What are the signs of hyperosmolar hyperglycemic state?

Hyperosmolar hyperglycemic state, or HHS, is a life-threatening complication of type 2 diabetes characterized by extremely high blood glucose, typically above 600 milligrams per deciliter, severe dehydration, and hyperosmolarity without significant ketoacidosis. It develops gradually over days to weeks, often triggered by infection, medication noncompliance, or acute illness. Signs include profound dehydration, altered mental status progressing to coma, seizures, tachycardia, and hypotension. ---