Hyperosmolar syndrome in a patient with uncontrolled diabetes mellitus

Nonketotic hyperglycemic hyperosmolar syndrome (HHS;) is found mostly in ty pe 2 diabetic patients with marked hyperglycemia. HHS is a metabolic emerge ncy and is associated with a high mortality rate. It is characterized by ex treme dehydration and neurologic symptoms, which are related directly to th e degree of hyperosmolality. We describe a 65-year-old patient who was admi tted because of impaired consciousness caused by HHS. The relevant clinical and laboratory findings are discussed, and a brief overview of the pathoph ysiology and therapeutic management is provided. (C) 2001 by the National K idney Foundation, Inc.