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Updated: May 20, 2025
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A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
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Euglycemic Hyperosmolar Hypernatremic State: A Variant Subtype of Traditional Hyperosmolar Hyperglycemic State With
Siyuan Cao1, Bijay Yadav2, Lihong Huo3
1Pulmonary and Critical Care Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, California.
The Journal of Emergency Medicine
|April 30, 2025
Summary
Euglycemic hyperosmolar hypernatremic state, a variant of hyperosmolar hyperglycemic state (HHS), presents with higher mortality despite less severe diabetes. This condition requires recognition and similar treatment to traditional HHS.
Area of Science:
- Endocrinology
- Diabetology
- Nephrology
Background:
- Hyperosmolar hyperglycemic state (HHS) is a severe diabetic complication defined by high glucose and osmolality.
- A subset of patients presents with hyperglycemia, hypernatremia, and high osmolality, termed euglycemic hyperosmolar hypernatremic state (EHHS).
Purpose of the Study:
- To investigate the clinical characteristics of EHHS in comparison to traditional HHS.
- To evaluate mortality rates and identify risk factors in EHHS patients.
Main Methods:
- Retrospective observational study of adult diabetic patients with effective osmolality >320 mOsm/kg.
- Analysis of demographic data, glycemic control (HbA1c), serum electrolytes, osmolality, and mortality.
Main Results:
- EHHS patients were older, had lower HbA1c, and worse hypernatremia than traditional HHS patients.
- EHHS exhibited significantly higher mortality (35.3%) compared to traditional HHS (0%).
- EHHS mortality mirrored that of hypernatremia alone, indicating a severe clinical presentation.
Conclusions:
- EHHS is a distinct subtype of HHS with shared pathophysiology but increased mortality.
- Early recognition and similar treatment strategies as traditional HHS are crucial for managing EHHS.
- EHHS warrants increased clinical attention due to its high mortality risk.
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