Master of Science in Nursing (MSN) Student Scholarship

Date Written

Summer 2015

Document Type


Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo


Diabetes Mellitus, Hyperosmolar Nonketotic Coma, Hyperglycemic Hyperosmolar Nonketotic Syndrome

Subject Categories

Endocrine System Diseases | Medical Pathology | Medicine and Health Sciences | Nursing


Hyperglycemic hyperosmolar state (HHS) is an acute complication associated with diabetes mellitus. HHS has been known by several other names in the past. These labels include Hyperosmolar Nonketotic Coma, Hyperosmolar Hyperglycemic Nonketotic Coma, and Hyperglycemic Hyperosmolar Nonketotic Syndrome (Hackel, 2014). HHS is characterized by severe hyperglycemia, profound dehydration, and is often accompanied by altered mental status. Less than 1% of diabetes-related admissions are due to HHS, but mortality rates are estimated to be 10% to 20% (Lenahan & Holloway, 2015). HHS typically affects the older adult population, with the average age of HHS patients being 60 years (Collopy, Kivlehan, & Snyder, 2013). The patient with HHS commonly has type 2 diabetes (Pasquel & Umpierrez, 2014). Up to 40% of those affected have never been diagnosed with diabetes prior to developing HHS (Collopy et al., 2013). HHS is a medical emergency. The incidence of HHS is expected to rise in the future due to the increase in the occurrence of type 2 diabetes (Lenahan & Holloway, 2015). It is important for healthcare providers to recognize HHS in order to provide appropriate care for the patient and reduce the mortality rates associated with this diabetic complication.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.