<prompt> Answer this question truthfullyWhat are the factors that increase the risk of hyperosmolar hyperglycemic state?  <response>: <reason> The following factors are associated with an increased risk of hyperosmolar hyperglycemic state HHS: Old age Obesity High mean glycosylated hemoglobin A1c HbA1c Infection Physiological stressors: Acromegaly Thrombosis Cerebrovascular accident Cushings disease Hemochromatosis PregnancyHeatstroke Hypothermia Dialysis Burns Neuroleptic malignant syndrome Rhabdomyolysis Depression Lack of health insurance Low body mass index BMI Delayed or improper management of diabetesThe following factors are associated with a reduced risk of hyperosmolar hyperglycemic state HHS: Optimum management of diabetes Optimum fluid intake Adequate renal functions Adequate cardiac functions Higher education level of patient Higher education level of care giver 