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	Diabetic coma - Wikipedia, the free encyclopedia
		Nonketotic hyperosmolar coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness.
		Nonketotic hyperosmolar coma usually develops more insidiously than DKA because the principal symptom is lethargy progressing to obtundation, rather than vomiting and an obvious illness.
		Coma from NKHC occurs most often in patients who develop type 2 or steroid diabetes and have an impaired ability to recognize thirst and drink.
	en.wikipedia.org /wiki/Diabetic_coma (791 words)

	* Coma - (Disease): Definition
		Coma is a medical emergency, and attention must first be directed to maintaining the patient's respiration and circulation, using intubation aand ventilation, administration of intravenous fluids or blood as needed, and other supportive care...
		Coma is an emergency The first step is to support and stabilize the vital signs, such as blood pressure, breathing, and temperature.
		Coma is a deep and prolonged state of unconsciousness resulting from disease, injury or poisoning...
	en.mimi.hu /disease/coma.html (863 words)

	Diabetic hyperglycemic hyperosmolar coma
		Diabetic hyperglycemic hyperosmolar coma is a condition characterized by decreased consciousness, extreme dehydration, and extremely high blood-glucose levels that is not accompanied by ketoacidosis.
		The condition is usually seen in noninsulin-dependent diabetes and may occur in those previously undiagnosed, or those who have neglected their diabetes.
		Hyperosmolarity is a condition in which the blood is concentrated with sodium, glucose, and other molecules which, attracts water into the blood stream as a result.
	www.rwjobgyn.com /Atoz/encyclopedia/article/000304.asp (460 words)

	Endotext.com - Diabetes, Ketoacidosis And Hyperosmolar Coma (Site not responding. Last check: 2007-11-06)
		Coma as a complication of diabetes mellitus was first described over 100 years ago, Most of these patients had some depression of sensorium, manifested by impaired response to verbal or painful stimuli.
		Nonketotic hyperosmolar coma with hyperglycemia (nonketotic coma) is characterized by hyperglycemia (plasma glucose above 34 mmol/L) and hyperosmolality (plasma osmolality above 350 mOsm/kg) without significant ketonemia (plasma acetest below 2+ at a 1:1 dilution) with depression of sensorium to at least a stupor 37.
		In nonketotic coma, most deaths are attributable to associated medical conditions, which tend to be serious, including myocardial infarction, pancreatitis, gram negative pneumonia, acute renal failure and pulmonary embolus 37.
	www.endotext.org /diabetes/diabetes11/diabetes11.htm (4494 words)

	Partial central diabetes insipidus complicating nonketotic hyperglycemic hyperosmolar coma -- Amundson et al. 96 (10): ...
		Nonketotic hyperglycemic hyperosmolar coma is an uncommon, but significant, complication of type II diabetes mellitus with a high overall mortality rate.
		In the patient described, nonketotic hyperglycemic hyperosmolar coma complicated by diabetes insipidus was successfully treated with desmopressin acetate.
		To the authors' knowledge, this is the first reported case of nonketotic hyperglycemic hyperosmolar coma associated with partial central diabetes insipidus.
	www.jaoa.org /cgi/content/abstract/96/10/603 (145 words)

	Diabetic hyperglycemic hyperosmolar coma (Disease) - Southwest Washington Medical Center
		Diabetic hyperglycemic hyperosmolar coma is a complication of type 2 diabetes that results in extremely high glucose levels without the presence of ketones (a by-product of fat, which can cause other complications).
		Diabetic hyperglycemic hyperosmolar coma is a condition characterized by decreased consciousness, extreme dehydration (lack of water), and extremely high blood glucose (sugar) levels, which is not accompanied by ketoacidosis.
		Hyperosmolarity is a condition in which the blood is concentrated with sodium, glucose, and other molecules that normally attract water into the bloodstream.
	www.swmedicalcenter.com /13218.cfm (512 words)

	My diabetic coma Page (Site not responding. Last check: 2007-11-06)
		Diabetic hyperglycemic hyperosmolar coma is a condition characterized by decreased consciousness...
		Coma as a complication of diabetes mellitus was...
		Hyperosmolar Hyperglycemic Nonketotic Coma - Hyperosmolar hyperglycemic nonketotic coma (HHNC) is a metabolic derangement that occurs principally in patients with adult-onset diabetes.
	www.free-glucose-meter.net /diabetes/19/diabetic-coma.html (492 words)

	Coma hiperosmolar (Site not responding. Last check: 2007-11-06)
		Hyperosmolar nonketotic diabetic coma as a cause of emergency hyperglicemic admission to Baragwanath Hospital.
		From diabetic ketoacidosis to hyperglycemic hyperosmolar nonketotic, the spectrum of uncontrolled hyperglycemia in diabetes mellitus.
		Diabetes ketoacidosis hyperglycemic hyperosmolar nonketotic coma, and hypoglycemia.
	bvs.sld.cu /revistas/med/vol40_3_01/med06301.htm (1402 words)

	Nonketotic Coma (Site not responding. Last check: 2007-11-06)
		Nonketotic Coma is a type of coma caused by a lack of insulin.
		A nonketotic crisis means: (1) very high levels of glucose (sugar) in the blood; (2) absence of ketoacidosis; (3) great loss of body fluid; and (4) a sleepy, confused, or comatose state.
		Nonketotic coma often results from some other problem such as a severe infection or kidney failure.
	www.paralumun.com /diabetesnonketotic.htm (61 words)

	THE MERCK MANUAL OF GERIATRICS, Ch. 64, Disorders of Carbohydrate Metabolism
		A syndrome characterized by hyperglycemia, extreme dehydration, and hyperosmolar plasma, leading to impaired consciousness, sometimes accompanied by seizures.
		Nonketotic hyperglycemic-hyperosmolar coma (NKHHC) is a complication of type II DM that has a high mortality rate.
		Laboratory studies show extreme hyperglycemia, hyperosmolarity, mild metabolic acidosis without marked hyperketonemia, and prerenal azotemia (or preexisting chronic renal failure).
	www.merck.com /mrkshared/mmg/sec8/ch64/ch64b.jsp (550 words)

	eMedicine - Hyperosmolar Coma : Article by J Michael Gonzalez-Campoy, MD, PhD, FACE
		Background: According to the nomenclature of the American Diabetes Association, the term hyperosmolar nonketotic state (HNS) is preferred to denote an acute metabolic complication of diabetes mellitus (DM) characterized by impaired mental status (MS) and elevated plasma osmolality in a patient with hyperglycemia.
		Hyperosmolarity also stimulates thirst, a defense mechanism that is impaired in people dependent on others for care.
		Coma is the end stage of this hyperglycemic process, when severe electrolyte disturbances occur in association with hypotension.
	www.emedicine.com /MED/topic1091.htm (5501 words)

	Driver Safety Information- Diabetes Glossary
		Transient complications that are temporary and reversible due to blood glucose fluctuations having a short term impact on driving capability, such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, and nonketotic hyperosmolar coma.
		It is characterized by rapidly passing into either reaction or coma precipitated by fluctuation between high and low levels of glucose in the blood.
		Are either short term (acute) or long term (chronic) impairments which affect the microvascular or macrovascular blood vessels of persons with diabetes, such as: (Acute) hypoglycemia, hyperglycemia, diabetic ketoacidosis, nonketotic hyperosmolar coma; (Chronic) visual impairments, diabetic nephropathy, cardiovascular and cerebrovascular disease, and diabetic neuropathy.
	www.dmv.ca.gov /dl/driversafety/diabetes_glossary.htm (5308 words)

	children with DIABETES - Diabetes Dictionary: N
		Nonketotic Coma (Hyperglycemic hyperosmolar nonketotic syndrome, Hyperglycemic hyperosmolar nonketotic coma)
		Nonketotic coma is more likely to be associated with Type 2 diabetes, and is sometimes the initial presenting situation for Type 2 diabetes.
		Nonketotic coma is uncommon in Type 1 Diabetes.
	www.childrenwithdiabetes.com /dictionary/n.htm (657 words)

	BioMed Central \| Full text \| Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome after renal transplantation ... (Site not responding. Last check: 2007-11-06)
		Risk factors for hyperglycemic hyperosmolar syndrome were similar except for the significance of positive recipient hepatitis C serology and non-significance of female gender.
		There was considerable overlap between risk factors for diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome except for the significance of recipient hepatitis C positive serology and the lack of significance of female gender (Table 4).
		The leading cause of death in patients hospitalized for hyperglycemic hyperosmolar syndrome was acute myocardial infarction (18%), cardiac arrest of unknown cause (13%), and sepsis (9%).
	www.biomedcentral.com /1472-6823/3/1 (5622 words)

	Zyprexa May Induce Diabetic Hyperosmolar Coma (Site not responding. Last check: 2007-11-06)
		Also known dibatetic hyperglcemic hyperosmolar coma (NKHHC), nonketotic hyperglycemic coma, and hyperosmolar non-ketotic coma or HONK, dabetic hyperosmolar coma is a complication of diabetes that results in extremely high glucose levels without the presence of ketones (a by-product of fat), which creates additional problems.
		The death rate associated with diabetic hyperglycemic hyperosmolar coma is up to 50%.
		I f you or a love one has developed diabetic hyperosmolar coma after taking Zyprexa, e-mail or call our experienced Zyprexa attorneys to schedule a free consultation.
	www.zyprexalawyer.net /hypersmolar_coma.html (405 words)

	Fresh Nonketotic Hyperglycemia info from Proven Diabetes Treatments (Site not responding. Last check: 2007-11-06)
		Hyperosmolar hyperglycemic nonketotic coma Hyperosmolar hyperglycemic nonketotic coma...
		Hyperosmolar Coma Hypoglycemia Nonketotic Hyperglycemic Hyperosmolar Coma A syndrome characterized by hyperglycemia, extreme dehydration, and hyperosmolar plasma leading to impaired...
		The condition is characterized by hyperglycemia, hyperosmolarity, and an absence of...
	proven-diabetes-treatments.com /diabetes/nonketotic_hyperglycemia.html (519 words)

	eMedicine - Hyperosmolar Hyperglycemic Nonketotic Coma : Article Excerpt by: Mark Sagarin, MD (Site not responding. Last check: 2007-11-06)
		Background: Hyperosmolar hyperglycemic nonketotic coma (HHNC) is a metabolic derangement that occurs principally in patients with adult-onset diabetes.
		The condition is characterized by hyperglycemia, hyperosmolarity, and an absence of significant ketosis.
		Contributing factors include the limitation on ketogenesis by hyperosmolarity, the lower levels of free fatty acids available for ketogenesis, the availability of insulin in amounts sufficient to inhibit ketogenesis but not sufficient to prevent hyperglycemia, and the hepatic resistance to glucagon in these patients.
	www.emedicine.com /emerg/byname/hyperosmolar-hyperglycemic-nonketotic-coma.htm (375 words)

	FindArticles search for "Coma"
		Coma, from the Greek word "koma," meaning deep sleep, is a state of extreme unresponsiveness, in which an individual exhibits no voluntary movement or behavior.
		A barbiturate-induced coma, or barb coma, is a temporary state of unconsciousness brought on by a controlled dose of a barbiturate drug, usually pentobarbital...
		The Coma Alex Garland Faber and Faber, [pounds sterling]9.99 Alex Garland's new novella is an exploration of the state of dreaming.
	www.findarticles.com /p/search?tb=art&qt=Coma (838 words)

	DiabetoValens.com - The Diabetes Guide
		Nonketotic hyperglycemic-hyperosmolar coma (NKHHC) usually develops after a period of symptomatic hyperglycemia in which fluid intake is inadequate to prevent extreme dehydration from the hyperglycemia-induced osmotic diuresis.
		In some patients, an infection, particularly pneumonia or gram-negative sepsis, is an initiating event; but NKHHC can also occur when patients with undiagnosed or neglected type II DM receive drugs that impair glucose tolerance (e.g., glucocorticoids) or increase fluid loss (e.g., diuretics).
		The consistent and diagnostic features of NKHHC are CNS alterations, extreme hyperglycemia, dehydration and hyperosmolarity, mild metabolic acidosis without marked hyperketonemia, and prerenal azotemia (or preexisting chronic renal failure).
	my.diabetovalens.com /nwly_dgsd/nonketotic.asp (636 words)

	Hyperglycemic Hyperosmolar Nonketotic Coma \| Diabetic-Network.com \| Hyperglycemic Hyperosmolar Nonketotic Coma
		Hyperosmolar Hyperglycemic Nonketotic Coma - Hyperosmolar hyperglycemic nonketotic coma (HHNC) is a metabolic derangement that occurs principally in...
		Hyperosmolar Hyperglycaemic Nonketotic Coma (HHNK) Hyperosmolar Hyperglycemic Nonketotic Coma develops as a result of very high blood glucose...
		Hyperglycemic Hyperosmolar Nonketotic Coma Topic Tree Definition: A syndrome consisting of extreme hyperglycemia, serum hyperosmolarity and...
	www.diabetic-network.com /diabetes/hyperglycemic-hyperosmolar-nonketotic-coma.html (229 words)

	Insights on Nonketotic Hypoglycemia info from Proven Diabetes Treatments (Site not responding. Last check: 2007-11-06)
		hypoglycemia, diabetic ketoacidosis, and hyperglycemic hyperosmolar nonketotic syndrome.
		Hyperosmolar Hyperglycemic Nonketotic Coma Hyperosmolar hyperglycemic nonketotic coma (HHNC) is a...
		to thrive (27 of 43), recurrent infections (27 of 43), encephalopathy (six of 43), nonketotic hypoglycemia (seven of 43), and cardiomyopathy (nine of 43).
	proven-diabetes-treatments.com /diabetes/nonketotic_hypoglycemia.html (462 words)

	Diabetes Care: Reversible quadriplegia and nonketotic hyperosmolar coma: is it an exceptional association or an ... (Site not responding. Last check: 2007-11-06)
		Atbromhotic stroke or cerebropontine myelinolysis associated with high serum osmolarity and cerebral edema are well-known complications of hyperosmolar nonketotic coma (1).
		We report on a case of a 56-year-old white woman with unknown diabetes who was admitted to the emergency department because of fever, chilis, arthromyalgia, and fatigue.
		The patient was diagnosed with hyperosmolar nonketotic coma and treated with normal saline, potassium, continuous insulin infusion, and antimicrobial therapy according to culture results.
	www.findarticles.com /p/articles/mi_m0CUH/is_5_27/ai_n6033095 (889 words)

	Diabetic Management (Site not responding. Last check: 2007-11-06)
		The result is called ketoacidosis, a severe condition that may put a person into a coma if not treated right away.
		A coma (loss of consciousness) related to high levels of glucose (sugar) in the blood and requiring emergency treatment.
		The point at which the blood is holding too much of a substance such as glucose (sugar) and the kidneys "spill" the excess sugar into the urine.
	www.diabetic-alliance.com /hyperosmolar-coma (12163 words)

	treatment diabetic coma
		Diabetic hyperglycemic hyperosmolar coma Alternative names: Nonketotic hyperglycemic coma ; NKHHC Treatment : The goal of treatment is to correct...
		Paramedics are familiar with the treatment of diabetic coma and will treat it with administration of sugars, blood test for glucose...
		Diabetic Hyperosmolar Syndrome - Early and Meneo, LLP - hyperosmolar...
	www.top-diabetes-help.info /treatment-diabetic-coma.html (602 words)

	Diabetes Monitor - hyperglycemic hyperosmolar nonketotic syndrome
		yperglycemic hyperosmolar nonketotic syndrome is a metabolic derangement that occurs principally in elderly patients with mild or undiagnosed type 2 diabetes.
		The complication is characterized by hyperglycemia, hyperosmolarity (thickening of the blood), with little if any ketosis.
		Ordinarily, coma is present in only a small percentage of cases (less than 10%) at the time of diagnosis.
	www.diabetesmonitor.com /b306.htm (377 words)

	NDI Article Translation:166 (Site not responding. Last check: 2007-11-06)
		Hyperosmolar Nonketotic Coma Precipitated by Lithium-induced Nephrogenic Diabetes Insipidus
		He was admitted to the hospital in a type of coma called a hyperosmolar nonketotic coma (HONK) that typically occurs in older patients with diabetes mellitus, which this man had developed.
		The authors recommend that patients who develop diabetes mellitus while on lithium have their plasma sodium concentration and urine output carefully monitored.
	www.ndif.org /Translation/jtran-166.html (277 words)

	Diabetic Coma Symptoms \| Diabetic-Network.com \| Diabetic Coma Symptoms
		Diabetic information, diabetic coma symptoms, diabetic pen pals senior citizens, exposure to asbestos and diabetes type ii, teleconferencing...
		The main symptom of a coma is the inability to be aroused to consciousness.
		DIABETIC COMA - A severe metabolic derangement that occurs in the absence of insulin.
	www.diabetic-network.com /diabetes/diabetic-coma-symptoms.html (168 words)

	References
		Arieff AI, Carrol H: Nonketotic hyperosmolar coma with hyperglycemia: clinical features, pathophysiology, renal function, acid-base balance, plasma-cerebrospinal fluid equilibria, and the effects of therapy in 37 cases.
		Guisado R, Arieff AI: Neurologic manifestations of diabetic comas: correlation with biochemical alterations in the brain.
		Ellis EN: Concepts of fluid therapy in diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic coma.
	www.medscape.com /content/2001/00/42/15/421556/421556_ref.html (3696 words)

	Find diabetic coma (Site not responding. Last check: 2007-11-06)
		top Nonketotic hyperglycemic coma ; NKHHC; HONK - hyperosmolar non-ketotic coma Definition Return to top Diabetic hyperglycemic hyperosmolar coma is a complication of type 2 diabetes that results...
		Although diabetic coma is well described in textbooks, patients do not always exhibit the typical signs and symptoms that would mandate the prescribed treatment.
		Disease - Diabetic hyperglycemic hyperosmolar coma - Henry Ford Health System is one of the nation's leading health care...
	twistedankledesigns.com /2/diabetic-coma.html (235 words)

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