Hyperosmolar Hyperglycemic State Questions & Answers

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4. Adeyinka A, Kondamudi NP. Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC, Hyperosmolar Hyperglycemic Nonketotic Syndrome). 2018 Jan. [QxMD MEDLINE Link]. [Full Text].

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6. Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 2001 Jan. 24(1):131-53. [QxMD MEDLINE Link]. [Full Text].

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8. Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006 Dec. 29(12):2739-48. [QxMD MEDLINE Link].

9. Campanella LM, Lartey R, Shih R. Severe hyperglycemic hyperosmolar nonketotic coma in a nondiabetic patient receiving aripiprazole. Ann Emerg Med. 2009 Feb. 53(2):264-6. [QxMD MEDLINE Link].

10. Ahuja N, Palanichamy N, Mackin P, Lloyd A. Olanzapine-induced hyperglycaemic coma and neuroleptic malignant syndrome: case report and review of literature. J Psychopharmacol. 2010 Jan. 24(1):125-30. [QxMD MEDLINE Link].

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12. Miyamura K, Nawa N, Nishimura H, Fushimi K, Fujiwara T. Association between heat exposure and hospitalization for diabetic ketoacidosis, hyperosmolar hyperglycemic state, and hypoglycemia in Japan. Environ Int. 2022 Sep. 167:107410. [QxMD MEDLINE Link]. [Full Text].

13. [Guideline] Kitabchi AE, Umpierrez GE, Murphy MB, et al. Hyperglycemic crises in diabetes. Diabetes Care. 2004 Jan. 27 Suppl 1:S94-102. [QxMD MEDLINE Link]. [Full Text].

14. Bradford AL, Crider CC, Xu X, Naqvi SH. Predictors of Recurrent Hospital Admission for Patients Presenting With Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. J Clin Med Res. 2017 Jan. 9 (1):35-9. [QxMD MEDLINE Link]. [Full Text].

15. Shaka H, El-Amir Z, Wani F, et al. Hospitalizations and inpatient mortality for hyperosmolar hyperglycemic state over a decade. Diabetes Res Clin Pract. 2022 Mar. 185:109230. [QxMD MEDLINE Link].

16. Agrawal S, Baird GL, Quintos JB, et al. Pediatric Diabetic Ketoacidosis With Hyperosmolarity: Clinical Characteristics and Outcomes. Endocr Pract. 2018 Aug. 24 (8):726-32. [QxMD MEDLINE Link]. [Full Text].

17. MacIsaac RJ, Lee LY, McNeil KJ, Tsalamandris C, Jerums G. Influence of age on the presentation and outcome of acidotic and hyperosmolar diabetic emergencies. Intern Med J. 2002 Aug. 32(8):379-85. [QxMD MEDLINE Link].

18. Kershaw MJ, Newton T, Barrett TG, Berry K, Kirk J. Childhood diabetes presenting with hyperosmolar dehydration but without ketoacidosis: a report of three cases. Diabet Med. 2005 May. 22(5):645-7. [QxMD MEDLINE Link].

19. Bhowmick SK, Levens KL, Rettig KR. Hyperosmolar hyperglycemic crisis: an acute life-threatening event in children and adolescents with type 2 diabetes mellitus. Endocr Pract. 2005 Jan-Feb. 11(1):23-9. [QxMD MEDLINE Link].

20. Singhi SC. Hyperglycemic hyperosmolar state and type 2 diabetes mellitus: yet another danger of childhood obesity. Pediatr Crit Care Med. 2005 Jan. 6(1):86-7. [QxMD MEDLINE Link].

21. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul. 32 (7):1335-43. [QxMD MEDLINE Link]. [Full Text].

22. Kao Y, Hsu CC, Weng SF, et al. Subsequent mortality after hyperglycemic crisis episode in the non-elderly: a national population-based cohort study. Endocrine. 2016 Jan. 51 (1):72-82. [QxMD MEDLINE Link].

23. Issa M, Alqahtani F, Ziada KM, et al. Incidence and Outcomes of Non-ST Elevation Myocardial Infarction in Patients Hospitalized with Decompensated Diabetes. Am J Cardiol. 2018 Oct 15. 122 (8):1297-302. [QxMD MEDLINE Link].

24. Schaapveld-Davis CM, Negrete AL, Hudson JQ, et al. End-Stage Renal Disease Increases Rates of Adverse Glucose Events When Treating Diabetic Ketoacidosis or Hyperosmolar Hyperglycemic State. Clin Diabetes. 2017 Oct. 35 (4):202-8. [QxMD MEDLINE Link]. [Full Text].

25. Pasquel FJ, Tsegka K, Wang H, et al. Clinical Outcomes in Patients With Isolated or Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: A Retrospective, Hospital-Based Cohort Study. Diabetes Care. 2020 Feb. 43 (2):349-57. [QxMD MEDLINE Link]. [Full Text].

26. Chan KH, Thimmareddygari D, Ramahi A, Atallah L, Baranetsky NG, Slim J. Clinical characteristics and outcome in patients with combined diabetic ketoacidosis and hyperosmolar hyperglycemic state associated with COVID-19: A retrospective, hospital-based observational case series. Diabetes Res Clin Pract. 2020 Aug. 166:108279. [QxMD MEDLINE Link]. [Full Text].

27. Chiasson JL, Aris-Jilwan N, Belanger R, et al. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. CMAJ. 2003 Apr 1. 168 (7):859-66. [QxMD MEDLINE Link]. [Full Text].

28. Katz MA. Hyperglycemia-induced hyponatremia--calculation of expected serum sodium depression. N Engl J Med. 1973 Oct 18. 289 (16):843-4. [QxMD MEDLINE Link].

29. Khardori R, Soler NG. Hyperosmolar hyperglycemic nonketotic syndrome. Report of 22 cases and brief review. Am J Med. 1984 Nov. 77 (5):899-904. [QxMD MEDLINE Link].

30. Middleton P, Kelly AM, Brown J, Robertson M. Agreement between arterial and central venous values for pH, bicarbonate, base excess, and lactate. Emerg Med J. 2006 Aug. 23(8):622-4. [QxMD MEDLINE Link]. [Full Text].

31. Rosa EC, Lopes AC, Liberatori Filho AW, Schor N. Rhabdomyolysis due to hyperosmolarity leading to acute renal failure. Ren Fail. 1997 Mar. 19(2):295-301. [QxMD MEDLINE Link].

32. Slovis CM, Mork VG, Slovis RJ, Bain RP. Diabetic ketoacidosis and infection: leukocyte count and differential as early predictors of serious infection. Am J Emerg Med. 1987 Jan. 5 (1):1-5. [QxMD MEDLINE Link].

33. Hu WS, Lin CL. Role of CHA₂DS₂-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort. BMJ Open. 2018 Mar 22. 8 (3):e020065. [QxMD MEDLINE Link]. [Full Text].

34. Kitabchi AE, Nyenwe EA. Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinol Metab Clin North Am. 2006 Dec. 35(4):725-51, viii. [QxMD MEDLINE Link].

35. Munoz C, Villanueva G, Fogg L, et al. Impact of a subcutaneous insulin protocol in the emergency department: Rush Emergency Department Hyperglycemia Intervention (REDHI). J Emerg Med. 2011 May. 40(5):493-8. [QxMD MEDLINE Link].

36. Kitabchi AE, Murphy MB, Spencer J, Matteri R, Karas J. Is a priming dose of insulin necessary in a low-dose insulin protocol for the treatment of diabetic ketoacidosis?. Diabetes Care. 2008 Nov. 31(11):2081-5. [QxMD MEDLINE Link]. [Full Text].

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39. Lu CL, Chang HH, Chen HF, et al. Inverse relationship between ambient temperature and admissions for diabetic ketoacidosis and hyperglycemic hyperosmolar state: A 14-year time-series analysis. Environ Int. 2016 Jul 6. [QxMD MEDLINE Link].

40. Hamdy O. Diabetic ketoacidosis (DKA). Medscape Drugs and Diseases from WebMD. 2021 Jan 19. [Full Text].

Dipa Avichal, DO Attending Physician, Department of Endocrinology, Diabetes and Metabolism, CHS Physician Partners, PC

Dipa Avichal, DO is a member of the following medical societies: American Association of Clinical Endocrinologists, American Thyroid Association, Endocrine Society

Disclosure: Nothing to disclose.

Nissa C Blocher, MD Attending Physician, Division of Endocrinology, Associate Program Director, Endocrinology Fellowship, Albert Einstein Medical Center

Nissa C Blocher, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American Medical Association, Endocrine Society, The Pituitary Society

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George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for Physician Leadership, American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society, International Society for Clinical Densitometry, Southern Society for Clinical Investigation

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Robin R Hemphill, MD, MPH Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine

Robin R Hemphill, MD, MPH is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

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Howard A Bessen, MD Professor of Medicine, Department of Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Program Director, Harbor-UCLA Medical Center

Howard A Bessen, MD is a member of the following medical societies: American College of Emergency Physicians

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Joseph Michael Gonzalez-Campoy, MD, PhD, FACE Medical Director and CEO, Minnesota Center for Obesity, Metabolism, and Endocrinology

Joseph Michael Gonzalez-Campoy, MD, PhD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, Association of Clinical Researchers and Educators (ACRE), and Minnesota Medical Association

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George T Griffing, MD Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, InternationalSocietyfor Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Lewis S Nelson, MD, FACEP, FAACT, FACMT Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Attending Physician, Department of Emergency Medicine, Bellevue Hospital Center, New York University Medical Center and New York Harbor Healthcare System

Lewis S Nelson, MD, FACEP, FAACT, FACMT is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine

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David S Schade, MD Chief, Division of Endocrinology and Metabolism, Professor, Department of Internal Medicine, University of New Mexico School of Medicine and Health Sciences Center

David S Schade, MD is a member of the following medical societies: American College of Physicians, American Diabetes Association, American Federation for Medical Research, Endocrine Society, New Mexico Medical Society, New York Academy of Sciences, and Society for Experimental Biology and Medicine

Disclosure: Nothing to disclose.

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Paulina B Sergot, MD Staff Physician, Department of Emergency Medicine, New York University/Bellevue Hospital Center

Paulina B Sergot, MD is a member of the following medical societies: American Medical Association

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Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

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