Endocrine & metabolic · UKMLA & AKT
Hyperosmolar hyperglycaemic state
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- HHS is a life-threatening metabolic emergency in type 2 diabetes: profound hyperglycaemia + hyperosmolality + NO significant ketosis/acidosis.
- JBDS diagnostic criteria - all four must be present:
- Hypovolaemia - clinically evident dehydration
- Hyperglycaemia - blood glucose >30 mmol/L
- Hyperosmolality - serum osmolality >320 mOsm/kg
- No significant hyperketonaemia (blood ketones <3 mmol/L) and no significant acidosis (pH >7.3, bicarbonate >15 mmol/L)
Why no ketones? Residual basal insulin in type 2 diabetes is enough to suppress lipolysis and inhibit ketogenesis - even though it cannot control glucose. This is the key distinction from DKA.
Unlock the full Hyperosmolar hyperglycaemic state revision
Get the complete high-yield notes (5 more sections covering investigations, management and complications), practice questions, mock exams and Sal, the AI tutor. Start free.