Diabetic Hyperosmolar Syndrome

• Definition: Osmolality > 350 mOsm/l

• Effective Osm >320

• Glucose > 600 mg/dl

• Dehydration (Osmotic Diuresis)

• Posm = 2 (Na + K) + Glucose/18 + BUN/2.8

• Eosm = 2 (Na + K) + Glucose/18

• Free H2O Deficit = TBW ( (Corrected Na-145)/ 145 )

• TBW Deficit 24%, Na loss 8 mEq/l, K loss 6 mEq/l