1,006 results match your criteria Hyperosmolar Hyperglycemic State


An atypical alpelisib-induced hyperglycemic hyperosmolar and diabetic ketoacidosis state: A case report and critical analysis of alpelisib-induced hyperglycemia management guidelines.

Ann Endocrinol (Paris) 2022 Apr 27. Epub 2022 Apr 27.

Diabetes department, Sud-Francilien hospital, Corbeil-Essonne, France; Paris-Saclay university, Paris, France. Electronic address:

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Development of a hyperosmolar-hyperglycemic state and possible fulminant type 1 diabetes mellitus during the treatment of a case of adenocarcinoma of the lung and interstitial pneumonia.

Diabetol Int 2022 Jul 30;13(3):580-583. Epub 2022 Mar 30.

Department of Diabetes and Endocrinology, NTT EAST Medical Center Sapporo, S-1, W-15, Chuo-ku, Sapporo, 060-0061 Japan.

An 85-year-old man was being treated with anti-cancer drugs for adenocarcinoma of the lung and was on a tapering dose of prednisolone for interstitial pneumonia. He attended our hospital complaining of fatigue, thirst, and polyuria in September 2020. His postprandial plasma glucose concentration was 976 mg/dL, his glycated hemoglobin was 8. Read More

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What is the optimal speed of correction of the hyperosmolar hyperglycemic state in diabetic ketoacidosis? An observational cohort study of USA intensive care patients.

Endocr Pract 2022 Jun 7. Epub 2022 Jun 7.

Staff Specialist Intensive Care Unit, Royal Darwin Hospital, 105 Rocklands Dr, Tiwi NT 0810, Australia; Associate Professor Flinders University, Sturt Rd, Bedford Park SA 5042 Australia; Honorary Clinical Fellow, Menzies School of Health Research, Royal Darwin Hospital Campus, 105 Rocklands Dr, Tiwi NT 0810, Australia.

Objective: International guidelines for the treatment of diabetic ketoacidosis (DKA) advise against rapid changes in osmolarity and glucose, but the optimal rates of correction are unknown. We aimed to evaluate rates of change in tonicity and glucose in intensive care patients with DKA and their relationship with mortality and altered mental status.

Methods: Observational cohort study using two publicly available databases of USA intensive care patients (Medical Information Mart for Intensive Care-IV and eICU), evaluating adults with DKA and associated hyperosmolarity (baseline Osm≥300mosm/L). Read More

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Hyperosmolar hyperglycemic state in children: case report and review of the literature.

J Klin Endokrinol Stoffwechs 2022 May 31:1-3. Epub 2022 May 31.

Department of Pediatrics, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran.

Hyperosmolar hyperglycemic state (HHS) is a rare complication in children and a life-threatening emergency that presents with a significant increase in blood sugar and hyperosmolarity with or without low ketosis. This study reports the case of a 9-year-old boy with severe HHS due to type 1 diabetes. The patient's initial serum glucose level was 1600; however, he was discharged in a stable condition. Read More

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Emphysematous Pyelonephritis Complicated With Hyperglycemic Hyperosmolar State and Sepsis: A Case Report and Literature Review.

Cureus 2022 May 30;14(5):e25498. Epub 2022 May 30.

Medicine, SBH (St. Barnabas Hospital) Health System, New York City, USA.

Emphysematous pyelonephritis (EPN) is an acute life-threatening necrotizing infection of the renal parenchyma and perirenal tissues. There are multiple treatment strategies for EPN depending on the initial classification; over the last three decades, the treatment approach has favored kidney sparing strategies and the use of nephrectomy only as salvage therapy. We report a case involving a patient with unilateral emphysematous pyelonephritis complicated with hyperglycemic hyperosmolar state (HHS), sepsis, and multiple risk factors associated with poor prognosis who was successfully treated with conservative management sparing nephrectomy. Read More

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[A geriatric case of hyperosmolar hyperglycemic state with osmotic demyelination syndrome that manifested with dysphagia].

Nihon Ronen Igakkai Zasshi 2022 ;59(2):225-232

Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital.

The patient was an 84-year-old man who had been on insulin therapy for type 2 diabetes mellitus for 55 years. He had undergone bile duct stenting to avoid obstruction due to adenocarcinoma of the bile duct. The patient had suffered from fever and anorexia for two weeks, and had subsequently stopped insulin therapy. Read More

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Lurasidone-induced hyperosmolar hyperglycemic syndrome: A case report.

Neuropsychopharmacol Rep 2022 May 24. Epub 2022 May 24.

Department of Psychiatry, Kyoto University Hospital, Kyoto, Japan.

Introduction: Lurasidone has few metabolic adverse effects and is recommended as an alternative when other antipsychotic drugs considerably increase body weight or blood sugar concentrations.

Case Presentation: An 81-year-old man with bipolar disorder developed hyperosmolar hyperglycemic syndrome as a side effect of lurasidone. Routine monitoring of blood glucose concentrations led to the early detection and treatment of this disease, preventing life-threatening complications. Read More

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Development of a pharmacist-managed protocol for the transition from intravenous to subcutaneous insulin in critically ill adults.

Am J Health Syst Pharm 2022 May 23. Epub 2022 May 23.

Eskenazi Health, Indianapolis, IN, USA.

Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Read More

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Case Report: Role of Ketone Monitoring in Diabetic Ketoacidosis With Acute Kidney Injury: Better Safe Than Sorry.

Front Pediatr 2022 6;10:869299. Epub 2022 May 6.

Division of Pediatrics, Department of Health Science, University of Piemonte Orientale, Novara, Italy.

Background: Type 1 Diabetes (T1D) is a well-known endocrinological disease in children and adolescents that is characterized by immune-mediated destruction of pancreatic β-cells, leading to partial or total insulin deficiency, with an onset that can be subtle (polydipsia, polyuria, weight loss) or abrupt (Diabetic Keto-Acidosis, hereafter DKA, or, although rarely, Hyperosmolar Hyperglycemic State, hereafter HHS). Severe DKA risk at the onset of T1D has recently significantly increased during the SARS-CoV-2 pandemic with life-threatening complications often due to its management. DKA is marked by low pH (<7. Read More

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Acute stroke-like deficits associated with nonketotic hyperglycemic hyperosmolar state: an illustrative case and systematic review of literature.

Neurol Sci 2022 Apr 28. Epub 2022 Apr 28.

Department of Neuroscience, Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, 48121, Ravenna, Italy.

Introduction: Nonketotic hyperglycemic hyperosmolar state (NKHHS) is associated with a wide spectrum of neurological syndromes including acute stroke-like deficits. Clinical features and etiology have not been established yet.

Methods: Here we provide a case illustration and systematic review on non-epileptic acute neurological deficits in NKHSS. Read More

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Severe hypernatremia in soft drink ketoacidosis and hyperglycemic hyperosmolar state at the onset of type 2 diabetes mellitus: a case series of three adolescents.

Clin Pediatr Endocrinol 2022 16;31(2):81-86. Epub 2022 Feb 16.

Department of Pediatrics, Chonnam National University Medical School & Children's Hospital, Gwangju, Korea.

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies. Some patients with a hyperglycemic crisis can present with an overlap of DKA and HHS. The coexistence of DKA and HHS is associated with higher mortality than in isolated DKA and HHS. Read More

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February 2022

Efficacy of Dulaglutide in a Patient With Type 2 Diabetes, High Cardiovascular Risk, and HIV: A Case Report.

Front Endocrinol (Lausanne) 2022 28;13:847778. Epub 2022 Feb 28.

Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy.

Background: Type 2 diabetes (T2D) is a common comorbidity in people living with HIV (PLWH). Anti-hyperglycemic treatment in PLWH is still a challenge, and no randomized controlled studies using new glucose-lowering agents are currently available.

Case Description: A 55-year-old-women was admitted to our Diabetes Unit because of hyperosmolar hyperglycemic state (HHS) and sepsis. Read More

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Associations of hyperglycemic emergency and severe hypoglycemia incidences with seasonality and ambient temperature among pregnant women with diabetes: a nested case-control study in Taiwan.

Environ Health Prev Med 2022 ;27(0):11

Department of Public Health, College of Medicine, National Cheng Kung University.

Background: Associations of acute glycemic complications with season and ambient temperature have been reported in general population with diabetes. However, little is known about the risks of acute glycemic complications in relation to season and ambient temperature in pregnant women, who are likely to be even more vulnerable. This work aimed to investigate the associations of season and ambient temperature with pregnancies complicated with hyperglycemia emergency or severe hypoglycemia. Read More

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Association between Hyperosmolar Hyperglycemic State and Venous Thromboembolism in Diabetes Patients: A Nationwide Analysis in Taiwan.

J Pers Med 2022 Feb 17;12(2). Epub 2022 Feb 17.

Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.

Background: Previous studies in Western countries have shown that a hyperosmolar hyperglycemic state (HHS) is associated with an increased risk of venous thromboembolism (VTE); in these cases, prophylactic anticoagulant treatment is suggested. However, the association between HHS and VTE in Asian populations remains undetermined. Therefore, we aimed to evaluate whether HHS is associated with an increased risk of VTE in diabetic Taiwanese patients. Read More

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February 2022

Hospitalizations and inpatient mortality for hyperosmolar hyperglycemic state over a decade.

Diabetes Res Clin Pract 2022 Mar 3;185:109230. Epub 2022 Feb 3.

Department of Internal Medicine, Central Michigan University, Saginaw, MI, USA; Department of Medicine, Samaritan Medical Center, Watertown, NY, USA.

Objectives: This study aimed to describe rates and trends in hospitalizations, inpatient mortality, total hospital charges, and mean lengths of stay among adult patients hospitalized for hyperosmolar hyperglycemic state (HHS).

Methods: The study included NIS databases 2008, 2010, 2012, 2014, 2016, and 2018. These databases were searched for hospitalizations with a principal discharge diagnosis of HHS in patients with T2DM using ICD codes (25020, 25022, and E110). Read More

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A case of sudden cardiac death due to mitochondrial disease.

Leg Med (Tokyo) 2022 Mar 22;55:102026. Epub 2022 Jan 22.

Department of Forensic Medicine, School of Medicine, University of Occupational and Environmental Health Japan, Iseigaoka 1-1, Yahatanishi, Kitakyushu, Japan.

A 25-year-old, emaciated man without medical treatment was found to have died suddenly at home by his mother. At autopsy, there were no injuries to his body, but significant circulatory insufficiency was observed. Electron microscopy revealed abnormal mitochondria in cells of the cardiac conduction system. Read More

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Hyperosmolar hyperglycaemic state as a stroke cause or stroke mimic: an illustrative case and review of literature.

Clin Med (Lond) 2022 01;22(1):83-86

Great Western Hospital, Swindon, UK.

Hyperosmolar hyperglycaemic state (HHS) is a life-threatening metabolic complication of type 2 diabetes (T2DM) that often presents with neurological symptoms. A 74-year-old man with known T2DM presented to the emergency department with collapse, left-sided weakness and slurred speech (National Institutes of Health Stroke Scale (NIHSS) 3) and a biochemical profile consistent with HHS. When he further deteriorated (NIHSS 20), he was managed for concurrent ischaemic stroke. Read More

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January 2022

New strategies of diagnostic and therapeutic approach to emergencies in the evolution of patients with diabetes mellitus (Review).

Exp Ther Med 2022 Feb 28;23(2):178. Epub 2021 Dec 28.

Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Diabetes mellitus, known as the most widespread disease in the world, along with four other chronic diseases, involves major expenditures and significant human resources for care, thus representing a burden on any type of health care system especially due to its rapid evolution of acute and chronic complications. For the emergency department (ED), the requirements of patients with acute complications of diabetes, determine expenses which are three times higher than those for non-diabetic patients and their hospitalizations are four times more frequent. The acute complications for which patients with diabetes most frequently require the ED are hypoglycemic, hyperosmolar, or ketoacidosis coma as well as alterations of the general condition that is typical of hypoglycemia, diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state and new-onset hyperglycemia. Read More

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February 2022

A Prospective study of Emphysematous Pyelonephritis in Patients with Type 2 Diabetes.

Indian J Nephrol 2021 Nov-Dec;31(6):536-543. Epub 2021 Nov 9.

Department of Medicine, subdivision Nephrology, SRMS IMS Bareilly, Uttar Pradesh, India.

Introduction: Emphysematous pyelonephritis (EPN) is a necrotizing infection of the renal parenchyma. There is a lack of studies on follow up of EPN patients. The study aimed to explore the effect of EPN in patients with type 2 diabetes (T2D) on glycemic and renal parameters on follow up, and factors suggesting the failure of medical treatment. Read More

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November 2021

Biomarker profiling of postmortem blood for diabetes mellitus and discussion of possible applications of metabolomics for forensic casework.

Int J Legal Med 2022 Jul 20;136(4):1075-1090. Epub 2022 Jan 20.

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Acute metabolic disorders of diabetes mellitus (DM), such as diabetic ketoacidosis, hyperosmolar hyperglycemic state, and hypoglycemia, are life-threatening and difficult to diagnose postmortem owing to lack of macroscopic and microscopic findings, especially when the medical history of the patient is not available before autopsy. Although various biochemical tests, including ketone bodies and hemoglobin A1c, have been used to diagnose diabetes in the postmortem setting, each marker has some limitations. Consequently, it would be helpful in forensic practice to find new biomarkers reflecting the decedent's history of DM irrespective of whether the DM was being treated. Read More

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Association of Area-Level Socioeconomic Deprivation With Hypoglycemic and Hyperglycemic Crises in US Adults With Diabetes.

JAMA Netw Open 2022 01 4;5(1):e2143597. Epub 2022 Jan 4.

Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota.

Importance: Social determinants of health play a role in diabetes management and outcomes, including potentially life-threatening complications of severe hypoglycemia and diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS). Although several person-level socioeconomic factors have been associated with these complications, the implications of area-level socioeconomic deprivation are unknown.

Objective: To examine the association between area-level deprivation and the risks of experiencing emergency department visits or hospitalizations for hypoglycemic and hyperglycemic crises (ie, DKA or HHS). Read More

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January 2022

Pediatric management challenges of hyperglycemic hyperosmolar state: case series of Korean adolescents with type 2 diabetes.

Ann Pediatr Endocrinol Metab 2022 Jan 17. Epub 2022 Jan 17.

Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.

The hyperglycemic hyperosmolar state (HHS) is considered the most fatal complication of type 2 diabetes mellitus (DM). The number of case reports describing pediatric HHS has increased recently in parallel with obesity and the prevalence of type 2 DM in pediatric patients. In this study, we investigated the patient characteristics and outcomes of HHS in nine adolescents with obesity and type 2 DM. Read More

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January 2022

Dramatic recovery without steroid therapy and withdrawal from insulin therapy in a subject with hyperglycemic and hyperosmolar syndrome and depletion of insulin secretory capacity induced by type 2 autoimmune pancreatitis: A case report.

Medicine (Baltimore) 2022 Jan;101(2):e28609

Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan.

Introduction: Autoimmune pancreatitis (AIP) is characterized by the involvement of autoimmune mechanisms and is classified as type 1, together with infiltration of IgG4-positive cells, and type 2 with poor serological abnormal findings. In clinical practice, AIP is often treated with steroid therapy.

Patient Concerns: An 81-year-old Japanese woman had thirst and appetite loss in the previous 5 days; thus, she visited a local doctor. Read More

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January 2022

Triple emergencies: Hyperosmolar hyperglycemic state, venous thromboembolism, and huge free-floating right heart thrombus successfully managed with anticoagulation.

Clin Case Rep 2021 Dec 26;9(12):e04710. Epub 2021 Dec 26.

Department of Physiology, Faculty of Clinical sciences Usmanu Danfodiyo University Sokoto Nigeria.

A 57-year-old man, with type 2 diabetes mellitus, was admitted with a hyperosmolar hyperglycemic state, who developed in-hospital venous thromboembolism with huge free-floating right heart thrombus, and there is no available optimal treatment option for the huge free-floating right heart thrombus, except anticoagulation with warfarin and low molecular weight heparin with successful outcome. Read More

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December 2021

Acute Pancreatitis as a Sequela of Hypertriglyceridemia Due to Hyperosmolar Hyperglycemic Syndrome.

Cureus 2021 Nov 16;13(11):e19640. Epub 2021 Nov 16.

Critical Care Physician, Jefferson Health New Jersey, Cherry Hill, USA.

It is well known that hyperosmolar hyperglycemic state (HHS) can lead to hypertriglyceridemia (HTG), and that HTG can lead to acute pancreatitis. However, few case reports exist of these three conditions occurring simultaneously. In this case report, we describe a 49-year-old female with a past medical history of well-controlled hypertension who presented to the emergency department with abdominal pain and hematemesis after being found minimally responsive at home. Read More

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November 2021

Hyperosmolar hyperglycaemic state causing atypical status epilepticus with hippocampal involvement.

Pract Neurol 2022 Apr 13;22(2):117-119. Epub 2021 Dec 13.

Chalfont Centre for Epilepsy, London, UK.

Diabetes mellitus may arise abruptly and decompensate suddenly, leading to a hyperglycaemic hyperosmolar state. Coma often ensues, although this usually reverses after the metabolic abnormalities have resolved. Acute symptomatic seizures can also occur in patients who are conscious, although these usually resolve after osmolarity and glycaemia have normalised. Read More

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Time trend in excess mortality in children with type 1 diabetes from 1987 to 2016 in mainland France.

Pediatr Diabetes 2022 02 19;23(1):38-44. Epub 2021 Dec 19.

Pediatric Diabetology, University Hospital, Angers, France.

Background: Mortality risk for children with type 1 diabetes (T1D) is unknown in France and their causes of death are not well documented.

Aim: To determine the standardized mortality ratios (SMRs) and causes of death in children aged 1-14 years with T1D from 1987 to 2016.

Methods: The French Center for Epidemiology on Medical Causes of Death collected all death certificates in mainland France. Read More

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February 2022

A quality improvement initiative to successfully reduce the frequency of hypoglycemia during treatment of hyperglycemic crises at an academic safety-net hospital: Insights and results.

J Clin Transl Endocrinol 2021 Dec 29;26:100269. Epub 2021 Oct 29.

Section of Endocrinology, Diabetes, Nutrition and Weight Management Boston Medical Center, 720 Harrison Ave, 8th Floor, Boston, MA 02118, USA.

Background: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are potentially life-threatening complications of diabetes. Many hospitals have developed protocols to guide the management of these conditions and align with best practices. One of the main complications encountered in the treatment of hyperglycemic crises is hypoglycemia. Read More

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December 2021