Hyperglycaemic-hyperosmolar-non-ketotic-coma: What are the differences in presentation as compared with dka?

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1. Hyperglycaemic-hyperosmolar-non-ketotic-coma: What are the differences in presentation as compared with dka?

Grade 1 - altered mood/behaviour, sleep disturbance grade 2 - increasing drowsiness and confusion grade 3 - stupor grade 4 - coma (unresponsive to verbal or noxious stimuli)
Presentation: * dka typically occurs in ti diabetics with a shorter history, 1-3/7. Presents with a ketosis and an acidosis. * honc typically occurs in tii diabetics and has a longer history of approx 1/52. The patient is often old and presenting for the first time. Presents with dehydration and raised glucose, typically more than 35mmol/l, and serum osmolality greater than 340mosmol/kg (normal is 285-300). Despite the name coma is only present in 10% of cases.
Stool mc+s (microscopy, culture and sensitivity) and cdt (c.diff toxin) to exclude infectious diarrhoea (c.diff, salmonella, shigella, campylobacter, e.coli) fbc, est, crp, u&e;, lft, and blood cultures. Axr ?colonic Dilatation (toxic > 6cm), perforation endoscopy and biopsy, sigmoidoscopy, colonoscopy, rectal biopsy barium enema - never do during an acute severe attack
Fluccloxacillin (+ fusidic acid for osteomyelitis) or clindamycin alone

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Hyperglycaemic-hyperosmolar-non-ketotic-coma: What are the differences in presentation as compared with dka?

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All trademarks, logos and brand names are the property of their respective owners. All company, product and service names used in this website are for identification purposes only. Use of these names, trademarks and brands does not imply endorsement.

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