Eleven diabetics with hyperglycaemic hyperosmolar non-ketotic metabolic decompensation are described. In all but one an underlying cause was detected. Three had experienced previous episodes of severe ketoacidosis. The management was facilitated by the use of hypotonic fluid and the 2 deaths that occurred have been attributed to underlying disease.
Hyperosmolar non-ketotic coma is not a distinct clinical entity either with regard to aetiology, prognosis or treatment, but rather is one end of a wide spectrum of severe diabetic metabolic decompensation.
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