Which of the following, if stated by the nurse, is correct about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?
A. “This syndrome occurs mainly in people with type 1 diabetes.”
B. “It has a higher mortality rate than diabetic ketoacidosis.”
C. “The client with HHNS is in a state of overhydration.”
D. “This condition develops very rapidly.”
Correct Answer: B. “It has a higher mortality rate than diabetic ketoacidosis.”
It is a medical emergency and has a higher mortality rate than Diabetic Ketoacidosis. The mortality rate in HHS can be as high as 20% which is about 10 times higher than the mortality seen in diabetic ketoacidosis. Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus.
Option A: Hyperglycemic Hyperosmolar Nonketotic Syndrome occurs only in people with type 2 diabetes. Hyperosmolar hyperglycemic syndrome (HHS) is a clinical condition that arises from a complication of diabetes mellitus. Type 2 diabetes accounts for about 90% to 95% of diabetes cases. It is most commonly seen in patients with obesity.
Option C: As a consequence of obesity and high body mass index (BMI), there is the resistance of the peripheral tissue to the action of insulin. The beta-cell in the pancreas continues to produce insulin, but the amount is not enough to counter the effect of the resistance of the end organ to its effect. HHS is a serious and potentially fatal complication of type 2 diabetes.
Option D: This condition develops very slowly over hours or days. HHS has similar pathophysiology to DKA but with some mild dissimilarities. The hallmark of both conditions is the deficiency of insulin. As a consequence of deficiency of this key hormone, there is a decrease in glucose utilization by the peripheral tissue causing hyperglycemia.
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