Hyperglycemic Hyperosmolar State

Hyperglyemic hyperosmolar state (HHS) is potentially fatal hyperglycemic crisis that occurs as acute complication of uncontrolled diabetes mellitus (DM). Despite improved treatment of diabetes mellitus complications and a relatively low incidence of HHS of less than 1 case per 1000 person years, it remains a significant mortality risk for patients with DM with a mortality rate that approaches 20%. The authors provide a review of the current epidemiology, precipitating factors, pathogenesis, clinical presentation, evaluation, and treatment of HHS.