Criteria

Diagnostic features of HHS[1][16][43]

  • Plasma glucose: ≥600 mg/dL

  • Osmolality: ≥320 mOsm/kg

  • Arterial or venous pH: ≥7.30

  • Serum bicarbonate: usually ≥15 mEq/L

  • Urine ketone: negative or small

  • Serum ketone: negative or small

  • Beta-hydroxybutyrate: ≤3 mmol/L

  • Effective serum osmolality: ≥320 mOsm/kg

  • Variable anion gap: usually <12 mEq/L

  • Mental status: lethargy/stupor/coma.

Criteria for resolution of HHS[1]

  • Normal plasma glucose (<250 to 300 mg/dL)

  • Normal plasma effective osmolality (<315 mOsm/kg)

  • Normal hemodynamic and mental status.

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