Hyperosmolar Syndrome Explained

HHS is a medical emergency. Blood sugar gets very high, and the blood holds too little water.

Extra sugar pulls water out through urine. The body loses a lot of fluid. This is called dehydration.

HHS needs care in a hospital. Knowing the signs early helps you get care sooner.

A blood sugar bar, a kidney and a big drop for body water. Sugar piles in and the bar climbs very high. The kidney sends sugar out in urine and water leaves with it, so the body water drop shrinks until the body is dry. Last, an ambulance comes, because this needs emergency care.

Ketones are made when the body burns fat for fuel. In DKA, ketones run high.

In HHS, ketones are usually low or not there. That is the main difference on a ketone test. Ketones are one clue, not the whole picture.

HHS usually builds over days, not hours. Early signs are extreme thirst, a dry mouth, and peeing more often. Call your care team soon if you see these.

Family members often notice these changes before the person with diabetes does.

Confusion can come later. Confusion with very high blood sugar is a 911 call.

Key takeaways

• HHS is a medical emergency with extremely high blood sugar and heavy fluid loss.
• Ketones are usually low or absent in HHS, so a normal ketone result does not rule it out.
• Thirst and peeing that keep building over days are a pattern to watch for.

Try it

Add the HHS warning signs and the 911 rule for confusion to your emergency plan. Then show that page to someone you live with.