Martin A
Postgrad Med J. 1968 Mar;44(509):218-22. doi: 10.1136/pgmj.44.509.218.
Three further cases of hyperosmotic non-keto-acidotic and non-lactic-acidotic diabetic coma have been described. A favourable outcome in these patients emphasizes the importance of recognizing this condition in its early stages. This may be difficult as there is no ketosis and no hyperventilation—features that one normally associates with diabetic coma. The signs are those of increasing drowsiness, gross dehydration, and occasionally of circulatory collapse, focal seizures and abdominal pain. Once diagnosed, vigorous treatment must be instituted with large doses of parenteral insulin and intravenous fluids, preferably normal saline initially, followed by mixtures of hypotonic saline and dextrose once the blood sugar has fallen significantly, together with adequate amounts of potassium. In this way it should be possible to reduce the previously high mortality rate.
本文描述了另外三例高渗性非酮症非乳酸酸中毒性糖尿病昏迷病例。这些患者的良好预后强调了在疾病早期识别该病症的重要性。这可能具有挑战性，因为不存在酮症和过度通气现象——而这些通常是人们与糖尿病昏迷联系在一起的特征。体征表现为嗜睡加重、严重脱水，偶尔还会出现循环衰竭、局灶性癫痫发作和腹痛。一旦确诊，必须立即进行积极治疗，给予大剂量肠外胰岛素和静脉输液，最初最好使用生理盐水，一旦血糖显著下降，随后使用低渗盐水和葡萄糖的混合液，并补充足量的钾。通过这种方式，应该有可能降低此前较高的死亡率。
