In this article, we will discuss the Definition, Etiology, and Precipitating Factors of Hyperosmolar Hyperglycemic Non-Ketotic Coma. So, let’s get started.
Hyperosmolar Hyperglycemic Non-Ketotic Coma (HHNKC) is an acute metabolic decompensation of the diabetic state in type 2 diabetes, characterized by extreme hyperglycemia (blood glucose> 600 mg/dl) and increased osmolality (> 320 mOsm/kg) with dehydration without significant ketosis or acidosis.
The patients of type 2 diabetes mellitus are prone to develop hyperosmolar hyperglycemic non-ketotic coma and it includes:
1. Type 2 diabetes detected for the first time (undiagnosed diabetics)
2. Middle aged or older diabetics (>50 years of age)
3. Those living alone
4. Those with no access to medical treatment
5. Those with associated infection or stroke
Acute infections, burns, trauma
Vascular episode (CVA or AMI)
Excessive alcohol consumption
Drugs, e.g. thiazides, steroids, phenytoin, chlorpromazine, diazoxide, immunosuppressive, sympathomimetics, beta-blockers, calcium channel blockers, etc
Dialysis (peritoneal or hemodialysis) in a patient with uremia
Use of osmotic agents (e.g. mannitol)