Friday, May 22, 2015

Diabetic hyperglycemic hyperosmolar coma

Table of Contents

Alternative Names

Hyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK)

  • Coma
  • Confusion
  • Convulsions
  • Increased thirst
  • Increased urination (at the beginning of the syndrome)
  • Lethargy
  • Nausea
  • Weakness
  • Weight loss

Symptoms may get worse over a period of days or weeks.

Other symptoms that may occur with this disease:

  • Dysfunctional movement
  • Loss of feeling or function of muscles
  • Speech impairment

Signs and tests

Signs may include:

  • Extreme dehydration
  • High temperature -- higher than 38 degrees Centigrade (100.4 degrees Fahrenheit)
  • Increased heart rate
  • Low systolic blood pressure

Test results include:

  • High serum osmolarity (concentration)
  • Higher than normal BUN and creatinine
  • Higher than normal serum sodium
  • Mild ketone buildup (ketosis)
  • Very high blood glucose

Evaluation for possible causes may include:

  • Blood cultures
  • Chest x-ray
  • Electrocardiogram (ECG)
  • Urinalysis

Review Date: 05/10/2010
Reviewed By: Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (