Hyperosmolar hyperglycaemic state

Also known as HHS

Diabetes mellitus 

Comparison to diabetic ketoacidosis

Similarities

• Insufficient insulin signalling in DKA and HHS
• Severe hyperglycaemia in DKA and HHS

Differences

• Endogenous insulin levels are higher in HHS
• Lipolysis is suppressed by endogenous insulin in HHS
• Elevated lipolysis and ketogenesis do not occur in HHS
• Ketoacidosis does not occur in HHS
• HHS is more likely in T2D, DKA is more likely in T1D

Complications

• Diabetic coma