Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein.

Hyperosmolar state

A hyperosmolar state develops when a person with type 2 diabetes has very high blood sugar—usually 600 milligrams per deciliter (mg/dL) or more. Sometimes this condition is the first time a person learns that they have type 2 diabetes.

A hyperosmolar state can develop when a person is very sick and/or dehydrated, such as from the flu, a severe infection, a heart attack, or water pills (diuretics). If the person does not drink enough liquids, they may become confused. Older people are at increased risk for developing a hyperosmolar state.

Symptoms of a hyperosmolar state include:

  • Increased urination for several days.
  • Dehydration, which develops because the person doesn't drink enough liquids.
  • A change in alertness from generalized fatigue to stupor, coma, or seizures. These changes may be mistaken for a stroke or mental illness.

Hyperosmolar state is treated in a hospital with insulin to reduce the blood sugar level and extra fluids through a vein (I.V.) to replace the lost fluids.

The best way to prevent a hyperosmolar state is to treat high blood sugar levels early and drink enough liquids.

Current as of: July 7, 2025

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

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