Definition of "Hyperosmolar hyperglycemic nonketotic syndrome"

Last modified: 21 hours

Hyperosmolar hyperglycemic [nonketotic] syndrome (HHS, aka hyperosmolar non-ketotic coma, HONK, nonketotic hyperosmolar coma) is a complication of diabetes mellitus (predominantly type 2), in which hyperglycemia (high blood sugars) cause severe dehydration, increases in osmolarity (relative concentration of solute), and a high risk of complications, coma and death.

  • Dehydration
  • Substantial thirst (polydipsia)
  • Neurological Sx, including:
    • Focal sensory or motor impairments
    • Focal seizures
    • Motor abnormalities, including flaccidity, depressed reflexes, tremors, or fasciculations
  • Blood tests, including:
    • Plasma glucose levels >30mmol/L
    • Serum osmolality >320 mOsm/kg
    • Serum pH>7.3
    • Bicarbonate >15 meQ/L
  • Profound dehydration, up to an average of 9L
  • Measurement of ketone bodies, to DDx from DKA, which are the underlying driver for DKA, but are usually NOT detectable in HONK, including:
    • Small ketones on dipstick
    • Absent-to-low ketonuria on urinalysis (<3mmol/L)
  • IV fluids, to correct the dehydration
  • Insulin, to reduce BSL's
  • Mx of underlying conditions that may have precipitated the illness, e.g. an acute infection
  • Hyperviscosity, and increased risk fo blood clot formation
See also
  • Diabetic ketoacidosis (DKA), another complication of diabetes, more often, but not exclusively, encountered in patients with T1DM

Find a practitioner

Practitioner count: 0
Sponsor a disease. And see how your proceeds help.
Express interest
Write text
Write FAQ
Snap photos
Record audio
Produce video
Interview experts

Definition of Hyperosmolar hyperglycemic nonketotic syndrome | Autoprac

RSS feeds: Most recent Most viewed