What is a common presenting symptom in patients with hyperglycemic hyperosmolar state?

In hyperglycemic hyperosmolar state (HHS), polyuria is a common presenting symptom due to the high levels of glucose in the blood. When blood glucose levels exceed the renal threshold, typically around 180 mg/dL, glucose spills into the urine. This osmotic diuresis leads to increased urination as the body attempts to excrete the excess glucose. The loss of fluid through urine results in dehydration, which is a characteristic feature of HHS.

While vomiting, abdominal pain, and fever can occur in various medical conditions, they are not primary symptoms associated specifically with HHS. Instead, the hallmark symptom of polyuria is closely linked to the underlying pathophysiology of hyperglycemia and fluid loss in this condition.