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Related Concept Videos

Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Diabetes Insipidus II: Pathophysiology01:22

Diabetes Insipidus II: Pathophysiology

Normally, water balance is maintained through three interconnected mechanisms: the hypothalamic thirst center, the synthesis and release of antidiuretic hormone (ADH, or vasopressin), and the kidneys' responsiveness to this hormone. ADH is synthesized in the hypothalamus, released from the posterior pituitary, and acts on the distal nephron, allowing water reabsorption and concentrated urine production.Diabetes Insipidus and Its TypesIn diabetes insipidus (DI), this regulatory system is...
Diabetes Insipidus I: Introduction01:29

Diabetes Insipidus I: Introduction

Definition Diabetes insipidus is a disorder marked by the production of large amounts of dilute urine because of impaired vasopressin production, release, or kidney response. The lack of effective vasopressin action limits water reabsorption in the renal collecting ducts, which leads to excessive urinary water loss and intense thirst.Clinical PresentationIndividuals with diabetes insipidus report persistent thirst and very high urine output. In severe cases, fluid intake can reach up to 20...
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of fluid...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...

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Updated: May 30, 2026

Osmotic Minipump Implantation for Increasing Glucose Concentration in Mouse Cerebrospinal Fluid
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Hypernatremia in hyperosmolar hyperglycemic syndrome.

Jorge Blas-Macedo1, Viridiana Blas-Soto

  • 1Hospital General Dr. Santiago Ramón y Cajal, Instituto de Seguridad y Servicios Social de los Trabajadores del Estado, Durango, Durango, México. dr_jblas@yahoo.com.mx

Revista Medica Del Instituto Mexicano Del Seguro Social
|August 16, 2011
PubMed
Summary

This study presents a case of hyperosmolar hyperglycemic state (HHS) with hypernatremia successfully treated with a hypotonic solution. The treatment rapidly improved neurological symptoms and normalized serum electrolytes and osmolality.

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Published on: January 26, 2024

Area of Science:

  • Endocrinology
  • Nephrology
  • Internal Medicine

Background:

  • Hyperosmolar hyperglycemic state (HHS) is a serious diabetic emergency characterized by severe hyperglycemia, hyperosmolality, and dehydration.
  • Hypernatremia in HHS presents a complex management challenge, requiring careful fluid and electrolyte correction.

Observation:

  • An 82-year-old woman presented with HHS and concurrent hypernatremia.
  • Initial treatment involved intravenous administration of 0.2% sodium chloride in 5% dextrose in water (0.2% NaCl in 5% D/W).

Findings:

  • The patient experienced rapid amelioration of neurological symptoms following treatment.
  • Serum glucose, serum sodium, and serum osmolality levels significantly decreased, indicating effective management of HHS and hypernatremia.
  • The use of a hypotonic solution did not result in subsequent neurological complications.

Implications:

  • 0.2% NaCl in 5% D/W is a valuable and effective therapeutic option for managing HHS with hypernatremia.
  • This case highlights the safety and efficacy of hypotonic fluid resuscitation in this specific patient population.
  • Further research into optimal fluid strategies for HHS with hypernatremia is warranted.