The biggest threat to someone with diabetes is the Hyperosmolar Syndrome. As with ketoacidosis, the hyperosmolar syndrome is a critical medical emergency and needs to be treated at a hospital. The Hyperosmolar syndrome occurs when your blood glucose level is excessive.

The hyperosmolar syndrome creates ketones in your blood, but unlike ketoacidosis, it doesn’t create and acid situation in your blood. The word hyperosmolar breaks down this way - hyper means something that is larger than normal and the osmolar relates to the concentration of various substances in the blood. So, in this circumstance, it means the blood has too high a concentration of glucose. There are other types of hyperosmolar syndromes that can take place when other substances are much higher than normal in the bloodstream.

In most cases, the hyperosmolar syndrome occurs in elderly folks that have diabetes. Those afflicted with this normally reside in nursing homes or live alone where there isn’t anyone who is closely monitoring their condition. When you combine age and neglect in many areas, you are likely going to run into some sort of problem, but in this case, it could very well be life threatening. In this case, an elderly person with this syndrome will lose large quantities of fluids via vomiting or diarrhea. The problem here is that without careful monitoring, these fluids will likely not be replaced. As a general rule elderly folks that run into this situation tend to have mild type 2 diabetes that has never been diagnosed or treated.

Another reason the elderly are more at risk for the hyperosmolar syndrome is due to their kidneys not being as efficient as they were in their earlier years. When your kidneys are functioning at their peak, they will remove excess glucose via urine when glucose levels reach only 180 mg/dl. But as you grow older, your kidneys are much slower to react and wont expel excess glucose until much higher levels of glucose are present in your blood. When someone is in their early 70’s, for example, their kidneys really have to work hard to remove any excess glucose. If they get into a situation where they are losing large volumes of fluids due to an illness, their blood volume will decrease which makes the job much, much harder for their kidneys. When this happens, their blood glucose level begins to shoot out of sight.

Another issue that crops up is that when your blood glucose level rises too high and you don’t have the fluid intake you need, your blood pressure will start to fall significantly. So much so that you’ll become very weak. As the glucose in your blood continues to rise, you will end up becoming confused and your metal state will diminish to the point where you will fall into a coma.

Other factors can also contribute to the hyperosmolar syndrome. Infections, failure to take insulin, along with reactions from other medications you may be taking can all lead to this. But the number one factor with folks running into an issue with the hyperosmolar syndrome is not replacing body fluids that are lost through vomiting.

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