title: [Non-ketosic hyperosmolar hyperglycemic coma. Case reports and therapeutic consideration].
abstract: Non-ketonic hyperosmolar hyperglycaemic coma (N.K.H.H.C.) is by no means uncommon in diabetes. Its picture includes sensorial depression, hyperglycaemia, hyperazotemia, marked dehydration and plasma hyperosmolarity. It is mostly found in elderly subjects with non-serious diabetes. Reference is made to 6 personal cases observed during a period of 14 months. The incidence of N.K.H.H.C. noted during this period was 2.2%; this was higher than that of ketoacidotic coma. Two patients died from hypovolaemic shock and one from septic complications. Three survived the episode. Treatment was based on three main points: high doses of insulin, though less than those employed for equal blood sugar levels in cases of ketoacidotic coma, hypotonic saline solutions, and correction of electrolyte imbalance. It is hoped that improved knowledge of the syndrome and, more particularly, earlier diagnosis and treatment, with lead to a reduction in the ta 50% mortality present associated with the disease.
mesh_terms: D000328:Adult; D000368:Aged; D003926:Diabetic Coma / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D009994:Osmolar Concentration; D012769:Shock / Q000517:prevention & control
chemical_list: D007328:Insulin
vernacular_title: Il coma iperglicemico iperosmolare non chetosico. Contributo casistico e considerazioni terapeutiche