HYPEROSMOLAR NONKETOTIC COMA


What is hyperosmolar nonketotic coma? Hyperosmolar nonketotic coma is a life-threatening condition which occurs in Type 2 diabetics when their sugar reaches very high levels . Sometimes this condition is called

“hyperosmolar hyperglycemic state.” “Hyperosmolar”means the blood has too much sugar and salts in it. “Nonketotic” means that there is no ketones

in their blood or urine . Ketones are toxic chemicals the body sometimes makes when people with diabetes (usually type 1 diabetes) have high blood sugar levels.

Hyperosmolar nonketotic coma is most common in older adults with type 2 diabetes. Most often, it happens after a person with diabetes:

  • Stops taking his or her diabetes medicine, or doesn’t take the medicine as directed
  • Takes other medicines that affect his or her sugar levels ?Gets an infection or other illness
  • Gets dehydrated, when the body loses too much water

Hyperosmolar nonketotic coma can also occur in undiagnosed people having type 2 diabetes.

What are the symptoms of hyperosmolar nonketotic coma?

Hyperosmolar nonketotic coma causes a person to lose consciousness and go into a coma. But before that happens, people usually have symptoms for a few days that include:

  • Urinating much more than usual l?Having dark yellow or brown urine
  • Being very thirsty, and drinking much more than usual ? Weight loss

Is there a test for hyperosmolar nonketotic coma? Yes. Tests for hyperosmolar nonketotic coma usually include:

  • Blood tests
  • Urine tests
  • An electrocardiogram (ECG or EKG) – This test measures the electrical activity in the heart
  • Other blood tests to look for an infection or illness and chest X- ray.

How is hyperosmolar nonketotic coma treated? People with hyperosmolar nonketotic coma are treated in the hospital with:

  • Insulin – Insulin is given through the vein to bring the person’s blood sugar level under control immediately.
  • Fluids and electrolytes – In hyperosmolar nonketotic coma, the body loses a lot of fluids and electrolytes, which are salts (such as sodium and potassium) that keep cells working normally. These are also replaced by injecting into the vein.

The doctor will also treat any infection or illness causing the hyperosmolar nonketotic coma.

Can hyperosmolar nonketotic coma be prevented? To reduce the chances of getting this condition again, people with diabetes should:

  • Take their diabetes medicines regularly and as prescribed
  • Check their blood sugar level often – A device called a “blood glucose meter” can be used to check blood sugar levels at home.
  •  Learn how to adjust their dose of diabetes medicine when they fall sick.