I fielded a question the other day on my Facebook page asking if I’ve ever head about a condition called HHNS or hyperosmolar hyperglycemic nonketotic syndrome.
HHNS can happen to people with either type 1 or type 2 diabetes that is not being controlled properly. What is HHNS though, and is it really similar to DKA or is it just your typical run of the mill high blood sugar? Lets take a closer look!
What Is HHNS?
People over the age of 65 with type 2 diabetes are at greater risk of hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Even though it is possible, it is very rare in people with type 1 diabetes can develop HHNS. HHNS is a medical emergency caused by a very high blood sugar, typically over 600 mg/dL due to poor control. Your kidneys try to get rid of the extra blood sugar by putting more sugar into the urine. This makes you urinate more and you lose too much body fluid, causing dehydration.
As you lose fluids, your blood becomes thicker and your blood sugar level gets too high for the kidneys to be able to fix. With the high blood sugar and dehydration there is also an imbalance of minerals, especially sodium and potassium in the blood. The imbalance of fluids, glucose, and minerals in the body can lead to severe problems, such as brain swelling, abnormal heart rhythms, seizures, coma, or organ failure. Without rapid treatment, HHNS can cause death.
Signs & Symptoms Of HHNS?
As mentioned earlier, HHS can happen to anyone, but is more common in older individuals who have type 2 diabetes. Symptoms may begin gradually and worsen over a few days or weeks. A high blood sugar level is a warning sign of HHS. I also found it very interesting that the symptoms are very similar to diabetic ketoacidosis (DKA) so its extremely important to be aware and if you suspect anything out of the ordinary, its imperative that you call 911 or get yourself into your doctors office.
- excessive thirst
- high urine output
- dry mouth
- warm skin that doesn’t perspire
- nausea, vomiting
- weight loss
- leg cramps
- vision loss
- speech impairment
- loss of muscle function
Treatment Options Of HHNS:
- Extreme dehydration
- Fever higher than 100.4° Fahrenheit
- Increased heart rate
- Low systolic blood pressure
Test that may be given include:
- Blood osmolarity (concentration)
- BUN and creatinine levels
- Blood sodium level
- Ketone test
- Blood glucose
- Blood cultures
- Chest x-ray
- Electrocardiogram (ECG)
I sound like a broken record but by taking these simple steps (I know, I know) you can really help to protect yourself:
- Checking your blood sugar regularly, as prescribed by your diabetes management plan.
- Know your target blood sugar ranges and what to do if the readings are too high, especially if your are newly diagnosed.
- Plan how often to check your blood sugar when you’re sick, put reminders in your phone, write them on sticky notes but stay on top of testing! I can not stress the importance of this!
Take extra care of yourself if you’re ill. We all know how difficult it can be in regards to controlling our blood sugars when our bodies are fighting a virus or cold.
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