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.

Lab tests

You'll likely have blood and urine tests to measure your blood sugar level and kidney function and to detect infection, among other conditions.


Emergency treatment can correct diabetic hyperosmolar syndrome within hours. Treatment typically includes:

  • Intravenous fluids to counter dehydration
  • Intravenous insulin to lower your blood sugar levels
  • Intravenous potassium, and occasionally sodium phosphate replacement 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 immediate medical help.

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?
April 11, 2015
  1. Kitabchi AE, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis. http://www.uptodate.com/home. Accessed March 25, 2015.
  2. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html. Accessed March 25, 2015.
  3. Kitabchi AE, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation and diagnosis. http://www.uptodate.com/home. Accessed March 25, 2015.
  4. Joint British Diabetes Societies Inpatient Care Group. The management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes. http://www.diabetes.org.uk/About_us/What-we-say/Improving-diabetes-healthcare/Management-of-the-hyperosmolar-hyperglycaemic-state-HHS-in-adults-with-diabetes/. Accessed March 25, 2015.
  5. Kitabchi AE, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. http://www.uptodate.com/home. Accessed March 25, 2015.
  6. Hyperglycemia (high blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html?loc=lwd-slabnav. Accessed March 26, 2015.
  7. Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. March 31, 2015.

Diabetic hyperosmolar syndrome