Endocrine » Diabetes

Hyperosmolar hyperglycaemic nonketotic coma (HHNC)

Hyperosmolar hyperglycaemic non-ketotic coma (HHNC) is a metabolic derangement that occurs principally in patients with adult-onset diabetes. The condition is characterized by hyperglycaemia, hyperosmolality, and an absence of significant ketosis. HHNC has a mean age of onset early in the seventh decade of life. In contrast, the mean age for DKA is early in the fourth decade of life.The mortality rate is high (10-20%). Standard care for dehydration and altered mental status is appropriate, including airway management, IV access, crystalloid, and any medications routinely given to coma patients. Fluid deficits in HHNC are large; the fluid deficit of an adult may be 10 L or more.

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