{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:12:20Z","timestamp":1780503140948,"version":"3.54.1"},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,26]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Hyperglycemic hyperosmolar state (HHS) is one of the most severe acute complications of diabetes mellitus (DM) characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. What is new? Since HHS in the pediatric population is rare and potentially life-threatening, every reported case is very valuable for raising awareness among healthcare professionals.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n A 7-year-old boy with previously diagnosed Joubert syndrome was admitted due to vomiting, polydipsia and polyuria started several days earlier. He was severely dehydrated, and the initial blood glucose level was 115\u00a0mmol\/L. Based on clinical manifestations and laboratory results, he was diagnosed with T1DM and HHS. The treatment with intravenous fluid was started and insulin administration began later. He was discharged after 10\u00a0days without any complications related to HHS.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Since HHS has a high mortality rate, early recognition, and proper management are necessary for a better outcome.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/jpem-2020-0720","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T20:26:00Z","timestamp":1620073560000},"page":"1045-1048","source":"Crossref","is-referenced-by-count":4,"title":["An extremely high blood glucose level in a child with hyperglycemic hyperosmolar state and type 1 diabetes"],"prefix":"10.1515","volume":"34","author":[{"given":"Ivona","family":"Butorac Ahel","sequence":"first","affiliation":[{"name":"Department of Pediatrics , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srecko","family":"Severinski","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Lah Tomulic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Milardovic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Baraba Dekanic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dora","family":"Palcevski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , Clinical Hospital Center Rijeka , Rijeka , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"2023040101170327497_j_jpem-2020-0720_ref_001_w2aab3b7c22b1b6b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"Wolfsdorf, JI, Glaser, N, Agus, M, Fritsch, M, Hanas, R, Rewers, A, et al.. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes 2018;19:155\u201377.","DOI":"10.1111\/pedi.12701"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_002_w2aab3b7c22b1b6b1ab2ab2Aa","unstructured":"Stoner, GD. Hyperosmolar hyperglycemic state. Am Fam Physician 2017;96:729\u201336."},{"key":"2023040101170327497_j_jpem-2020-0720_ref_003_w2aab3b7c22b1b6b1ab2ab3Aa","doi-asserted-by":"crossref","unstructured":"Cho, YM, Park, BS, Kang, MJ. A case report of hyperosmolar hyperglycemic state in a 7-year-old child: an unusual presentation of first appearance of type 1 diabetes mellitus. Medicine (Baltim) 2017;96:e7369.","DOI":"10.1097\/MD.0000000000007369"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_004_w2aab3b7c22b1b6b1ab2ab4Aa","doi-asserted-by":"crossref","unstructured":"Zeitler, P, Haqq, A, Rosenbloom, A, Glaser, N, For the Drugs and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Hyperglycemic hyperosmolar syndrome in children: pathophysiological considerations and suggested guidelines for treatment. J Pediatr 2011;158:9\u201314.","DOI":"10.1016\/j.jpeds.2010.09.048"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_005_w2aab3b7c22b1b6b1ab2ab5Aa","doi-asserted-by":"crossref","unstructured":"Wetter, J, Gohlke, BC, Woelfle, JF. Hyperglycemic hyperosmolar state as initial manifestation of pediatric insulin-dependent diabetes. Klin P\u00e4diatr 2012;224:32\u20133.","DOI":"10.1055\/s-0031-1275680"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_006_w2aab3b7c22b1b6b1ab2ab6Aa","doi-asserted-by":"crossref","unstructured":"Watanabe, S, Kido, J, Ogata, M, Nakamura, K, Mizukami, T. Hyperglycemic hyperosmolar state in an adolescent with type 1 diabetes mellitus. Endocrinol Diabetes Metab Case Rep 2019 Mar 5. https:\/\/doi.org\/10.1530\/EDM-18-0131 [Epub ahead of print].","DOI":"10.1530\/EDM-18-0131"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_007_w2aab3b7c22b1b6b1ab2ab7Aa","doi-asserted-by":"crossref","unstructured":"Klingensmith, GJ, Connor, CG, Ruedy, KJ, Beck, RW, Kollman, C, Haro, H, et al.. Presentation of youth with type 2 diabetes in the pediatric diabetes consortium. Pediatr Diabetes 2016;17:266\u201373.","DOI":"10.1111\/pedi.12281"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_008_w2aab3b7c22b1b6b1ab2ab8Aa","doi-asserted-by":"crossref","unstructured":"Reddy, A, Finley, L, Horrall, S. Hyperosmolar hyperglycemic syndrome in a young boy. Proc (Bayl Univ Med Cent) 2019;32:627\u20138.","DOI":"10.1080\/08998280.2019.1646598"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_009_w2aab3b7c22b1b6b1ab2ab9Aa","doi-asserted-by":"crossref","unstructured":"Hern\u00e1ndez Moreno, A, Sanz Fern\u00e1ndez, M, Ballesteros Pomar, MD, Rodr\u00edguez S\u00e1nchez, A. Hyperglycemic hyperosmolar state: an unusual way of first appearance of type 1 diabetes in children. Endocrinol Nutr 2016;63:252\u20133.","DOI":"10.1016\/j.endoen.2016.02.011"},{"key":"2023040101170327497_j_jpem-2020-0720_ref_010_w2aab3b7c22b1b6b1ab2ac10Aa","doi-asserted-by":"crossref","unstructured":"Alharfi, IM, Singh, R, Clarson, C, Foster, JR. Hyperosmolar hyperglycemic state without ketosis in a toddler with type 1 diabetes. Pediatr Emerg Care 2014;30:485\u20137.","DOI":"10.1097\/PEC.0000000000000167"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0720\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0720\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T19:12:11Z","timestamp":1680376331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0720\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,3]]},"references-count":10,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,6,14]]},"published-print":{"date-parts":[[2021,8,26]]}},"alternative-id":["10.1515\/jpem-2020-0720"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2020-0720","relation":{},"ISSN":["2191-0251","0334-018X"],"issn-type":[{"value":"2191-0251","type":"electronic"},{"value":"0334-018X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5,3]]}}}