Definition, precipitants, pathophysiology-hyperosmolar hyperglycemic state

(Med Clin North Am 2017;101:587)

• Extreme hyperglycemia (w/o ketoacidosis) + hyperosm. + Δ MS in T2D (typically elderly)
• Precip same as for DKA, but also include dehydration and renal failure
• Hyperglycemia → osmotic diuresis → vol depletion → prerenal azotemia → ↑ glc, etc.