Hyperosmolar hyperglycemic state HHS

• Facts:
  Complication seen in DM II
• History / PE:
  Profound dehydration
  AMS
  Blurred vision
  
• Diagnosis:
  Extremely high glucose ( > 600 mg/dL) without acidosis
  Absent ketones
  
• Treatment:
  Aggressive IVF hydration (most important!)
  Electrolyte replacement
  Insulin
• See Also:
  Diabetic ketoacidosis
• Associated With:
  Acute stress/infections
  Diabetes Mellitus type 2