Hyperglycemic-hyperosmolar state is characterized by which finding?

Hyperglycemic-hyperosmolar state is characterized by which finding?

• A. Positive serum ketones
• B. Severe metabolic acidosis
• C. Elevated serum osmolarity
• D. Low glucose

Answer: (C)

The key feature of hyperglycemic-hyperosmolar state is a markedly elevated serum osmolality caused by severe hyperglycemia with significant water loss. This high osmolality drives intracellular dehydration and neurologic symptoms, and it distinguishes HHS from other diabetic emergencies. Ketones are not produced in large amounts because enough insulin is present to suppress lipolysis and ketogenesis, so there isn’t the metabolic acidosis seen with diabetic ketoacidosis. Glucose is not low; it is typically very high, often well above 600 mg/dL. Thus, elevated serum osmolarity best characterizes this condition.

The key feature of hyperglycemic-hyperosmolar state is a markedly elevated serum osmolality caused by severe hyperglycemia with significant water loss. This high osmolality drives intracellular dehydration and neurologic symptoms, and it distinguishes HHS from other diabetic emergencies. Ketones are not produced in large amounts because enough insulin is present to suppress lipolysis and ketogenesis, so there isn’t the metabolic acidosis seen with diabetic ketoacidosis. Glucose is not low; it is typically very high, often well above 600 mg/dL. Thus, elevated serum osmolarity best characterizes this condition.