Define Hyperosmolar Hyperglycemic Syndrome (HHS) Understand diagnostic criteria: hyperglycemia, hyperosmolality, absence of significant ketosis and acidosis. Explain key considerations in HHS diagnosis and management Total vs effective osmolality, corrected sodium, and severity assessment. Describe epidemiology and precipitating factors of HHS Trends, mortality rates, and common triggers such as infections and medication non-compliance. Understand pathogenesis and pathophysiology of HHS Mechanisms of hyperglycemia, osmotic diuresis, and inflammatory state. Identify clinical presentation and systemic evaluation for HHS Symptoms, lab investigations, and monitoring parameters. Apply principles and aims of HHS treatment Fluid therapy, insulin therapy, potassium replacement, and thrombosis prevention. Discuss treatment considerations and monitoring protocols JBDS vs ADA guidelines, rate of osmolality and glucose correction, and transition to subcutaneous insulin. Outline resolution criteria for HHS and transition strategies Clinical and biochemical targets for safe recovery. Recognize and manage mixed HHS-DKA cases Diagnostic criteria and treatment approach tailored to combined features.