title: Hyperosmolar nonketotic diabetic coma.
abstract: The authors report the case of a 12-year-old boy with hyperosmolar nonketotic diabetic coma. Pathogenetic aspects and the HLA genotype are discussed. To reduce the hyperglycaemia, a continuous intravenous infusion of regular insulin at a low rate was used. The too rapidly infused sodium-bicarbonate overloaded tha body with sodium and caused intracellular sodium accumulation with edema. This could explain the disorientation after regaining consciousness. Much more important than the sodium-bicarbonate infusion is an accurate rehydration regimen.
mesh_terms: D001639:Bicarbonates / Q000627:therapeutic use; D002648:Child; D003926:Diabetic Coma / Q000175:diagnosis*; D005838:Genotype; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000175:diagnosis* / Q000188:drug therapy; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D013997:Time Factors
chemical_list: D001639:Bicarbonates; D006680:HLA Antigens; D007328:Insulin