SHENBAGAM TIMES

 
 
Health Check-up
Food & Nutrition
Medical Tourism
Our Achievements
Who We Are
Our partnerships
Social Responsibilty
The Vision
 
News
   
  Diabetes Mellitus with Hyperosmolar Coma
  ADAM 09-29-2011
 
 

Definition

Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes that involves extremely high blood sugar (glucose) levels without the presence of ketones. Ketones are byproducts of fat breakdown.

Symptoms

  • Coma
  • Confusion
  • Convulsions
  • Increased thirst
  • Increased urination (at the beginning of the syndrome)
  • Lethargy
  • Nausea
  • Weakness

Symptoms may get worse over a period of days or weeks.

Other symptoms that may occur with this disease:

  • Dysfunctional movement
  • Loss of feeling or function of muscles
  • Speech impairment

Causes & Risk Factors

Diabetic hyperglycemic hyperosmolar syndrome is a condition of:
 

  • Extremely high blood sugar (glucose) levels
  • Extreme lack of water (dehydration)
  • Decreased consciousness

The buildup of ketones in the body (ketoacidosis) may also occur.

This condition is usually seen in people with type 2 diabetes. It may occur in those who have not been diagnosed with diabetes, or in people who have not been able to control their diabetes. The condition may be brought on by:

  • Infection
  • Other illness
  • Medications that lower glucose tolerance or increase fluid loss (in people who are losing or not getting enough fluid)

Normally, the kidneys try to make up for high glucose levels in the blood by allowing the extra glucose to leave the body in the urine. If you do not drink enough fluids, or you drink fluids that contain sugar, the kidneys can no longer get rid of the extra glucose. Glucose levels in the blood can become very high as a result. The blood then becomes much more concentrated than normal (hyperosmolarity).

Hyperosmolarity is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances that normally cause water to move into the bloodstream. This draws the water out of the body's other organs, including the brain. Hyperosmolarity creates a cycle of increasing blood-glucose levels and dehydration.

Risk factors include:

  • A stressful event such as infection, heart attack, stroke, or recent surgery
  • Congestive heart failure
  • Impaired thirst
  • Limited access to water (especially in patients with dementia or who are bedbound)
  • Older age
  • Poor kidney function
  • Poor management of diabetes -- not following the treatment plan as directed
  • Stopping insulin or other medications that lower glucose levels

Tests & Diagnostics

Signs may include:

  • Extreme dehydration
  • High temperature -- higher than 38 degrees Centigrade (100.4 degrees Fahrenheit)
  • Increased heart rate
  • Low systolic blood pressure

Test results include:

  • High serum osmolarity (concentration)
  • Higher than normal BUN and creatinine
  • Higher than normal serum sodium
  • Mild ketone buildup (ketosis)
  • Very high blood glucose

Evaluation for possible causes may include:

  • Blood cultures
  • Chest x-ray
  • Electrocardiogram (ECG)
  • Urine analysis

Treatments

The goal of treatment is to correct the dehydration. This will improve the blood pressure, urine output, and circulation.

Fluids and potassium will be given through a vein (intravenously). High glucose levels are treated with intravenous insulin.

Complications

  • Acute circulatory collapse (shock)
  • Blood clot formation
  • Brain swelling (cerebral edema)
  • Increased blood acid levels (lactic acidosis)

Prevention

Controlling type 2 diabetes and recognizing the early signs of dehydration and infection can help prevent this condition.

Go Back
«
Your ‘healthy’ glass of fruit juice can actually up cancer risk
«
Fat cell dysfunction causes obesity
«
Soon, a supplement to cure spine injury
«
The slim forever diet!
«
Breakfast right to achieve fitness goal
 
 
 
Untitled Document
 
TREATMENT
Dental Care
 
Dermatology
 
Diabetalogy
 
ENT Care
 
FACIO MAXILLARY
 
Gastroenterology
 
General & Laproscopy
 
Gynaecology
 
Health Check Up
 
Internal Med&Cardio
 
Neurology
 
Oncology
 
Ortho & Trauma Care
 
Pediatrics
 
Plastic Surgery
 
Psychiatry
 
Rheumatology
 
Urology & Nephrology
 
Vascular Surgery
 
 
FACILITIES
DIALYSIS
ENDOSCOPY
INSURANCE
LABORATORY
OPERATION THEATRE
DEPARTMENTS
DIABETIC CENTRE
NURSING SCHOOL
 
About Shenbagam
Contact Us
Press Releases
Social Responsibilty
The Vision
Copyright 2011 Shenbagam Hospital
Powered by: NEWSSMART.India