Registered Nurse (RN) Endocrine Licensure Exam

What is a common cause of HHNS in diabetes patients?

1. A. Excessive exercise

2. B. Infection or illness

3. C. Sudden medication change

4. D. Multivitamin overdose

The correct answer is: B. Infection or illness

In hyperglycemic hyperosmolar nonketotic syndrome (HHNS), a common trigger is infection or illness. This condition often arises in patients with type 2 diabetes and is characterized by extremely high blood glucose levels without the production of ketones, distinguishing it from diabetic ketoacidosis (DKA). When a diabetic patient experiences an infection or acute illness, the body responds by releasing stress hormones like cortisol and epinephrine, which can increase insulin resistance and elevate blood sugar levels. In this context, the body struggles to utilize glucose effectively due to underlying insulin resistance. As blood glucose levels rise substantially, dehydration can occur due to osmotic diuresis, further complicating the patient's state and leading to HHNS. While excessive exercise, sudden medication changes, and multivitamin overdose can have various impacts on glucose levels, they are not commonly associated with HHNS to the same extent as infections or illnesses. Therefore, understanding the relationship between infection and the potential for HHNS is crucial in managing diabetes complications effectively.