RT Book, Section A1 Graffeo, Charles S. A2 Tintinalli, Judith E. A2 Stapczynski, J. Stephan A2 Ma, O. John A2 Yealy, Donald M. A2 Meckler, Garth D. A2 Cline, David M. SR Print(0) ID 1121514722 T1 Hyperosmolar Hyperglycemic State T2 Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071794763 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1121514722 RD 2024/10/11 AB The hyperosmolar hyperglycemic state (HHS) is characterized by progressive hyperglycemia and hyperosmolarity typically found in a debilitated patient with poorly controlled or undiagnosed type 2 diabetes mellitus, limited access to water, and commonly, a precipitating illness. A number of terms, including hyperosmolar hyperglycemic nonketotic state/coma/syndrome and nonketotic hyperglycemiccoma, are used to describe HHS. The syndrome does not necessarily include ketosis or coma, and we will use the terminology adopted by the American Diabetes Association.1 Most cases of HHS occur in the elderly with comorbid organ or metabolic diseases, and about 70% of patients have been previously diagnosed as diabetics. However, the incidence in children is increasing, with the common risk factors being obesity and African American race.2