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Hyperglycaemic presentations in type 2 diabetes

Clare Willix1, Emma Griffiths2, Sally Singleton3

  • 1MBBS, FRACGP, FACRRM, Clinical Senior Lecturer, Rural Clinical School of Western Australia, Bunbury, WA. clare.willix@rcswa.edu.au

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Hyperosmolar hyperglycaemic state (HHS) is a serious complication in type 2 diabetes mellitus (T2DM). Early recognition of HHS, characterized by dehydration, hyperglycemia, and hyperosmolality, is crucial for timely management and improved patient outcomes.

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Area of Science:

  • Endocrinology
  • Internal Medicine
  • Emergency Medicine

Background:

  • Hyperosmolar hyperglycaemic state (HHS) is a critical syndrome in type 2 diabetes mellitus (T2DM).
  • It shares similarities with diabetic ketoacidosis (DKA) in type 1 diabetes.
  • Recognition is vital for rural general practitioners in emergency settings.

Purpose of the Study:

  • To review hyperglycaemic states in T2DM.
  • To outline biochemical derangements in HHS and DKA.
  • To focus on HHS recognition and management.

Main Methods:

  • Literature review of hyperglycaemic states in T2DM.
  • Discussion of pathophysiology influencing HHS.
  • Emphasis on clinical guidelines for management.

Main Results:

  • HHS presents with severe dehydration, hyperglycemia, and hyperosmolality.
  • Understanding pathophysiology aids in recognizing and treating HHS.
  • Access to clinical guidelines supports early management.

Conclusions:

  • HHS is a high-mortality condition (5–20%).
  • Prompt identification and management are essential.
  • Clinical guidelines are valuable for guiding early treatment strategies.