HYPERGLYCEMIC HYPEROSMOLAR NONKETOTIC COMA (HHNKC)

- potentially fatal
- findings
- severe hyperglycemia usually > 600 mg/dL
- plasma hyperosmolarity
- dehydration
- altered LOC - decreased
- absence of ketoacidosis
- usually precipitated by physical stress such as an infection
- in non-diabetics can be due to tube feedings without supplemental water, or too rapid rate of infusion for parenteral nutrition
- occurs more often in the elderly, typically
- expected: to correct fluid depletion, insulin deficiency, and electrolyte imbalance




other chronic complications

diabetic triopathy
- retinopathy
- nephropathy
- neuropathy

macrovascular disease in the
- coronary artery
- peripheral vascular