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Tests and diagnosis
By Mayo Clinic staffIf you experience a diabetic hyperosmolar syndrome, prompt diagnosis is critical. The emergency medical team will do a physical exam and may ask those who are with you about your medical history.
Lab tests
You may need various lab tests to measure:
- Your current blood sugar level
- Glycated hemoglobin (A1C) — a blood test that indicates your average blood sugar level for the past two to three months
- Whether or not ketones are present in your urine — ketones are byproducts made when fat is used as fuel instead of glucose
- Your kidney function, by testing the amount of nitrogen or creatinine (a breakdown product of creatine, an important part of muscle) in your blood
- The amount of potassium, phosphate and sodium in your blood
You'll be diagnosed with diabetic hyperosmolar syndrome if your blood sugar level is 600 mg/dL (33 mmol/L) or higher.
- Kitabchi AE, et al. Hyperglycemic crises in adult patients with diabetes (Consensus statement). Diabetes Care. 2009:32;1335.
- Masharani U. Diabetes mellitus and hypoglycemia. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y.: McGraw-Hill Medical; 2010. http://www.accessmedicine.com/content.aspx?aID=15524. Accessed Jan. 26, 2010.
- Masharani U, et al. Pancreatic hormones and diabetes mellitus. In: Gardner DG, et al. Greenspan's Basic and Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aID=2633151. Accessed Jan. 26, 2010.
- Hyperosmolar hyperglycemic nonketotic syndrome (HHNS). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html. Accessed Jan. 29, 2010.
- Kitabchi AE, et al. Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 18, 2010.
- Stoner, G. Hyperosmolar hyperglycemic state. American Family Physician. 2005;71:1723.
- Standards of medical care in diabetes, 2010. American Diabetes Association. Diabetes Care. 2010;33(suppl):11.
- Collazzo-Clavell ML (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 1, 2010.
- Rosenow E (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2010.
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