hyperosmolar?

[Doetsch]

I was doing some reading and research and found this on the CDC's Website.

"Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma."

I feel a little embarassed to say but I have never heard of this term prior to today. I first thought that maybe it was a Diabetic Coma due to a Low (I thought this due to the lack of present Ketones), But then I realized that the prefix of the word is HYPER and not HYPO. I am at loss and figured other people on the forum might have some use of knowing what this is. Could someone answer this for me. Thank's

[DeusXM]

http://www.emedicine.com/EMERG/topic264.htm

From what I've glanced out, it's basically the same as DKA but without the ketones. Your cells become severely dehydrated through osmosis.

[gettingby]

From what I have been able to learn, this is the state that most type 2's have that is similar to what a type 1 is going through with DKA.
I found this from Wikipedia:
Nonketotic hyperosmolar coma
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. Extreme hyperglycemia is accompanied by dehydration due to inadequate fluid intake. 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. It is classically a nursing home condition but can occur in all ages.

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals extreme hyperglycemia (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.
Hope this helps you some.

[Doetsch]

Thank's. Those answered my questions perfectly :)

[gettingby]

I didn't know about this until about 12-14 years ago myself. My hubby's grandmother was a type 2 living in a nursing home. Apparently, this home allowed her bg's to rise very high and this condition was thrown out at us by the hospital doctors. They never said that she was in this state but they did mention it as a possilbity.
PS...... BTW, YW

[psilocybin]

so you can go into a koma even if you dont have ketones?? dont worry doetsch..i never knew this either...i always thought that when yourblood sugars raise above a certain point you automatically develope ketones

[Doetsch]

so you can go into a koma even if you dont have ketones?? dont worry doetsch..i never knew this either...i always thought that when yourblood sugars raise above a certain point you automatically develope ketones

I thought the same thing. I always develop at least a trace amount when my sugar goes above 550.

[psilocybin]

I thought the same thing. I always develop at least a trace amount when my sugar goes above 550.

and than when u develope enough ketones you go into a coma was my understanding

[greendavid]

It's not the ketones that mess you up, it's the acidity of your blood. Ketosis is not the problem; ketoacidosis is.

Extremely low-carb diets deliberately cause ketosis, because it means that the body is burning fat instead of carbohydrate (thus leading to rapid weight loss). This is dangerous when blood sugars are high, because the blood becomes acidic and you can get lethally sick.

At least, this is the way I understand it from publicly available sources on the web (like deleted-commercial site).

[Doetsch]

I would never trust a diet like that. The Ketones that are released into your blood is one of the main ways that your blood becomes Acidic. If the Ketones were not released into the blood yes, You can still be Acidic but not to the point of serious Illness.

It is indeed the Ketones that push Diabetics into the Coma, without the Ketones it would be rare to happen.

The body is meant to break carbs into energy not fat. That is toying with Human Anatomy and can be dangerous. At least IMHO.

[HelenM]

In ' Diabetics for Dummies' the author writes about hyperosmolar syndrome. I don't know if there are 2 distinct syndromes- one with and one without ketones.
He says that the syndrome 'creates ketones in your blood, but it doesn't make your blood as acidic as ketoacidosis does. It also raises blood glucose levels considerably higher than ketoacidosis does.' He says that the difference in symptoms between it and DKA is that there is no rapid breathing and that glucose is 33mmol or higher.
He too says that the syndrome is most often developed in nursing homes and that sometimes the person has unrecognised and untreated type 2. Age and neglect contributing to the problem.
It tends to affect the elderly because the reduced efficiency in the kidneys results in higher glucose levels this in turn when combined with dehydration - perhaps from vomiting or diarrhoea (unoticed or neglected at times) in turn leads to low blood pressure, weakness, mental confusion and eventually coma. Sadly the death rate from hyperosmolar syndrome is high.