PATHOPHYSIOLIOLOGY.
• Absolute or relative insulin deficiency causes inadequate control of blood glucose concentration leading to severe hyperglycemia, which overwhelms renal glucose homeostasis.
CLINICAL MANIFESTATION.
• Hyperglycemia with insignificant ketoacidosis
• Dilute urine (polyuria)
• Altered mental state
• Severe dehydration
CLINICAL MANAGEMENT.
• Stabilize ABCs
• Administer Oxygen supplementation
• Measure, monitor glycemia and electrolytes especially Na and K every 2 hrs until it stabilizes.
• Administer thiamine in all malnourished patients to protect against wernickes encephalopathy
• Before starting insulin therapy, correct hypovolemia and hypokalemia to prevent development of oliguria and cerebral edema and in case of hypokalemia to prevent fatal arrhythmias.
• In HHS, the mainstay treatment is . . .
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