Hyperosmolar hyperglycemic state natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

• The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
• The symptoms of (disease name) typically develop ___ years after exposure to ___.
• If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

The symptoms of hyperosmolar hyperglycemic state (HHS) usually develop over several days to weeks as compared to diabetic ketoacidosis which presents within hours of inciting event. HHS usually presents with symptoms of hyperglycemia such as polyuria, polydipsia, and dehydration. As the HHS progresses, it leads to increase in serum osmolality which can present with altered sensorium, focal signs, confused state or even coma. Neurological symptoms rarely present with an osmolality of less than 320 mOsm/kg.

Complications

• Common complications of Hyperosmolar hyperglycemic state include:
  • Cardiovascular complications
  • Acute renal failure
  • Thrombotic events
  • Infectious complications

• Less common complications of Hyperosmolar hyperglycemic state include:
  • Cerebral edema

Prognosis

• Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
• Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
• The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
• [Subtype of disease/malignancy] is associated with the most favorable prognosis.
• The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.