Question

In hyperosmolar hyperglycemic syndrome, the laboratory results are similar to those of diabetic ketoacidosis, with three major exceptions. What differences would you expect to see in patients with hyperosmolar hyperglycemic syndrome?

a. Lower serum glucose, lower osmolality, and greater ketosis
b. Lower serum glucose, lower osmolality, and milder ketosis
c. Higher serum glucose, higher osmolality, and greater ketosis
d. Higher serum glucose, higher osmolality, and no ketosis

Answer 1

In hyperosmolar hyperglycemic syndrome (HHS), the differences compared to diabetic ketoacidosis (DKA) include higher serum glucose, higher osmolality, and no ketosis.

Step-by-step explanation:

In hyperosmolar hyperglycemic syndrome (HHS), you would expect to see the following laboratory differences when compared to diabetic ketoacidosis (DKA): higher serum glucose, higher osmolality, and no ketosis. This means that in HHS, patients typically do not exhibit significant ketone production, which is a key feature of ketoacidosis in DKA. Additionally, the serum glucose and osmolality levels are elevated even more than in DKA, partially because fluid loss through osmotic diuresis is more pronounced due to the extreme hyperglycemia.

HHS is commonly seen in type 2 diabetes where there is enough insulin to prevent excessive breakdown of fats and subsequent ketone production but not enough to prevent hyperglycemia. Patients with HHS may have blood glucose levels that far exceed those typically seen in DKA, often higher than 600 mg/dL, and plasma osmolality that exceeds 320 mOsm/kg, which can lead to severe dehydration and altered consciousness.