Diabetic hyperglycemic hyperosmolar coma.
Diabetic hyperglycemic hyperosmolar or non-ketotic coma is a  dangerous condition characterized by sharp increase of blood glucose level, severe dehydration and the
absence of ketoacidosis signs. It occurs mainly
in elderly people suffering from type 2 diabetes and
it is associated with poor health state. The latest can be an aftermath of a recent
surgery, heart attack, stroke, renal failure, infectious disease, poor diabetes
management and serious chronic diseases.
The use of certain medications, such as diuretics, which increase urination, can lead to
general dehydration and diabetic hyperglycemic hyperosmolar coma, if the water intake is
not adequate.
How hyperglycemic hyperosmolar coma occurs.
In normal conditions, the kidneys contribute to glucose control by excreting the
excessive amounts of it in urine. However, when dehydration occurs, the kidneys try to
save water by reducing the production of urine. Therefore, the excessive glucose cannot
be excreted and builds up in the blood stream. In a case of diabetic hyperglycemic
hyperosmolar coma, the blood glucose level can reach or exceed the 600mg/dL. High
concentrations of glucose and sodium in the body fluids increase their osmolarity. This, in turn, leads to water
transfer through the membrane from the interior of the cell into the surrounding
environment, resulting in cellular dehydration and impaired function.
Signs and symptoms of diabetic hyperglycemic hyperosmolar coma.
Early signs can be prolonged periods of increased thirst and/or excessive urination.
When the condition occurs, drowsiness, decreased consciousness, restlessness, lethargy,
confusion, fatigue, partial paralysis, headaches, difficulty in speech, palpitations, low blood pressure, nausea,
impaired muscular function and spasms can follow.
Treatment of diabetic hyperglycemic hyperosmolar coma.
The condition has to be treated urgently, because it may be fatal. In most of the
cases, hospitalization is needed, since intravenous therapy is necessary to deal with
dehydration and hyperglycemia. Normal glucose level and electrolyte balance must be
restored immediately.
Complications of diabetic hyperglycemic hyperosmolar coma.
As it has been already mentioned, if the condition is not treated in time, it can be
extremely dangerous. Fatality rates reach 40% of the cases. Blood clot formation, brain
swelling, acute circulatory collapse and increased blood acidity are the most typical and
serious complications.
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