non-ketotic hyperglycemic coma

non-ketotic hyperglycemic coma

NKHHC; nonketotic hyperglycemic coma Endocrinology A complication of type 2 DM that results in high serum glucose levels without ketone production Clinical ↓ consciousness, extreme dehydration, ↑ glucose, no DKA; NHC is most common in previously undiagnosed or poorly controlled diabetics, precipitated by infection or drugs that impair glucose tolerance or ↑ fluid loss; normally the kidneys compensate for high serum glucose by spilling glucose; when dehydration occurs, kidneys conserve fluid and glucose levels ↑ further, creating a vicious cycle of ↑ dehydration and ↑ glucose Risk factors Elderly, underlying renal failure, CHF; recent discontinuation of insulin or oral hypoglycemics, precipitating events–eg, infection, stroke, recent surgery or other trauma. See Diabetes mellitus, Diabetic ketoacidosis.
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