Hyperosmolar Nonketotic Coma
(HHNC; Hyperosmolar Coma; Diabetic Nonketotic Coma; Hyperosmolar Nonketotic State)
- Mental confusion
- Frequent urination
- Nausea or vomiting
- Dry mouth
- Warm, dry skin without sweating
- High fever
- Vision loss
- Weakness or strange movements on one side of the body with or without seizures
- Blood tests—can also test kidney function
- Urine tests
- Urine, blood, and sputum cultures
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- Fluids and minerals through an IV—to replace substances you lost and improve your urine output.
- Insulin through an IV—to help control your blood glucose levels.
- Monitor your blood glucose levels regularly. Your doctor can instruct you about how often to check your levels, and what the numbers mean.
- Drink plenty of fluids throughout the day.
- Talk with your doctor about how to manage your blood glucose when you are sick.
American Diabetes Association http://www.diabetes.org
National Diabetes Information Clearinghouse http://diabetes.niddk.nih.gov
Canadian Diabetes Association http://www.diabetes.ca
Health Canada http://www.hc-sc.gc.ca
Chiasson JL, Aris-Jilwan N, et al. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Can Med Assoc J. 2003;168:859-866.
Hyperosmolar hyperglycemic crisis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated January 12, 2013. Accessed September 4, 2013.
Kim DW, Moon Y, et al. Blood-brain barrier disruption is involved in seizure and hemianopsia in nonketotic hyperglycemia. Neurologist. 2011 May;17(3):164-166.
Kitabchi AE. Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinol Metab Clin North Am. 2006;35:725-751.
Ondo WG. Hyperglycemic nonketotic states and other metabolic imbalances. Handb Clin Neurol. 2011;100:287-291.
Stoner GD. Hyperosmolar hyperglycemic state. Am Fam Physician. 2005;71:1723-1730.
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS). American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html. Accessed September 4, 2013.
- Reviewer: Kim Carmichael, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -