For diabetic hyperosmolar syndrome, prompt diagnosis is critical. The emergency medical team will do a physical and mental status exam and may ask those who are with you about your medical history.
You'll likely have several lab tests, including blood and urine tests to measure your blood sugar level and kidney function and to detect infection, among other conditions. Your doctor may take other samples to test in a lab if your doctor thinks you may have an infection. You may also have an electrocardiogram to check for certain heart problems.
Emergency treatment can correct diabetic hyperosmolar syndrome within hours. Treatment typically includes:
- Fluids given through a vein (intravenously) to treat dehydration
- Insulin given through a vein (intravenously) to lower your blood sugar levels
- Potassium and sometimes sodium phosphate replacement given through a vein (intravenously) to help your cells function correctly
If you have an infection or an underlying health condition, such as congestive heart failure or kidney disease, these conditions will be treated as well.
Preparing for your appointment
Diabetic hyperosmolar syndrome is a medical emergency that you won't have time to prepare for.
If you have symptoms of high blood sugar, such as extreme thirst and excessive urination, for a few days, check your blood sugar level and call your doctor for advice. If you feel the symptoms of extreme high blood sugar, call 911 or your local emergency number. Don't try to drive yourself to the hospital.
If you're with someone who has diabetes and is acting confused, has one-sided weakness or has passed out, call for medical help right away.
After you've received treatment and are feeling better, some questions you might want to ask your doctor include:
- How can I better control my diabetes?
- What range does my blood sugar need to be in?
- Do I need to see a specialist?
- I have these other health problems. How can I manage them together?
- What dietary changes do I need to follow?
- Should I see a dietitian?
- Does eating a meal with a lot of sugar bring on this syndrome?
- Do I need to drink more fluids?
- Can diabetic hyperosmolar syndrome happen again?
July 25, 2020
- Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis. https://www.uptodate.com/contents/search. Accessed June 23, 2020.
- Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. https://www.uptodate.com/contents/search. Accessed June 23, 2020.
- Walls RM, et al., eds. Diabetes mellitus and disorders of glucose homeostasis. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018. https://www.clinicalkey.com. Accessed June 23, 2020.
- American Diabetes Association. Diabetes care in the hospital. Standards of Medical Care in Diabetes—2020. Diabetes Care 2020; doi:10.2337/dc20-S015.
- Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. https://www.uptodate.com/contents/search. Accessed June 23, 2020.
- Goldman L, et al., eds. Diabetes mellitus. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed June 23, 2020.
- Hyperglycemia (high blood glucose). American Diabetes Association. https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-control/hyperglycemia. Accessed June 24, 2020.
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Diabetic hyperosmolar syndrome