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Related Experiment Videos

Hyperosmolar nature of diabetic coma.

M Fulop, A Rosenblatt, S M Kreitzer

    Diabetes
    |June 1, 1975
    PubMed
    Summary

    Hyperosmolarity, not acidemia, causes stupor in patients with diabetic ketoacidosis or nonketotic hyperglycemia. This finding clarifies the cause of altered consciousness in uncontrolled diabetes mellitus.

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    Area of Science:

    • Endocrinology
    • Neurology
    • Metabolic Disorders

    Background:

    • Depressed consciousness in nonketotic hyperglycemia is linked to hyperosmolarity.
    • The cause of stupor in diabetic ketoacidosis has been unclear.

    Purpose of the Study:

    • To investigate the cause of depressed consciousness in diabetic ketoacidosis.
    • To compare the factors contributing to stupor in diabetic ketoacidosis and nonketotic hyperglycemia.

    Main Methods:

    • Measured blood pH, serum glucose, serum sodium, and serum osmolality.
    • Analyzed data from 85 episodes of diabetic ketoacidosis and 47 of nonketotic hyperglycemia.

    Main Results:

    • Stupor in both conditions correlated with hyperosmolarity, not acidemia.
    • Similar serum osmolality levels were observed in obtunded ketotic and nonketotic patients.

    Conclusions:

    • Hyperosmolarity is the likely cause of depressed consciousness in severe, uncontrolled diabetes mellitus.
    • This applies whether or not ketoacidosis is present.

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