Anticoagulation in hyperosmolar hyperglycaemic state: a case report and review of the literature

Authors

  • Sing Yee Sim Specialist Registrar in Diabetes & Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
  • Amy Morrison Specialist Registrar in Diabetes & Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
  • Robert Gregory University Hospitals of Leicester NHS Trust Department of Diabetes, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW
  • Marie-France Kong University Hospitals of Leicester NHS Trust Department of Diabetes, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW

DOI:

https://doi.org/10.15277/bjd.2021.313

Keywords:

type 2 diabetes, hyperosmolar hyperglycaemia state, case report, anticoagulation, venous thromboembolism, low molecular weight heparin

References

Joint British Diabetes Societies Inpatient Care Group. The management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes. August 2012. https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-storage/migration/pdf/JBDS-IP-HHS-Adults.pdf

Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care 2009;32:1335–43. https://doi.org/10.2337/dc09-9032

Shujaat A, Shapiro JM. Massive pulmonary embolism in diabetic ketoacidosis and non-ketotic hyperosmolar state: case series and review of the literature. Clin Intensive Care 2004;15(2–3):73–7. https://doi.org/10.3109/09563070410001711771

Goh EL, Gurung KP, Ma S, et al. Direct oral anticoagulants in the prevention of venous thromboembolism following surgery for hip fracture in older adults: a population based cohort study. Geriatr Orthop Surg Rehabil 2020; 11:2151459319897520. https://doi.org/10.1177/2151459319897520

Turpie AGG. Extended duration of thromboprophylaxis in acutely ill medical patients, optimising therapy? J Thromb Haemost 2007;5(1):5–11. https://doi.org/10.1111/j.1538-7836.2006.02268.x

Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. [Updated 9 May 2021]. In: Feingold KR, Anawalt B, Boyce A, et al, editors. Endotext [Internet]. South Dartmouth, Massachusetts: MDText.com, 2000. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279052/

Pasquel FJ, Umpierrez GE. Hyperosmolar hyperglycaemic state: a historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care 2014;37(11):3124–31. https://doi.org/10.2337/dc14-0984

Chaudhuri A, Umpierrez GE. Oxidative stress and inflammation in hyperglycemic crises and resolution with insulin: implications for the acute and chronic complications of hyperglycemia. J Diabetes Complications 2012;26(4):257–8. https://doi.org/10.1016/j.jdiacomp.2012.04.016.

Chu CH, Lee JK, Lam HC, Lu CC. Prognostic factors of hyperglycemic hyperosmolar nonketotic state. Chang Gung Med J 2001;24(6):345–51.

Petrauskiene V, Falk M, Waernbaum I, et al. The risk of venous thromboembolism is markedly elevated in patients with diabetes. Diabetologia 2005;48:1017–21. https://doi.org/10.1007/s00125-005-1715-5

Park J, Kim DJ, Kim HY, et al. Extensive venous thrombosis of the upper extremity in a diabetic patient with hyperosmolar hyperglycemic state. Korean J Intern Med 2006;21(4):244–7. https://doi.org/10.3904/kjim.2006.21.4.244

Hamblin PS, Topliss DJ, Chosich N, et al. Deaths associated with diabetic ketoacidosis and hyperosmolar coma 1973–1988. Med J Aust 1989; 151(8): 439, 441–2, 444. https://doi.org/10.5694/j.1326-5377.1989.tb101253.x

Keenan CR, Murin S, White RH. High risk for venous thromboembolism in diabetics with hyperosmolar state: comparison with other acute medical illnesses. J Thromb Haemost 2007;5(6):1185–90. https://doi.org/10.1111/j.1538-7836.2007.02553.x

Sinson N, van Veen JJ, Brown PL, Creagh F. Acute pyelonephritis with renal vein and inferior vena cava thrombosis and pulmonary emboli in poorly controlled type 2 diabetes and HHS. Pract Diabetes 2016; 33(5):167–9. https://doi.org/10.1002/pdi.2029

Campbell NR, Hull RD, Brant R, et al. Aging and heparin-related bleeding. Arch Intern Med 1996;156(8):857–60.

Klok FA, Hösel V, Clemens A, et al. Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment. Eur Respir J 2016;48:1369–76. https://doi.org/10.1183/13993003.00280-2016

ATTACC, ACTIV-4a and REMAP-CAP multiplatform RCT. Results of interim analysis. January 2021. https://nhlbi-connects.org/documents/mpRCT%20Interim%20Presentation.pdf (Accessed 5 March 2021).

Hull RD, Schellong SM, Tapson VF, et al. Extended-duration venous thromboembolism prophylaxis in acutely ill medical patients with recently reduced mobility: a randomized trial. Ann Intern Med 2010;153(1):8–18. https://doi.org/10.7326/0003-4819-153-1-201007060-00004

Wordsworth G, Robinson A, Ward A, Atkin M. HHS – full or prophylactic anticoagulation? Br J Diabetes 2014;14(2). https://doi.org/10.15277/bjdvd.2014.011

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Published

2021-11-19

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Case Reports

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