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Differences between Hyperosmolar Non-Ketotic Hyperglycaemic Coma and Diabetic Ketoacidosis

The differences between diabetic ketoacidosis and hyperglycemic non-ketotic hyperosmolar coma are:

Diabetic ketoacidosis
Non-ketotic hyperosmolar coma
Definition Triad of: hyperglycemia, ketonemia and high anion gap acidosis State of hyperosmolality with low or no ketone bodies
Cause Excessive synthesis of ketone bodies from free fatty acids Severe hyperglycemia due to insufficient insulin resulting in plasma hyperosmolality and excessive water loss
Symptoms Kussmaul respiration, acetone breath, nausea, vomiting, abdominal pain Mental confusion, DehydrationComa
Lab Investigations Plasma glucose

Serum Urea

Serum creatinine

Serum ketones

Serum electrolytes

Plasma Osmolality

Urine analysis (ketones)

ABG analysis

Complete blood count with differentiatials

HbA1c

Plasma glucose

Serum Urea

Serum creatinine

Serum ketones

Serum electrolytes

Plasma Osmolality

Urine analysis (ketones)

ABG analysis

Complete blood count with differentiatials

HbA1c

General Treatment Fluid therapy

Insulin therapy

Potassium therapy

Bicarbonate  therapy

Fluid therapy

Insulin therapy

Potassium therapy

 

 

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