Hyperglycemic hyperosmolar state (HHS) are both life-threatening complications of diabetes that occur when blood sugar levels are too high. They are characterized by different metabolic processes, but both are caused by a reduction in insulin and an increase in counterregulatory hormones:
- DKACharacterized by ketoacidosis, hyperglycemia, and metabolic acidosis. DKA occurs when the body doesn’t have enough insulin, so it breaks down fat for energy instead. This process releases ketones into the bloodstream, which make the blood acidic. Common causes of DKA include missing an insulin dose or an acute illness.
- HHSCharacterized by severe hyperglycemia, hyperosmolality, and dehydration. HHS occurs when blood sugar levels are too high for a long period, leading to severe dehydration and highly concentrated blood. The most common cause of HHS is an infection. HHS is mainly a complication of Type 2 diabetes, but it can also occur in younger people.
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