Endocrine & metabolic · UKMLA & AKT
Hyperosmolar hyperglycaemic state (HHS)
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
- Blood glucose >30 mmol/L
- Serum osmolality >320 mOsm/kg - formula: 2(Na + K) + glucose + urea
- Serum bicarbonate >15 mmol/L and/or pH >7.3 (no significant acidosis)
- Ketones absent or minimal (<3 mmol/L; urine ketones ≤2+)
- Typically type 2 diabetes; may be first presentation in up to 25% of cases
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