOPHYSIOLOGY OF HYPEROSMOLAR HYPERGLYCEMIC NONKETOTIC SYNDROME AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN ITS MANAGEMENT.