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
Ok, so over the past couple of weeks, I’ve received several questions relating to the issues diabetics face in relation to kidney problems and how diabetes affects the kidneys, also known as nephropathy.
Diabetic nephropathy is the most common cause of renal failure, accounting for more than half of all cases of end-stage renal disease in the United States. Renal disease will affect between 20-40% of diabetics in their lifetime, so lets take a closer look at what its all about and more importantly, what we can do to avoid it!
Stop me if you’ve heard this one before, but as we’re aware, diabetes can affect many parts of the body, including the kidneys. In healthy kidneys, many tiny blood vessels filter waste products from your body. The blood vessels have holes that are big enough to allow tiny waste products to pass through into the urine but are still small enough to keep useful products (such as protein and red blood cells) in the blood.
High levels of sugar in the blood can damage these vessels over time if diabetes is not controlled. This can cause kidney disease, which is also called nephropathy (say: nef-rah-puh-thee). If your not well controlled and the damage is bad enough, your kidneys could stop working.
Signs And Symptoms Of Nephropathy:
Early signs and symptoms of kidney disease in patients with diabetes are typically unusual. However, signs and symptoms listed below may manifest when kidney disease has progressed:
- Albumin or protein in the urine
- High blood pressure
- Ankle and leg swelling, leg cramps
- Going to the bathroom more often at night
- High levels of blood urea nitrogen (BUN) and serum creatinine
- Less need for insulin or antidiabetic medications
- Morning sickness, nausea, and vomiting
- Weakness, paleness, and anemia
The differential diagnosis of diabetic nephropathy are extensive, but they include the following in a patient with known type 1 and type 2 diabetes:
- Primary or secondary glomerular disease
- Renovascular hypertension
- Renal artery stenosis
- Renal vein thrombosis
- Multiple myeloma
- Cholesterol embolization
- Chronic obstruction
- Interstitial nephritis