Clinical Case Database / Category: Clinical Care

Hyperglycaemic hyperosmolar state

Publication details

Dr Chloe Broughton, MBChB Hons, Dr Seshadri Pramodh, Dr Alex Bickerton
Foundation Years Journal, volume 4, issue 9, p.48 (123Doc Education, London, December 2010)


Hyperglycaemic hyperosmolar state (HHS) is a complication of diabetes mellitus seen in the acute medical setting. It is a challenging condition to diagnose and manage, and there are currently no comprehensive guidelines. This article aims to give an overview of HHS in order to help Foundation doctors identify and treat these patients.

Access the Clinical Cases Database

A subscription is required to read the full article. Please subscribe using one of the options below.

Foundation Years Clinical Cases Database£29.006 months
Add to cart
Foundation Years Clinical Cases Database£39.0012 months
Add to cart


Dr Chloe Broughton, MBChB Hons

Foundation Year 1 Doctor
Yeovil District Hospital

Dr Seshadri Pramodh

Consultants in Diabetes and Endocrine Medicine
Yeovil District Hospital

Dr Alex Bickerton

Consultants in Diabetes and Endocrine Medicine
Yeovil District Hospital


1. Kitabchi AE, Umpierrez GE, Murphy MB, et al. (2001) Management of hyperglycaemic crises in patients with diabetes. Diabetes Care, 24: 131–153.
2. Kitabchi AE, Umpierrez GE, Murphy MB, et al. (2001) American Diabetes Association. Hyperglycaemic Crises in Patients with Diabetes Mellitus. Diabetes Care, 24(1): 154–161.
3. English P, Williams G (2004) Hyperglycaemic crises and lactic acidosis in diabetes mellitus. Postgrad Med J, 80: 253–261.
4. Milionis HJ, Elisaf MS (2005) Therapeutic management of hyperglycaemic hypserosmolar syndrome. Expert Opin. Pharmacother, 6(11): 1821–1849.
5. Savage MW, Kilvert A (2006) on behalf of the Association of British Clinical Diabetologists (ABCD). ABCD guidelines for the management of hyperglycaemic hyperosmolar emergencies in adults. Pract Diab Int, June, 23(5): 227–231.


Conflict Of Interest

The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (

Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts ( The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.