diagnostic criteria

Last reviewed 06/2022

diagnostic criteria for hyperglycemic hyperosmolar state

The following diagnostic criteria have been recommended:

• plasma glucose concentration >33.3 mmol/L (600 mg/dL)
• arterial pH > 7.30; venous pH > 7.25
• serum bicarbonate >15 mmol/L
• small ketonuria, absent to small ketonemia
• effective serum osmolality >320 mOsm/kg
• obtundation, combativeness, or seizures (in approximately 50%) (1,2)

Reference:

• (1) Wolfsdorf JI et al. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014;15 Suppl 20:154-79. 
• (2) Pasquel FJ, Umpierrez GE. Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care. 2014;37(11):3124-31.