1. Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of uncontrolled diabetes mellitus characterized by severe hyperglycemia, extreme dehydration, and altered mental status.
2. Risk factors include older age (average 60 years old), female sex, type 2 diabetes, and acute illnesses or medications that increase blood sugar levels or cause dehydration.
3. Symptoms include weakness, vision changes, seizures, nausea, vomiting, confusion, tachycardia, hypotension, and hyperthermia if an infection is present. Diagnosis is based on physical exam findings and hyperglycemia without ketosis.
1. Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of uncontrolled diabetes mellitus characterized by severe hyperglycemia, extreme dehydration, and altered mental status.
2. Risk factors include older age (average 60 years old), female sex, type 2 diabetes, and acute illnesses or medications that increase blood sugar levels or cause dehydration.
3. Symptoms include weakness, vision changes, seizures, nausea, vomiting, confusion, tachycardia, hypotension, and hyperthermia if an infection is present. Diagnosis is based on physical exam findings and hyperglycemia without ketosis.
1. Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of uncontrolled diabetes mellitus characterized by severe hyperglycemia, extreme dehydration, and altered mental status.
2. Risk factors include older age (average 60 years old), female sex, type 2 diabetes, and acute illnesses or medications that increase blood sugar levels or cause dehydration.
3. Symptoms include weakness, vision changes, seizures, nausea, vomiting, confusion, tachycardia, hypotension, and hyperthermia if an infection is present. Diagnosis is based on physical exam findings and hyperglycemia without ketosis.
1. Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of uncontrolled diabetes mellitus characterized by severe hyperglycemia, extreme dehydration, and altered mental status.
2. Risk factors include older age (average 60 years old), female sex, type 2 diabetes, and acute illnesses or medications that increase blood sugar levels or cause dehydration.
3. Symptoms include weakness, vision changes, seizures, nausea, vomiting, confusion, tachycardia, hypotension, and hyperthermia if an infection is present. Diagnosis is based on physical exam findings and hyperglycemia without ketosis.
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HYPEROSMOLAR HYPERGYLICEMIC Radya Agna Nugraha
1610211011
STATE Pisi Nopita Wigati
1610211016 DEFINISI • Merupakan komplikasi akut dan kegawatdaruratan/emergency diabetes mellitus. (ilmu penyakit dalam UI). • Hyperglicemic hyperosmolar nonketotic syndrome (HHNS) atau Sindrom hiperglikemik hiperosmolar (SHH) adalah komplikasi yang mengancam nyawa dari penyakit diabetes mellitus yang tidak terkontrol. • Hyperosmolar hyperglycemic state is a metabolic complication of diabetes mellitus (DM) characterized by severe hyperglycemia, extreme dehydration, hyperosmolar plasma, and altered consciousness. •HHS adalah istilah untuk HHNK (Hiperglikemia-hiperosmolar non ketotik) dan HHK (Hiperglikemia-hiperosmolar koma) EPIDEMIOLOGI • Sekitar 5-15% dari seluruh kasus emergensi hiperglikemi pada diabetes. • Frekuensi 17,5 kasus per 100.000 penduduk per tahun. • The average age of patients with HHS is 60 years ( 50-69 years on most published series) t • The prevalence is slightly higher in females than in males. • Increased prevalence of type 2 DM in these populations. • The mortality rate for patients with HHS is between 10 and 20 percent, which is approximately 10 times higher than that for DKA •Afrika amerika, hispanik, native amerika meningkat ETIOLOGI • Hyperglicemia • Complication of diabetes melitus Hyperglicemia • The stress response to any acute illness tends to increase counterregulatory hormones that favor elevated glucose levels. • Patients with underlying renal dysfunction • Drugs that raise serum glucose levels, inhibit insulin, or cause dehydration may contribute to development of HHS. (Antidiabetic medications) RISK-FACTOR GEJALA KLINIS -Lemah -Perubahan status mental : coma -gangguan penglihatan -kejang: umum, lokal, mioklonik -Kaki kejang -85% disertai penyakit penyerta -mual muntah -takikardia dan hipotensi -letargi, pusing bingung -hipotermia: prognosis buruk -Hemiparesis -tanda2 dehidrasi berat -peningkatan suhu tubuh karena infeksi GEJALA KLINIS DIAGNOSIS • Anamnesis : lihat riwayat pengobatan terkontrol •Physical exam findings and signs related to HHS atau tidak include the following: • Altered mental status, confusion • Px Fisik : • Vital signs related to HHS include the following : • Lethargy • Tachycardia • Ill appearance • Orthostatic decrease in blood pressure • Dry mucous membranes • Hypotension • Sunken eyes • Tachypnea • Decreased skin turgor • Hyperthermia, if infection is present • Poor capillary refill • Weak thread pulse • Anhidrosis • Decreased urine output • Coma DIAGNOSIS CAIRAN INSULIN ELEKTROLIT TATALAKSANA PROGNOSIS • Overall mortality for HHS is estimated at 5-20% • Prognosis is worse for elderly patients and patients in whom coma and hypotension are found. • In children, mortality from complications from HHS also appears to be higher than mortality from DKA.