What sign suggests a diabetic patient is suffering from hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?

The indication that a diabetic patient is suffering from hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is marked by the complaint of thirst and a dry mouth. In HHNS, the very high blood sugar levels lead to severe dehydration. As the body becomes dehydrated, the patient may experience increased thirst as a physiological response to high osmolarity and fluid loss. The sensation of a dry mouth is also associated with dehydration and a lack of adequate fluid in the oral cavity, making this symptom particularly relevant in assessing for HHNS.

While other symptoms such as confusion and disorientation can occur in severe cases due to the effects of hyperglycemia on cerebral function, the distinctive complaint of thirst and dry mouth specifically reflects the underlying cause of HHNS—extreme dehydration resulting from elevated glucose levels. Therefore, recognizing this symptom can be crucial in identifying and managing HHNS effectively.