Editing Diabetic coma (section)

===Nonketotic hyperosmolar coma===
[[Nonketotic hyperosmolar coma]] usually develops more insidiously than diabetic ketoacidosis because the principal symptom is lethargy progressing to [[obtundation]], rather than vomiting and an obvious illness. Extremely high blood sugar levels are accompanied by dehydration due to inadequate fluid intake. Coma occurs most often in patients who have [[type 2 diabetes|type 2]] or [[steroid diabetes]] and have an impaired ability to recognize thirst and drink. It is classically a [[nursing home]] condition but can occur in all ages.

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800&nbsp;mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.