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Warning-sign checks

Diabetic hyperglycemic hyperosmolar syndrome: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services now if someone with diabetes or possible diabetes has confusion, marked drowsiness, a seizure, fainting, new trouble speaking or moving, or cannot be woken normally.

    Do not give food, drink, or medicine to someone who is not fully alert.

    Emergency assessment is also needed for very high glucose accompanied by severe thirst, repeated urination, worsening weakness, vomiting, inability to drink, or signs of major dehydration.

    Do not try to manage suspected HHS at home.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek same-day medical advice during illness if your glucose remains much higher than your usual range despite following your sick-day plan, you cannot keep fluids down, or you are unsure how to take your diabetes medicines safely.

    Contact your usual diabetes team sooner if practical problems are preventing you from following the plan.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up is appropriate after recovery to review diabetes control, medicines, glucose-monitoring supplies, and your sick-day plan.

Every sign above is quoted from the sofidex article on Diabetic hyperglycemic hyperosmolar syndrome. If you are not sure, err upward — it is always reasonable to be checked.