Nonketotic hyperosmolar coma is a type of diabetic coma associated with a high mortality seen in diabetes mellitus type 2. The preferred term used by the American Diabetes Association is hyperosmolar nonketotic state (HNS). Another commonly used name is hyperosmolar hyperglycemic nonketotic coma (HHNKC). Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of three acute complications of diabetes: Severe diabetic hypoglycemia Advanced diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic... Diabetes mellitus type 2 (formerly Diabetes mellitus type II and also known as non-insulin-dependent diabetes, NIDDM or adult-onset diabetes) is a long-term metabolic disorder that is primarily characterized by insulin resistance, hyperglycemia, relative insulin deficiency and obesity. ... The American Diabetes Association, or the ADA, is an American health organization providing diabetes research, information and advocacy. ...

Nonketotic coma is usually precipitated by an acute illness. The serum glucose is usually higher than 600 mg/dl, and the resulting serum osmolarity is greater than 350 mOsm. Ketosis is absent because the presence of insulin inhibits lipolysis, unlike diabetic ketoacidosis. Glucose (Glc), a monosaccharide, is one of the most important carbohydrates. ... Osmolality, in biology and chemistry, is a measure of moles of solute per kg of water. ... Ketosis (keh-toe-sis) is a stage in metabolism occurring when the liver has been depleted of stored glycogen and switches to a fasting mode such as occurs during sleep, during dieting, and during the bodys response to starvation. ... The structure of insulin. ... Lipolysis is the breakdown of fat stored in fat cells. ... Diabetic ketoacidosis (DKA) is one consequence of severe, out-of-control diabetes mellitus (chronic high blood sugar, or hyperglycemia). ...

The treatment involves slow hydration and insulin. Anticoagulants (such as low molecular weight heparins) are often commenced as there is a significant rate of thrombosis in patients with NKHC. The structure of insulin. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... In medicine, low molecular weight heparin (LMWH) is a class of medication used as an anticoagulant in diseases that feature thrombosis, as well as for prophylaxis in situations that lead to a high risk of thrombosis. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ...