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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