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The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
It is classically a nursing home condition but can occur in all ages. The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.
Hyperglycemia or hyperglycaemia is a condition where unusually high amount of glucose is present in blood. It is defined as blood glucose level exceeding 6.9 mmol/L (125 mg/dL ) after fasting for 8 hours and 10 mmol/L (180 mg/dL) 2 hours after eating.
Hyperosmolar syndrome or diabetic hyperosmolar syndrome is a medical emergency caused by a very high blood glucose level.. The prefix "hyper-" means high, and "osmolarity" is a measure of the concentration of active particles in a solution, so the name of the syndrome simply refers to the high concentration of glucose in the blood.
Hyperglycemia alters lung dendritic cell function, leading to an increase in susceptibility to respiratory agents. [44] Several studies also show diabetes associated with a worse disease course and slower recovery from respiratory infections. [45] Increased risk of wound infections; Restrictive lung disease is known to be associated with diabetes.
Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. [6] In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis"). [3] A pH measurement is performed to detect acidosis.
Much evidence suggests that many of the long-term complications of diabetes, result from many years of hyperglycemia (elevated levels of glucose in the blood). [11] "Perfect glycemic control" would mean that glucose levels were always normal (70–130 mg/dL or 3.9–7.2 mmol/L) and indistinguishable from a person without diabetes.
Stress hyperglycemia (also called stress diabetes or diabetes of injury) is a medical term referring to transient elevation of the blood glucose due to the stress of illness. It usually resolves spontaneously, but must be distinguished from various forms of diabetes mellitus .
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