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[Non-ketosic hyperosmolar hyperglycemic coma. Case reports and therapeutic consideration].
Minerva Medica
|February 18, 1976
Summary
Non-ketonic hyperosmolar hyperglycaemic coma (NKHHC) is a common diabetes complication, especially in the elderly. Early diagnosis and treatment, including insulin and fluid correction, can reduce its high mortality rate.
Area of Science:
- Endocrinology
- Metabolic Disorders
Background:
- Non-ketonic hyperosmolar hyperglycaemic coma (NKHHC) is a serious complication of diabetes mellitus.
- It is characterized by hyperglycemia, hyperosmolarity, dehydration, and altered mental status.
Observation:
- NKHHC is frequently observed in elderly patients with less severe diabetes.
- A 2.2% incidence of NKHHC was noted over 14 months, exceeding that of ketoacidotic coma.
- Six personal cases highlight the syndrome's presentation and outcomes.
Findings:
- Treatment involves insulin (doses lower than for ketoacidotic coma), hypotonic saline, and electrolyte correction.
- Mortality rates remain high, with reported deaths from hypovolemic shock and sepsis.
- Three out of six observed patients survived the NKHHC episode.
Implications:
- Improved understanding and earlier diagnosis of NKHHC are crucial.
- Timely treatment can potentially reduce the current 50% mortality rate associated with this condition.
- Further research into NKHHC management strategies is warranted.