Diabetes Wiki

Hyperosmolar nonketotic state (HNS) is a dangerous form of diabetic coma. This state is also known by some other terms like hyperosmolar hyperglycemic nonketotic coma (HHNKC) or hyperosmotic non-ketoic acidosis (HONK). This complication may arise in persons having any type of the diabetes, Type 1 diabetes as well as Type 2 diabetes. In HNS, the level of blood sugar continues to rise, and the body tries to get rid of the excess sugar in the blood by passing more urine. The feeling of thirst continues despite intake of more than usual water or other liquids. If sufficient water or liquids are not consumed, the body becomes dehydrated. The HNS develops over a period of time lasting several days, weeks, and even months.


It is essential to understand the signs and symptoms of HNS as neglecting it may lead to more serious complications. Some major signs of HNS are:

  • Level of Blood sugar beyond 600 mg/dl which continues to hover over this level.
  • Continuous feeling of being thirsty which does not get quenched despite taking sufficient water and other liquids though after a time (days or weeks) this may disappear.
  • Dry skin that does not sweat; parched mouth; and weakness affecting a side of the body.
  • Fever with temperature generally of over 101 degrees of over 101 Fahrenheit.
  • Confusion while awake including hallucinations; and sleeplessness.
  • Weakening of the vision.


Hyperosmolar nonketotic state (HNS) may be prevented by keeping your blood sugar level within the acceptable levels. This may require regular check up of blood sugar, as also better treatment and management of the diabetes.


  • HHNS - a page from the website of the American Diabetes Association
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