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Current diagnostic HHS criteria include a plasma glucose level &amp;gt;600 mg\/dL and increased effective plasma osmolality &amp;gt;320 mOsm\/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be &amp;lt;1% of hospital admissions of patients with diabetes. The reported mortality is between 10 and 20%, which is about 10 times higher than the mortality rate in patients with diabetic ketoacidosis (DKA). Despite the severity of this condition, no prospective, randomized studies have determined best treatment strategies in patients with HHS, and its management has largely been extrapolated from studies of patients with DKA. There are many unresolved questions that need to be addressed in prospective clinical trials regarding the pathogenesis and treatment of pediatric and adult patients with HHS.<\/jats:p>","DOI":"10.2337\/dc14-0984","type":"journal-article","created":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T21:47:30Z","timestamp":1414100850000},"page":"3124-3131","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":281,"title":["Hyperosmolar Hyperglycemic State: A Historic Review of the Clinical Presentation, Diagnosis, and Treatment"],"prefix":"10.2337","volume":"37","author":[{"given":"Francisco J.","family":"Pasquel","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo E.","family":"Umpierrez","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, 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