What is a leading cause of death in patients suffering from HHS?

Hyperglycemic Hyperosmolar State (HHS) is characterized by extremely elevated blood glucose levels, leading to severe dehydration, electrolyte imbalances, and significant alterations in osmolarity. One of the most critical complications that arise from HHS is dehydration, which can result in hypovolemic shock due to the substantial fluid loss.

In HHS, patients often experience profound diuresis due to the osmotic diuresis caused by the high glucose levels, which can lead to decreased blood volume and inadequate perfusion of vital organs. If not promptly addressed, this can progress to hypovolemic shock, where the body's tissues do not receive enough blood flow, resulting in insufficient oxygen delivery and potential organ failure.

While acidosis, heart failure, and cardiac arrest are serious medical conditions that can occur in a variety of patient populations, they are not as direct or immediate consequences of HHS compared to dehydration and hypovolemic shock. Thus, the leading cause of death among HHS patients is primarily attributed to the complications arising from severe dehydration and the resultant hypovolemic shock.