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Related Experiment Videos

Hyperglycemic hyperosmolar nonketotic syndrome.

R Venkatraman1, Sunit C Singhi

  • 1Department of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research Center, Chandigarh, India.

Indian Journal of Pediatrics
|January 31, 2006
PubMed
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Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is increasingly diagnosed in obese children with type 2 diabetes. Early recognition and prompt treatment are crucial for managing this severe dehydration complication.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Critical Care Medicine

Background:

  • Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is increasingly diagnosed in obese children with type 2 diabetes mellitus (T2DM).
  • This trend is driven by rising childhood obesity rates and associated insulin resistance.
  • HHNS is characterized by severe hyperglycemia, hyperosmolality, and dehydration without significant ketoacidosis due to residual insulin secretion.

Purpose of the Study:

  • To highlight the increasing incidence and characteristics of HHNS in pediatric T2DM.
  • To outline current emergency treatment strategies for HHNS.
  • To identify the need for evidence-based guidelines in pediatric HHNS management.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for HHNS in children.

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  • Description of standard emergency treatment protocols, including fluid and electrolyte replacement, and insulin therapy.
  • Discussion of potential complications such as rhabdomyolysis and malignant hyperthermia.

    • Main Results:

    • HHNS presents with severe dehydration, altered mental status, and continued polyuria despite hyperglycemia.
    • Children with HHNS are at risk for rhabdomyolysis and malignant hyperthermia.
    • Current treatment involves hemodynamic stabilization with isotonic fluids, followed by hypotonic fluids, electrolyte correction, and insulin infusion.

    Conclusions:

    • HHNS is a growing concern in pediatric T2DM, requiring prompt recognition and aggressive management.
    • Standard treatment focuses on fluid resuscitation, electrolyte balance, and glycemic control.
    • Further research is needed to establish evidence-based guidelines for optimal fluid and insulin therapy in pediatric HHNS.