Hyperosmolar hyperglycemic state history and symptoms: Difference between revisions
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* Older adults especially with low perception of thirst or low fluid intake tend to present more likely with hyperosmolar hyperglycemic state (HHS) as the first presentation of [[Diabetes mellitus type 2|type 2 diabetes]].<ref name="pmid23758313">{{cite journal |vauthors=de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M |title=Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents |journal=Diabet. Med. |volume=30 |issue=11 |pages=1360–6 |year=2013 |pmid=23758313 |doi=10.1111/dme.12252 |url=}}</ref><ref name="urlKetoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports">{{cite web |url=https://www.nature.com/articles/srep27519 |title=Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports |format= |work= |accessdate=}}</ref> | * Older adults especially with low perception of thirst or low fluid intake tend to present more likely with hyperosmolar hyperglycemic state (HHS) as the first presentation of [[Diabetes mellitus type 2|type 2 diabetes]].<ref name="pmid23758313">{{cite journal |vauthors=de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M |title=Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents |journal=Diabet. Med. |volume=30 |issue=11 |pages=1360–6 |year=2013 |pmid=23758313 |doi=10.1111/dme.12252 |url=}}</ref><ref name="urlKetoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports">{{cite web |url=https://www.nature.com/articles/srep27519 |title=Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports |format= |work= |accessdate=}}</ref> | ||
* Hyperosmolar hyperglycemic state has also been seen in young adults and childeren with type 1 diabetes but less commonly.<ref name="pmid22925225">{{cite journal| author=Bagdure D, Rewers A, Campagna E, Sills MR| title=Epidemiology of hyperglycemic hyperosmolar syndrome in children hospitalized in USA. | journal=Pediatr Diabetes | year= 2013 | volume= 14 | issue= 1 | pages= 18-24 | pmid=22925225 | doi=10.1111/j.1399-5448.2012.00897.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22925225 }} </ref> | * Hyperosmolar hyperglycemic state has also been seen in young adults and childeren with type 1 diabetes but less commonly.<ref name="pmid22925225">{{cite journal| author=Bagdure D, Rewers A, Campagna E, Sills MR| title=Epidemiology of hyperglycemic hyperosmolar syndrome in children hospitalized in USA. | journal=Pediatr Diabetes | year= 2013 | volume= 14 | issue= 1 | pages= 18-24 | pmid=22925225 | doi=10.1111/j.1399-5448.2012.00897.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22925225 }} </ref> | ||
* Hyperosmolar hyperglycemic state has slower onset with symtoms developing over several days to weeks as compared to diabetic ketoacidosis which presents within hours. | |||
=== Family history === | === Family history === | ||
* Patients who have a family history of [[Diabetes mellitus |diabetes]] have less chance of developing diabetic complications, possibly due to increased awareness of the disorder.<ref name="pmid21890652">{{cite journal |vauthors=Hekkala A, Ilonen J, Knip M, Veijola R |title=Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis |journal=Eur. J. Endocrinol. |volume=165 |issue=5 |pages=813–7 |year=2011 |pmid=21890652 |doi=10.1530/EJE-11-0376 |url=}}</ref> | * Patients who have a family history of [[Diabetes mellitus |diabetes]] have less chance of developing diabetic complications, possibly due to increased awareness of the disorder.<ref name="pmid21890652">{{cite journal |vauthors=Hekkala A, Ilonen J, Knip M, Veijola R |title=Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis |journal=Eur. J. Endocrinol. |volume=165 |issue=5 |pages=813–7 |year=2011 |pmid=21890652 |doi=10.1530/EJE-11-0376 |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The majority of patients with [disease name] are asymptomatic. OR The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
===History===
Age of onset
- Older adults especially with low perception of thirst or low fluid intake tend to present more likely with hyperosmolar hyperglycemic state (HHS) as the first presentation of type 2 diabetes.[1][2]
- Hyperosmolar hyperglycemic state has also been seen in young adults and childeren with type 1 diabetes but less commonly.[3]
- Hyperosmolar hyperglycemic state has slower onset with symtoms developing over several days to weeks as compared to diabetic ketoacidosis which presents within hours.
Family history
- Patients who have a family history of diabetes have less chance of developing diabetic complications, possibly due to increased awareness of the disorder.[4]
Initial presentation
- Patients may present with a history of poor compliance with insulin therapy or missed insulin injections due to vomiting or psychological reasons.
Past medical history
- Hyperosmolar hyperglycemic state is associated with a past medical history of type 2 diabetes. Type 1 diabetes melitus may also lead to HHS is rare cases.[5][6]
- History of other comorbidies such as cerbrovascular diseases, myocardial infarcstions etc can precipitate hyperosmolar hyperglycemic state by releasing counterregularotry hormones.
- History of infections (for example, urinary tract infections, pneumonia in an individual suffering from type 2 diabetes.[7]
Social history
- Patients may have a history of use of illicit drugs, for example, alcohol and cocaine.[8]
- Patients may have poor socioeconomic status, which contributes to poor medication adherence in diabetics.[9]
- Elederly patients in instutionalized care may have poor fluid intake.
Common Symptoms
Common symptoms of [disease] include:
- [symptom 1]
- [symptom 2]
- [symptom 3]
Less Common Symptoms
Less common symptoms of [disease name] include
- [symptom 1]
- [symptom 2]
- [symptom 3]
References
- ↑ de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M (2013). "Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents". Diabet. Med. 30 (11): 1360–6. doi:10.1111/dme.12252. PMID 23758313.
- ↑ "Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports".
- ↑ Bagdure D, Rewers A, Campagna E, Sills MR (2013). "Epidemiology of hyperglycemic hyperosmolar syndrome in children hospitalized in USA". Pediatr Diabetes. 14 (1): 18–24. doi:10.1111/j.1399-5448.2012.00897.x. PMID 22925225.
- ↑ Hekkala A, Ilonen J, Knip M, Veijola R (2011). "Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis". Eur. J. Endocrinol. 165 (5): 813–7. doi:10.1530/EJE-11-0376. PMID 21890652.
- ↑ Newton CA, Raskin P (2004). "Diabetic ketoacidosis in type 1 and type 2 diabetes mellitus: clinical and biochemical differences". Arch. Intern. Med. 164 (17): 1925–31. doi:10.1001/archinte.164.17.1925. PMID 15451769.
- ↑ Lin MV, Bishop G, Benito-Herrero M (2010). "Diabetic ketoacidosis in type 2 diabetics: a novel presentation of pancreatic adenocarcinoma". J Gen Intern Med. 25 (4): 369–73. doi:10.1007/s11606-009-1237-9. PMC 2842543. PMID 20119682.
- ↑ Casqueiro J, Casqueiro J, Alves C (2012). "Infections in patients with diabetes mellitus: A review of pathogenesis". Indian J Endocrinol Metab. 16 Suppl 1: S27–36. doi:10.4103/2230-8210.94253. PMC 3354930. PMID 22701840.
- ↑ Warner EA, Greene GS, Buchsbaum MS, Cooper DS, Robinson BE (1998). "Diabetic ketoacidosis associated with cocaine use". Arch. Intern. Med. 158 (16): 1799–802. PMID 9738609.
- ↑ Lewis KR, Clark C, Velarde MC (2014). "Socioeconomic factors associated with pediatric diabetic ketoacidosis admissions in Southern West Virginia". Clin. Endocrinol. (Oxf). 81 (2): 218–21. doi:10.1111/cen.12350. PMID 24117508.