Hyperglycaemic, hyperosmolar, nonketotic coma

Abstract

As mentioned in the previous article, the 'diabetic -related' comas listed in order of their probable frequency are 1 hypoglycaemia coma 2 diabetic ketoacidosis 3 hyperglycaemic hyperosmolar non-ketotic coma; and 4 lactic acidosis A combination of disorders may be often seen, and it must also be appreciated that ketoacidosis can be met with in alcoholic individuals who are not necessarily diabetic, which alcoholic ketoacidosis might also be complicated by hypoglycaemia. It must be remembered that a great variety of diseases that could induce coma can be present in diabetics as well as in non-diabetics, and hence one must avoid the pitfall of always equating a coma problem in a diabetic with one of the so-called 'diabetes-related' comas. Among the commoner possibilities of coma- inducing conditions one finds alcohol, epilepsy, insulin (too much or too little), opium and narcotics, uraemia, trauma (head ... ), infections ofthe C.N.S., C.V.A., and shock.