Marián Mokáň, Jozef Polko, Peter Galajda
Hyperglycaemic hyperosmolar syndrome is severe acute hyperglycaemic complication of diabetes mellitus. It is presented mainly in patients with type 2 diabetes mellitus with preserved insulin secretion in pancreatic ß-cells. The most common precipitating cause is an infection. Additional risk factors include non-compliance, undiagnosed diabetes, drugs associated with dehydration (diuretics) and coexisting disease. It is characterized by severe hyperglycaemia, hyperosomolarity and dehydration without ketoacidosis. Management of hyperglycaemic hyperosmolar syndrome includes restoration of the intravascular volume, insulin therapy and correction of electrolyte deficits. It is important to monitor the patient for complications such as thrombotic vascular occlusions (stroke, myocardial infarction, pulmonary embolism, and mesenteric artery occlusion), disseminated intravascular coagulopathy and rhabdomyolysis.