Hyperosmolar nonketotic diabetic coma referred to as hyperosmolar coma for diabetes a rare and severe acute complications. Is a rare, severe acute com

Hyperosmolar nonketotic diabetic coma outlined
Hyperosmolar nonketotic diabetic coma referred to as hyperosmolar coma for diabetes a rare and severe acute complications. Is a rare, severe acute complications of diabetes, its main clinical features of severe hyperglycemia, dehydration, plasma osmolality increased without obvious ketoacidosis. Often in patients with disturbance of consciousness or coma. High case-fatality rate of this disease should be sufficient vigilance and timely diagnosis and effective treatment.
Hyperosmolar nonketotic diabetic coma diagnosis
1, the slow onset, often induced by disease or symptoms associated with the incidence overshadowed easy delaying diagnosis;
2, early first polydipsia, polyuria, and more food instead of little or loss of appetite, it is often ignored, much higher than the urine into the water;
3, severe dehydration cell disease, characterized by:
① nervous system symptoms: such as irritability, lethargy, hallucinations, convulsions, etc., and finally fell into a coma;
② severe dehydration, there is no corresponding decrease in urine and even showed polyuria;
③ circulatory failure neurological symptoms than the relatively light.

Hyperosmolar nonketotic diabetic coma treatment
Should be immediately in the emergency room for treatment, his condition to allow the admission or the treatment of ICU wards.
1, active rehydration:
Shock, and given saline and colloid (plasma, etc.) solution, as soon as possible to correct shock; no shock or shock has been corrected, plasma osmolality> 350moSm / L, could be in intensive care under the infusion of hypotonic 0.45% sodium chloride solution; plasma osmolality fell to 330 moSm / L, then changed to such exudate.
2, application of insulin:
2-6U / h intravenous drip, blood glucose decreased gradually to prevent the decline in excessive lead to cerebral edema. Reduced blood glucose 16.7mmol / L, the change lose 5% glucose plus insulin, according to its proportion of insulin: glucose = 1u :3-4g..
3, to maintain electrolyte balance:
Potassium <5mmol began potassium, so potassium is maintained at the 4-5mmol / L.
4, removing the incentive treatment, and pay attention to monitoring life disease, blood, urine sugar, electrolytes, BUN, etc..
Hyperosmolar nonketotic diabetic coma prevention
1, early to detect, correct and reasonable treatment of diabetes.
2, usually pay attention to drinking water.
3, the law of life, appropriate exercise.
4, to strengthen the blood glucose testing.
5, the earliest possible diagnosis and treatment, infection control is the key to reducing mortality.