THE HYPERGLYCEMIC HYPEROSMOLAR SYNDROME: HISTORY AND ESSENTIAL CLINICAL INSIGHTS

Hyperglycemic hyperosmolar state (HHS) is one of the most severe acute complications of diabetes mellitus. It is characterized by profound hyperglycemia, absence of ketoacidosis, and altered mental status. With a mortality rate that may reach up to 20%, HHS remains a critical but often underrecognized clinical entity. Historically marginalized due to its relative rarity and poorly understood pathophysiology, its clinical relevance is increasing in parallel with lifestyle changes and the global rise in type 2 diabetes prevalence. The aim of this article was to compile key information on the history, pathophysiology, and management of HHS in order to raise awareness among all healthcare professionals involved in the care of patients with diabetes. Early recognition of HHS is essential to initiate timely treatment and improve patient outcomes. Classic symptoms such as excessive thirst with accompanying polyuria and altered mental status particularly in patients with seemingly mild infections or those with chronic but untreated or poorly controlled diabetes - should prompt increased vigilance among medical staff. Rapid diagnostic evaluation and prompt initiation of treatment must be prioritized in emergency settings to reduce morbidity and mortality associated with this life-threatening condition.