Hyperosmolar hyperglycemic syndrome (HHS) (Smarty PANCE)

What is the hallmark triad of hyperosmolar hyperglycemic syndrome (HHS)?

Hyperglycemia, Hyperosmolarity, Severe Dehydration

What is a key differential feature between HHS and DKA?

HHS generally lacks significant ketosis

Name two common triggers for HHS in older adults

Infections (pneumonia, UTI), recent medical events (heart attack, stroke)

What is the first line of treatment for HHS?

Aggressive IV fluid rehydration

What is a critical aspect of monitoring during HHS treatment?

Frequent electrolyte checks (especially potassium) are essential, as rehydration and insulin therapy can cause rapid shifts that require correction

Besides addressing the acute HHS episode, what's another key treatment goal?

Identifying and managing the underlying cause (infection, medication, other medical condition) to prevent recurrence

Why is gradual blood sugar lowering important in HHS treatment?

Rapidly lowering blood sugar can worsen brain cell swelling due to osmotic shifts, potentially causing complications