A patient with diabetes mellitus may become comatose without evidence of ketoacidosis if the serum osmolarity becomes markedly elevated. Often the patient is elderly with comorbid conditions.
(1) depressed level of consciousness
(3) often an acute precipitating event (acute infection, myocardial infarction, etc.)
(1) hyperglycemia (typically > 500 mg/dL)
(2) markedly elevated serum osmolality (due to combination of elevated glucose and dehydration), often > 320 mOsm per kg water
(3) absence of ketoacidosis
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Purpose: To identifya diabetic with nonketotic hyperglycemic hyperosmolar coma.
Specialty: Endocrinology, Clinical Laboratory
Objective: clinical diagnosis, including family history for genetics