Hyperosmolar hyperglycemic state epidemiology and demographics

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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

The epidemiological parameters of the hyperosmolar hyperglycemic state (HHS) are difficult to predict because of the lack of population-based studies on HHS. According to the national diabetes surveillance program of the Centers for Disease Control and Prevention (CDC), hyperosmolar hyperglycemic state accounts for less than 1000 hospital admissions per 100,000 diabetic admissions. The overall mortality rate of the hyperosmolar hyperglycemic state varies from a low of less than 5000 per 100,000 individuals to a high of 20,000 per 100,000 individuals. The incidence of the hyperosmolar hyperglycemic state is more common in African-American male population as compared to the Caucasian population. The hyperosmolar hyperglycemic state also affects the elderly more compared to children and young adults.

Epidemiology and Demographics

Incidence

  • The exact incidence of the hyperosmolar hyperglycemic state is not known due to lack of population-based studies. However, according to the the national diabetes surveillance program of the Centers for Disease Control and Prevention (CDC), HHS accounts for less than 1000 hospital admissions per 100,000 diabetic admissions.[1][2]
  • In the year 1995, the annual incidence of the hyperosmolar hyperglycemic state has been reported to be 17.5 persons per 100,000 persons per year.[3][1]

Case-fatality rate

  • Case-fatality rate of hyperosmolar hyperglycemic state varies from a low of less than 5000 per 100,000 individuals to a high of 20,000 per 100,000 individuals.[2]
  • Case-fatality rate of hyperosmolar hyperglycemic state differ according to the level of care provided and healthcare setting.[4]
Both the crude and age-adjusted death rates for hyperglycemic crises as underlying cause decreased from 1980 to 2009. , source: Centers for Disease Control and Prevention. Diabetes Public Health Resource: Diabetes Data & Trends. http://www.cdc.gov/diabetes/statistics/mortalitydka/fratedkadiabtotals.htm


Age

  • The hyperosmolar hyperglycemic state commonly affects type 2 diabetic individuals older than 65 years of age. It is less commonly seen in children and young adults.[2]

Race

  • Hyperosmolar hyperglycemic state usually affects individuals of the African-Americans race.[5][1]

Gender

  • Men are more commonly affected by hyperosmolar hyperglycemic state than women.[5]

References

  1. 1.0 1.1 1.2 Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE (1997). "Hyperglycemic crises in urban blacks". Arch. Intern. Med. 157 (6): 669–75. PMID 9080921.
  2. 2.0 2.1 2.2 Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009). "Hyperglycemic crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725. PMID 19564476.
  3. Lorber D (1995). "Nonketotic hypertonicity in diabetes mellitus". Med. Clin. North Am. 79 (1): 39–52. PMID 7808094.
  4. "Diabetes Care".
  5. 5.0 5.1 Farsani SF, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA (2017). "Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review". BMJ Open. 7 (7): e016587. doi:10.1136/bmjopen-2017-016587. PMID 28765134.

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