BIOCHEM 3H03 Lecture Notes - Lecture 18: Hyperosmolar Hyperglycemic State, Sepsis, Hypothermia
12 Apr 2017
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Document Summary
Feature of type 1 diabetes due to absolute lack of insulin. Type 2 diabetes is characterized by hyperosmolar non-ketotic coma. Feature of type 2 diabetes: marked hyperglycemia (> 50 mmol/l), but no ketosis. High glucose causes: osmotic diuresis, severe water and electrolyte loss, volume depletion, na+ due to water loss, increased plasma osmolality, coma develops due to cerebral dehydration. Treatment: fluid replacement to restore blood volume and glomerular filtration, insulin if required in small doses, monitor k, laboratory role, monitoring of metabolic state similar to role in dka. Type ii due to insulin resistance: relative but not absolute lack of insulin. Glucagon: insulin ratio not high enough to allow runaway lipolysis. Increased glucose but little or no increase in ketones. Type 1 diabetes almost always diagnosed when patient presents in crisis. Type 2 diabetes almost always diagnosed using lab data. Reactive hypoglycemia: following a stimulus including a meal.
