Explore
Hyperosmolar hyperglycemic syndrome (HHS) is a serious complication of diabetes mellitus. HHS occurs when a person’s blood glucose (sugar) levels are too high for a long period, leading to severe dehydration (extreme thirst) and confusion. Hyperosmolar hyperglycemic syndrome is also known by many other names, including: Diabetic HHS.
What is hyperosmolar hyperglycemic syndrome?
The loss of water also makes the blood more concentrated than normal. This is called hyperosmolarity. It is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances.
What is hyperosmolarity of the blood?
The term hyperosmotic refers to the property of having a high osmotic pressure. That means; the number of solute molecules in one side of the semipermeable membrane (in the sample solution) is higher than the number of solute molecules on the other side.
What is the meaning of hyperosmotic?
Good daily control of your diabetes can help you prevent diabetic hyperosmolar syndrome. 1 Know the symptoms of high blood sugar... 2 Monitor your blood sugar level... 3 When you're sick, drink plenty of liquids... 4 Follow your diabetes management plan... 5 Educate your loved ones, friends and co-workers... 6 ... (more items)
How to prevent diabetic hyperosmolar syndrome?
What does urine Hyperosmolarity mean?
It's often triggered by illness or infection. In diabetic hyperosmolar syndrome, your body tries to rid itself of the excess blood sugar by passing it into your urine. Left untreated, diabetic hyperosmolar syndrome can lead to life-threatening dehydration.
What causes high urine osmolality?
An osmolality urine test is performed to measure the concentration of particles in urine. Greater than normal results may indicate conditions such as Addison disease, congestive heart failure or shock.
What is considered concentrated urine?
1.000 to 1.030 (normal specific gravity) 1.001 after drinking excessive amounts of water. More than 1.030 after avoiding fluids. Concentrated after receiving ADH.
How do you interpret urine osmolality?
A urine osmolality value of less than 100 mOsm/kg indicates complete and appropriate suppression of antidiuretic hormone secretion. A urine sodium level less than 20 mmol/L is indicative of hypovolemia, whereas a level greater than 40 mmol/L is suggestive of the syndrome of inappropriate antidiuretic hormone secretion.
Why is urine osmolality high in dehydration?
Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood. Your body has a unique way to control osmolality. When osmolality increases, it triggers your body to make antidiuretic hormone (ADH).
What osmolality means?
“Osmolality” refers to the concentration of dissolved particles of chemicals and minerals -- such as sodium and other electrolytes -- in your serum. Higher osmolality means you have more particles in your serum. Lower osmolality means the particles are more diluted. Your blood is a little like a liquid chemistry set.
What is hypertonic urine?
Hypertonic solution is that solution in which water moves out by osmosis. So hypertonic urine is that urine in which water moves out from the urine. Since water moves out of the urine, so urine is concentrated and is called hypertonic urine. We mammals produce hypertonic urine to avoid loss of water.
What conditions cause urine to become concentrated?
Increased urine concentration may be due to different conditions, such as:Heart failure.Loss of body fluids (dehydration) from diarrhea or excessive sweating.Narrowing of the kidney artery (renal arterial stenosis)Sugar, or glucose, in the urine.Syndrome of inappropriate antidiuretic hormone secretion ( SIADH )More items...•
How do I get rid of concentrated urine?
Treating ammonia-smelling urineStay hydrated. Share on Pinterest Drinking water is a simple way to stay hydrated. ... Cut down on diet triggers. Anyone who consumes a lot of triggering foods can stop ammonia-smelling urine by cutting those foods out of their diet. ... Pass urine often. ... Stay clean.
Is urine osmolality increased in kidney disease?
Random urine osmolality is more precise than self-reported fluid intake in predicting hydration status since it entails fluid loss to reflect fluid balance in the body and is less subject to recall bias. CKD is associated with low or normal osmolality rather than high osmolality due to renal concentrating defects.
Why is urine osmolality high in pre renal failure?
In contrast, a urine osmolality above 500 mosmol/kg is highly suggestive of prerenal AKI because it usually reflects both a hypovolemic stimulus to the secretion of antidiuretic hormone and the maintenance of normal tubular function.
What does it mean to have low urine osmolality?
Several conditions may cause low urine osmolality, including: excessive fluid intake, or over-hydration. kidney failure. renal tubular necrosis.
What Is Hyperosmolar Hyperglycemic State?
Hyperosmolar hyperglycemic state (HHS) is a serious medical condition that develops if your blood sugar levels get very high. Your body gets rid of...
What Are The Signs and Symptoms of HHS?
Signs and symptoms of HHS usually develop over days or weeks. You may have any of the following: 1. Blood sugar level above 600 mg/dL 2. Frequent u...
Call 911 For Any of The Following
1. You have a seizure. 2. You begin to breathe fast, or are short of breath. 3. You become weak and confused.
When Should I Seek Immediate Care?
1. You are urinating more often than usual. 2. You are more thirsty than usual. 3. You are more drowsy than usual.
When Should I Contact My Healthcare Provider?
1. Your blood sugar levels are higher than your healthcare provider says they should be. 2. You have blurred vision. 3. You have a fever. 4. You ha...
What is the name of the condition where blood sugar is too high?
Hyperosmolar hyperglycemic syndrome (HHS) is a serious complication of diabetes mellitus. HHS occurs when a person’s blood glucose (sugar) levels are too high for a long period, leading to severe dehydration (extreme thirst) and confusion. Hyperosmolar hyperglycemic syndrome is also known by many other names, including:
What is the name of the condition where blood sugar levels are high for a long period of time?
Hyperosmolar Hyperglycemic Syndrome. A serious complication of diabetes mellitus, hyperosmolar hyperglycemic syndrome (HHS) happens when blood sugar levels are very high for a long period of time. Symptoms of HHS can include extreme thirst, frequent urination, changes in your vision and confusion.
What happens when blood sugar is too high?
HHS occurs when the blood sugar of a person with diabetes becomes too high (hyperglycemia) for a long time. The extra sugar is passed into the urine, which causes the person to urinate frequently. As a result, he or she loses a lot of fluid, which can lead to severe dehydration (extreme thirst).
How high is the blood sugar level for HHS?
Your doctor will examine you, ask about your symptoms, and order a blood test to check your blood sugar level. A very high blood sugar level (over 600 mg/dL) with low ketone levels (acids in blood and urine) will help the doctor make a diagnosis of HHS.
What is hyperosmolar hyperglycemic state?
Hyperosmolar hyperglycemic state (HHS) is a serious medical condition that develops if your blood sugar levels get very high. Your body gets rid of the extra sugar through your urine. This leads to severe dehydration. HHS can occur in people with type 1 or type 2 diabetes, but is more common in people with type 2 diabetes.
What causes HHS?
HHS usually develops because of other illnesses or conditions that cause blood sugar levels to rise, such as the following:
What are the signs and symptoms of HHS?
Signs and symptoms of HHS usually develop over days or weeks. You may have any of the following:
How is HHS diagnosed?
Your healthcare provider will ask about your symptoms and when they started. He or she may also ask about other health conditions you have and about medicines that you take. Your blood and urine will be tested to check your blood sugar level and ketones.
How is HHS treated?
HHS can be treated and controlled most of the time, but early treatment is very important. You may need to stay in the hospital for treatment. Healthcare providers will first treat dehydration by giving you fluids and electrolytes, such as potassium, through an IV.
How can I prevent HHS?
Check your blood sugar level regularly. Ask your healthcare provider for information about how to check your blood sugar and how often to check it. He or she will tell you what your blood glucose level should be.
When should I contact my healthcare provider?
Your blood sugar levels are higher than your healthcare provider says they should be.
How much blood sugar is considered hyperosmolarity?
There are some clear symptoms of hyperosmolarity, the most obvious being extremely elevated blood sugar defined as 600 milligrams per deciliter (mg/dL), with 400 mg/dL as the threshold for seeking emergency care.
What are the symptoms of hyperosmolarity?
Weakness. Convulsions and coma. If you are exhibiting symptoms of hyperosmolarity, immediately get medication attention. Tests will be conducted to determine your blood sugar and ketone levels in your blood and urine. Ketones are a natural byproduct produced when your body burns fat for fuel (energy).
Is hyperosmolarity a serious condition?
Hyperosmolarity is a serious but rare condition that mostly affects people living with type 2 diabetes. If you are successfully following your diabetes management plan and your blood sugar levels are within your target range, you are at lower risk of developing this condition. Even if your blood sugar is well managed and you stay within your target range, you should understand the risk factors of hyperosmolarity. Things like an illness, infection, and stress can be triggers for this condition.
What is the role of AVP in hyperosmolality?
During hyperosmolality, the reabsorption of water promoted by the actions of AVP is the principal renal adaptation that acts to prevent additional homeostatic imbalance. In this event, retention of water is critical, but enhanced reabsorption of electrolytes such as sodium would only exacerbate the hypertonicity of the ECF. Because hypovolemia involves the loss of both water and solutes, the prevention of additional loss requires the conservation of both water and sodium. Since the 1930s, it has been known that adrenal cortical extracts decrease sodium excretion and that surgical removal of the adrenal glands (adrenalectomy) results in extreme and uncontrollable sodium loss (Richter, 1936). We now recognize that these antinatriuretic effects of adrenal cortical extracts are mediated by the actions of the adrenal steroid hormone, aldosterone.
What is the normal osmolality?
HYPEROSMOLALITY AND HYPERTONICITY. Normal serum, and therefore body fluid, osmolality is in the range of 275 to 295 mOsm/kg; clinically significant effects are generally seen at levels greater than 325 mOsm/kg.
What is Spurious Hyponatremia?
Spurious hyponatremia results from hyperosmolality of the serum (i.e., from hyperglycemia), resulting in movement of intracellular water to the extracellular space and subsequent dilution of the Na+ in the ECF. These patients are not symptomatic from hyposmolality (unlike patients with true hyponatremia). If they are symptomatic at all, it is due to their hyperosmolar state. Attention should be directed to correcting the hyperosmolar state. It is important to distinguish these two categories of hyponatremia from true hyponatremia associated with hyposmolality because the diagnostic work-up and therapeutic management are different.
What is the cause of hypernatremia?
Hypernatremia is thus caused by a defect in thirst or inability to access water, inadequate release or effect of ADH, loss of hypotonic fluid, or addition of concentrated sodium. Hyperglycemia is nearly always caused by diabetes mellitus, which results from either inadequate insulin production or insulin resistance.
Is hyperosmolality a risk factor for rhabdomyolysis?
Hyperosmolality alone could be a risk factor for rhabdomyolysis. 138,139 Rumpf and colleagues described in 1981 the association of acute rhabdomyolysis with myoglobinuric renal failure in a patient with HHS. 140 Since then, several cases have been reported in adult and pediatric patients. Subclinical rhabdomyolysis appears to be a common finding in HHS, and there seems to be a linear relationship between serum osmolarity, serum sodium, and the level of creatine kinase increase.141 Rhabdomyolysis is a potentially life-threatening complication associated with acute kidney failure, hyperkalemia, hypocalcemia, hyperphosphatemia, compartment syndrome, disseminated intravascular coagulation, and multi-organ failure.96,142,143
What cells detect ADH?
Circumventricular cells detect the concentration of ADH, angiotensin II (Sewards and Sewards, 2000 ), and relaxin ( Sunn et al., 2002). This means that peripheral events, such as diminished renal perfusion, are linked to the thirst centers of the brain.
Which layer of the adrenal cortex is responsible for aldosterone synthesis?
The most superficial layer, the zona glomerulosa, is the site of aldosterone synthesis and release. Cells in this portion of the adrenal cortex release aldosterone in response to a variety of stimuli. Surprisingly, hyponatremia is not a very potent stimulus for aldosterone release (Cade and Perenich, 1965).
What is the normal range for serum osmolarity?
The normal range for serum osmolarity is 280–295 mOsm/L. However, because urea is freely permeable across cell membranes, it does not contribute to the serum tonicity, also referred to as the effective osmolarity, relative to the intracellular space. Effective osmolarity (Eosm) is therefore calculated by:
What is a history of urinary incontinence?
The history is usually notable for complaints of progressive weakness, malaise, and perhaps hints of possible precipitating events. Patients may complain of new-onset urinary incontinence resulting from marked polyuria due to the osmotic diuresis.
What is the HHS of a diabetic?
2. HHS is differentiated from diabetic ketoacidosis by a more insidious onset, an older average patient age, extreme hyperglycemia, and severe dehydrat ion. 3.
What are the electrolyte disturbances?
Other common electrolyte disturbances include hypophosphatemia, hypomagnesemia, and hypocalcemia. Hemoconcentration usually results in a hematocrit in the range of 55–60%, and the white blood cell count is typically elevated to between 12,000 and 20,000.
How is osp94 induced?
Osp94 mRNA can be induced by either heat shock or hyperosmotic stress. The levels of induction in both cases are comparable, but the kinetics of induction differ; heat-induced Osp94 mRNA peaks within 3 h, whereas, hyper-osmolarity-induced Osp94 mRNA peaks 12–24 h later.
What causes hyperglycemia in older adults?
Infections top the list, with pneumonias and urinary tract infections most common. Another very common cause is inadequately treated or untreated diabetes. Up to 40% of older adults with a hyperglycemia syndrome do not have a prior diabetes diagnosis. Other inciting events include vascular events, such as myocardial infarction and cerebral vascular accident. Rounding out the list of common causes are gastrointestinal tract conditions (such as pancreatitis or cholecystitis), trauma, burns, drugs, and medications.
How does fluid resuscitation affect insulin?
Fluid resuscitation lowers blood glucose levels independent of insulin by diluting serum glucose and by improving renal perfusion , which leads to increased glycosuria. Fluid resuscitation also reduces levels of counter-regulatory hormones, thereby improving insulin sensitivity.
What is HHS in diabetes?
HHS is a condition of: Extremely high blood sugar (glucose) level. Extreme lack of water ( dehydration ) Decreased alertness or consciousness (in many cases) Buildup of ketones in the body (ketoacidosis) may also occur. But it is unusual and is often mild compared with diabetic ketoacidosis. HHS is more often seen in people with type 2 diabetes who ...
What is it called when the blood has a high concentration of salt?
This is called hyperosmolarity. It is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances. This draws the water out of the body's other organs, including the brain. Risk factors include: A stressful event such as infection, heart attack, stroke, or recent surgery. Heart failure.
Why does the kidneys lose water?
Normally, the kidneys try to make up for a high glucose level in the blood by allowing the extra glucose to leave the body in the urine. But this also causes the body to lose water.
Hyperosmotic Definition
Hyperosmotic can refer to solutions that have increased osmotic pressure, or a greater difference between solutes and solutions between a membrane.
Examples of Hyperosmotic
Science tells us every living object is made of cells. Solids, liquids, and gasses are essentially made of the same materials, in different concentrations.
Related Biology Terms
Plasma – The material that makes up the interior of the cell, keeping the nucleus and organelles in place.
Quiz
1. We float in the Dead Sea because the water in the Dead Sea is ___________ to human bodies.
What is the difference between isosmotic and hypoosmotic?
The key difference between isosmotic hyperosmotic and hypoosmotic is that isosmotic refers to the property of having equal osmotic pressures, but hyperosmotic refers to the property of having a high osmotic pressure. Meanwhile, hypoosmotic refers to the property of having a low osmotic pressure.
What is isosmotic pressure?
What is Isosmotic. The term isosmotic refers to the property of having equal osmotic pressures. This means the number of solute molecules in one side of the semipermeable membrane is equal to the number of solute molecules on the other side. Therefore, there is no net movement of solute molecules through the semipermeable membrane via osmosis ...
What is the term for the pressure that is responsible for the passing of solutes from one side to the other side
Often, we use this term to express the concentration of the solution. Moreover, the term osmotic pressure also describes the pressure that is responsible for the passing of solutes from one side to the other side through a semipermeable membrane.
What Is Hyperosmolarity?
- Diabetic hyperosmolar syndrome can take days or weeks to develop. Possible signs and symptoms include: 1. Blood sugar level of 600 milligrams per deciliter (mg/dL) or 33.3 millimoles per liter (mmol/L) or higher 2. Excessive thirst 3. Dry mouth 4. Increased urination 5. Warm, dry s…
Symptoms and Diagnosis
Prevention and Treatment