Hyperosmolar coma is a serious complication associated with type 2 diabetes, caused by extremely high blood glucose levels and dehydration. Symptoms include confusion, nausea, and weakness, and treatment involves intravenous insulin and fluids. Risk factors include advanced age, impaired kidney function, and congestive heart failure. Early diagnosis and treatment are crucial to prevent further complications.
A hyperosmolar coma, also known as non-ketotic hyperosmolar coma (HONK), is a serious complication associated with type 2 diabetes. Due to the development of hyperosmolarity or extremely high blood glucose levels, there are a number of associated risk factors to the development of this condition. Treatment may include intravenous administration of insulin and fluids. As with any serious medical condition, there are risks associated with HONK, and people who become symptomatic should see a doctor right away to prevent further complications.
Commonly found among individuals diagnosed with type 2 diabetes, HONK is a condition that can also affect individuals who have failed to regulate blood sugar levels or do not know they are diabetic. Severe illness or the presence of infection can trigger the development of a hyperosmolar coma. HONK is a condition composed of multiple factors including extreme dehydration, abnormally high blood glucose levels, and disturbances in consciousness.
Individuals who stay hydrated keep blood glucose levels steady. The kidneys act as a filter to rid the body of excess glucose, however, as an individual decreases fluid intake, the amount of glucose filtered out of the body also decreases. Additionally, the consumption of sugary drinks by those with existing high glucose levels can also cause impaired kidney function. Unfiltered glucose builds up and eventually results in a condition known as hyperosmolarity.
The blood of those who develop hyperosmolarity has abnormally high levels of salt, sugar, and other substances that affect water levels in the body. The organs and tissues of the body need a constant supply of water to function properly. When water intake is reduced, the body draws water from various tissues and organs to maintain balance and function. The resulting situation of increased blood sugar levels and decreased water availability contributes to hyperosmolarity.
Individuals at greatest risk for hyperosmolarity are those who have recently had a heart attack or stroke. Those of advanced age or who have been diagnosed with impaired kidney function are also at increased risk. Additional risk factors include an inability to adequately manage your diabetes, stopping your diabetes medications, and congestive heart failure.
Those who experience confusion, nausea, or weakness may be symptomatic of having hyperosmolarity. Symptoms that develop during the early onset of hyperosmolarity progressively worsen over time. Individuals exhibiting impaired speech or numbness in the limbs may experience dangerously high blood glucose levels associated with the development of a hyperosmolar coma.
A variety of blood tests are usually administered to confirm a diagnosis of this condition. The individual may undergo a urinalysis to evaluate for the presence of compounds and determine the dilution versus concentration of the urine. In cases where the individual is recommended for further evaluation, an electrocardiogram (ECG) and chest X-ray may be performed to assess the condition and function of their heart.
Treatment for hyperosmolar coma may include intravenous insulin administration to stabilize the individual’s blood glucose levels. Potassium and fluids are given intravenously to restore hydration and electrolytes. The death rate associated with this condition is relatively high since most people who develop it have a pre-existing condition. Complications associated with HONK include blood clots, shock, and swelling of the brain, known as cerebral edema. Individuals with type 2 diabetes can prevent the onset of hyperosmolarity and hyperosmolar coma by understanding the warning signs of dehydration and taking appropriate steps to rehydrate.
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