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Hperglycemic hyperosmolar nonketotic syndrome (cause (older age (50-70…
Hperglycemic hyperosmolar nonketotic syndrome
definition
is a complication of diabetes mellitus in which elevated blood sugar levels results in osmolarity without significant ketoacidosis
cause
older age (50-70 years old)
poor fluid intake
poor kidney function
certain medical conditions
lack of insufficient insulin
certain medication
signs and symptoms
weakness
vision problems
leg cramp
altered level of consciousness
dehydration
pathophysiology
insulin deficiency leads to serum glucose higher than 33mmol/L
also a resulting serum osmolarity higher than 320mOsm
usually precipitated by an infection
this leads to excessive urination which leads to volume depletion and hemoconcentrarion
management
electrolyte replacement especially potassium is often required as the metabolic problems are corrected
intravenous fluids is the first line treatment which promotes tissue perfusion
insulin is given to reduce blood glucose concentration