Hyperosmolytic diabetic coma

Health And Medical Video: Acute Complications Of Diabetes - Hyperosmolar Hyperglycemic Nonketotic State | Khan Academy (February 2019).


In type 2 diabetes, such a terrible complication, as a coma, develops gradually.

Hyperosmolytic diabetic coma, also known as hyperosmolytic hyperkalaemia, is a serious complication that can develop in a person with type 2 diabetes mellitus.

Hyperosmolar diabetic coma occurs when excessive increase in blood sugar (numbers can reach 55 mmol/l or more) and is accompanied by strong dehydration of the body. Unlike ketoacidosis, which usually occurs in patients with type 1 diabetes and leads to the development of similar symptoms, with hyperosmolyarnaya diabetic coma in the blood do not appear ketone bodies. Ketoacidosis rarely develops in such patients.

According to statistics, the diabetic coma more often develops in patients with type 2 diabetes over 60 years. This can happen due to the dullness of the thirst for the elderly and leads to the development of dehydration. Most of the victims know that they have diabetes, but some have not been diagnosed or have not been adequately treated.

Hyperglycemic coma develops gradually: over a period of weeks there is intense thirst and frequent urination. Accelerated urination and excessive increase in blood sugar result in dehydration, including dehydration at the cellular level.

Strong dehydration can lead to shock, coma or death. The mortality rate for a diabetic coma reaches 50%. The group of people at increased risk includes patients with chronic diseases and people with disabilities.

The provocative factors of the diabetic coma

  • Infectious diseases;
  • Heart attack;
  • Kidney failure;
  • Medicines (diuretics, cardiac drugs or steroids);
  • Concomitant chronic diseases;
  • Vomiting, diarrhea;
  • Blood loss of any origin;
  • Thrombi;
  • Lack of blood sugar control.

Early symptoms of diabetic coma

  • Intense thirst;
  • Accelerated urination;
  • weakness;
  • drowsiness;
  • Disturbance of mental condition;
  • headache;
  • Excited state;
  • Difficulty in speaking.

If a patient has any of these symptoms, he or she should measure blood sugar levels and seek medical advice if the sugar level is unusually high.

A diabetic coma usually occurs when blood sugar levels rise to 600 mg/dL (33.3 mmol/l) or more.

Treatment methods

Treatment of a diabetic coma usually consists of intravenous administration of solutions that eliminate dehydration and regulate the electrolyte composition of the blood. Additional insulin may also be needed. In the absence of therapy, the diabetic coma may end with the death of the patient.

Prevention of diabetic coma

The development of a diabetic coma can be prevented by following such recommendations.

  • It is necessary to regularly measure the level of sugar in the blood.
  • During the illness, blood sugar levels should be measured every four hours.
  • It is necessary to pay special attention to the level of sugar when vomiting, diarrhea, injury, loss of blood.
  • The patient needs to pay particular attention to his or her treatment (especially the medications taken) and the diet.
Hyperosmolytic diabetic coma
Category Of Medical Issues: Diseases