Successful treatment requires frequent monitoring of clinical and laboratory parameters to achieve resolution criteria. Glucose measurement should be repeated every 1 to 2 hours, and serum potassium every 2 to 4 hours. Serum calcium, magnesium, phosphate, BUN, and creatinine should be repeated every 4 to 6 hours, depending on the patient's clinical condition and response to therapy.
A flow sheet classifying these findings as well as mental status, vital signs, insulin dose, fluid and electrolyte therapies, and urine output enables easy analysis of response to therapy and resolution of crises.
Criteria for resolution of HHS include normalization of plasma glucose (<250 to 300 mg/dL) and plasma effective osmolality (<315 mOsm/kg), and normal hemodynamic and mental status.
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