[4][5] Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness.
[3] Complications may include seizures, disseminated intravascular coagulopathy, mesenteric artery occlusion, or rhabdomyolysis.
[2][3] Initial treatment generally consists of intravenous fluids to manage dehydration, intravenous insulin in those with significant ketones, low molecular weight heparin to decrease the risk of blood clotting, and antibiotics among those in whom there are concerns of infection.
[6] Symptoms of HHS include: The main risk factor is a history of diabetes mellitus type 2.
[4] Other risk factors: HHS is usually precipitated by an infection,[7] myocardial infarction, stroke or another acute illness.
Ketosis is absent because the presence of some insulin inhibits hormone-sensitive lipase-mediated fat tissue breakdown.
[citation needed] According to the American Diabetes Association, diagnostic features include:[8][9] Cranial imaging is not used for diagnosis of this condition.
However, if an MRI is performed, it may show cortical restricted diffusion with unusual characteristics of reversible T2 hypointensity in the subcortical white matter.
In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL).