Definition

Hyperosmolar nonketotic coma occurs in people with diabetes]]> . This condition is life-threatening, so it is important to seek medical attention immediately if you think you have any symptoms of an impending hyperosmolar nonketotic coma.

Causes

Hyperosmolar nonketotic coma is a complication]]> of hyperosmolar hyperglycemic nonketotic syndrome (HHNS), in which your body tries to get rid of excess blood glucose by passing it through your urine. When HHNS is severe, it can lead to ]]>seizures]]> , ]]>coma]]> , and eventually death.

Risk Factors

The following factors are thought to increase the risk of hyperosmolar nonketotic coma:

• Older age
• Diabetes and poorly monitored glucose levels
• Infection
• Drugs (eg, diuretics, steroids, anticonvulsant, chemotherapy]]> drugs)
• Disease states ( ]]>heart attack]]> , ]]>stroke]]> , ]]>kidney failure]]> , ]]>overactive thyroid gland]]> )
• ]]>Substance abuse]]>
• Recent operation

Stroke

© 2009 Nucleus Medical Art, Inc.

Symptoms

Symptoms that may occur before the onset of hyperosmolar nonketotic coma may include:

• High blood glucose (over 600 milligrams per deciliter)
• Dry mouth
• Thirst
• Warm, dry skin
• Absence of sweating
• Fever
• Leg cramps
• Sleepiness
• Confusion
• Vision loss
• Hallucinations
• Weakness on one side of the body
• Frequent urination

Diagnosis

If you arrive at the hospital in a hyperosmolar nonketotic coma, your vital signs will be monitored and you may receive the following tests:

• Blood tests—to test blood sugar, electrolytes, kidney function
• Chest x-ray]]> —a test that uses radiation to take pictures of structures inside the body, especially bones
• Urine tests
• ]]>Electrocardiogram (ECG, EKG)]]> —a test that records the heart’s activity by measuring electrical currents through the heart muscle

EKG

© 2009 Nucleus Medical Art, Inc.

Treatment

Common treatments for hyperosmolar nonketotic coma include the following:

Prevention

The best way to prevent hyperosmolar nonketotic coma is to monitor your blood glucose levels regularly. Your doctor can instruct you about how often to check your levels, and what the numbers mean. Also, talk with your healthcare provider about how to manage your blood glucose when you are sick.