MedifocusHealth

Hyperosmotic Nonketotic Hyperglycemic Coma

Hyperosmotic nonketotic hyperglycemic coma is a potentially life-threatening condtion that primarily affects older patients with type 2 diabetes. This condition evolves over time and is characterized by blood glucose levels >600mg/dL with severe dehydration. It may be the presenting manifestation of diabetes in some individuals. Risk factors include kidney impairment, congestive heart failure, concurrent use of certain medications (phenytoin, thiazide diuretics, glucocorticoids and diazoxide), surgery or acute stress.

Symptoms of hyperosmotic nonketotic hyperglycemic coma include:

• Thirst
• Frequent urination
• Weakness
• Lethargy
• Confusion
• Coma

Hypoglycemia

Hypoglycemia, also known as "insulin shock", is a complication that occurs if the blood glucose levels fall below normal and can be caused by insufficient intake of food, exercise, or alcohol consumption. Hypoglycemia occurs most commonly in persons using insulin and those who are attempting to achieve tight control of glucose levels. At the extreme, repeated episodes of hypoglycemia (glucose < 65mg/dL) can lead to permanent brain damage (hypoglycemia encephalopathy) or death.

Symptoms of hypoglycemia include:

• Sweating
• Trembling
• Headache
• Hunger
• Rapid heartbeat
• Mood changes
• Neurologic symptoms
• Confusion and disorientation
• Weakness
• Combativeness
• Coma (rare)
• Seizures (rare)
• Death (rare)

These symptoms should be promptly treated with juice, glucose tablets, glucose gel or another source of quick-acting carbohydrate, which should carried and available at all times. Severe hypoglycemia can be treated with glucagon, which may be injected intramuscularly or intravenously.