Hyperglycaemic Hyperosmolar State (Non-ketotic Coma) Flashcards
1
Q
who gets non-ketotic coma?
A
unwell T2DM patients
2
Q
how do they present?
how does it differ from DKA?
A
a week long of marked dehydration with glucose >30
no switch to ketoacidosis
so Ketonaemia is <3 and pH is >7.3
3
Q
what is the complications of non-ketotic coma considering it is HYPEROSMOLAR
A
- Risk of occlusive vascular events
- DIC
- chorea (abnormal involuntary movements)
4
Q
how do you treat it?
when do you replace K+?
when do yo use insulin?
A
LMWH in all patients
rehydrate slowly with 0.9% saline over 24 hours
when urine starts to flow
if glucose isn’t falling by 5mmol/L with rehydration
5
Q
at what level do you keep blood glucose for first 24 hours to prevent cerebral oedema?
A
10-15 mmol/L
