Hyperosmolar hyperglycaemic state (HHS) (previously known as hyperosmolar non-ketotic coma (HONK)) is a serious metabolic derangement that can occur in patients with diabetes mellitus, predominantly those with type 2. While there are no distinct imaging features, it is useful for a radiologist to be familiar with this condition.
It usually occurs in type 2 diabetics who have some concomitant illness that leads to reduced fluid intake.
High blood glucose levels lead to severe dehydration, increases in osmolarity (relative concentration of solute) and, in turn, carries a high risk of complications, coma and death.
History and etymology
HHS is thought to have been first described by von Frerichs and Dreschfeld in the 1880s 1.