Diabetic ketoacidosis

Abstract

The diabetic-related comas listed in order of their probable frequency are; 1) Hypoglycaemic coma. 2) Diabetic Ketoacidosis 3) Hyperglycaemic Hyperosmolar 110n- ketotic coma. 4) Lactic acidosis. Whilst in general, diabetic ketoacidosis occurs in patients with the insulin-dependent form of the disease, and the syndrome of hyperosmolar non- ketotic coma is commoner in the elderly diabetic, it is not uncommon to meet a combination of these disorders in a variable degree of severity in the same patient. This discussion, taken from studies and accounts by leading investigators including Foster and McGarry in the U.S.A. and 'Alberti, Johnston and Owens in England (see chart) wll concentrate on diabetic ketoacidosis. Although as stated above a combination of diabetic comas can occur, in general, Insulin . Dependent Diabetes Mellitus (LD.D.M) patients ordinarily do not progress to marked hyperosmolar coma, but hyperosmolar non-ketotic coma can develop in a patient with a Type I diabetes.