Hyperosmolar hyperglycemic state diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

There is no single specific diagnostic study of choice for the diagnosis of hyperosmolar hyperglycemic state. There are specific cut-offs for serum glucose level, ketone levels, body pH, serum bicarbonate levels and anion gap for the diagnosis of the hyperosmolar hyperglycemic state as outlined by the American Diabetes Association.

Diagnostic Criteria

The diagnosis of hyperosmolar hyperglycemic state is based on the following criteria according to American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE):[1][2]

Parameter Lab value
Serum glucose
  • > 600 mg/dl
Serum osmolality
  • > 320 mOsm/kg
Arterial ph
  • > 7.30
Serum ketones
  • Trace or negative
Urine ketones
  • Trace or negative
Anion gap
  • Variable
Mental status

References

  1. "www.aace.com" (PDF).
  2. Pasquel FJ, Umpierrez GE (2014). "Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment". Diabetes Care. 37 (11): 3124–31. doi:10.2337/dc14-0984. PMC 4207202. PMID 25342831.

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