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The diabetic hyperosmolar state.

T J Wachtel1

  • 1Community Health, Brown University, Providence, Rhode Island.

Clinics in Geriatric Medicine
|November 1, 1990
PubMed
Summary
This summary is machine-generated.

Diabetic hyperosmolar state (DHS) is a serious diabetes complication affecting over 17 new cases yearly per 100,000 people. Prompt fluid replacement and monitoring are key to managing this condition and improving survival rates.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Diabetic hyperosmolar state (DHS) is a critical acute complication of diabetes mellitus.
  • Characterized by severe hyperglycemia (serum glucose > 600 mg/dL) and high serum osmolarity (> 320 mOsm/L).
  • Can occur with or without ketoacidosis or lactic acidosis.

Purpose of the Study:

  • To define the incidence, predisposing factors, clinical presentation, and management of diabetic hyperosmolar state.
  • To highlight the high mortality associated with DHS and identify factors influencing survival.
  • To outline preventive strategies for primary care physicians and diabetic patients.

Main Methods:

  • Review of existing literature and clinical data on diabetic hyperosmolar state.

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  • Analysis of incidence rates, patient demographics, and risk factors.
  • Summary of current therapeutic approaches and outcomes.

    • Main Results:

    • DHS incidence is 17.5 cases per 100,000 person-years, frequently encountered by primary care physicians.
    • Predisposing factors include advanced age, female sex, institutionalization, and infections.
    • Common symptoms include fatigue, polydipsia, polyuria, nausea, and altered consciousness.

    Conclusions:

    • Intravenous fluid resuscitation and close electrolyte monitoring in a hospital setting are the primary treatments for DHS.
    • Mortality remains high (10-20%), influenced by age, osmolarity, and co-existing severe illnesses.
    • Prevention involves diabetes screening, patient education, prompt infection management, and adherence to diabetes treatment.