Virginija Žilinskaitė, Veslava Žukovskaja, Danutė Petraitienė
Abstract
Hyperglycemic hyperosmolar nonketotic state was infrequently diagnosed till recently. Now its being diagnosed with increased frequency in obese children with type 2 diabetes mellitus. The syndrome is characterized by severe hyperglycemia, a marked increase in serum osmolality and dehydration without ketoacidosis. Significant ketogenesis is restrained by the ability of pancreas to secrete a small amount of insulin. Prolonged phase of osmotic diuresis leads to severe depletion of body water and electrolytes, resulting in hypertonic dehydration. These children usually present with signs of severe dehydration and depressed mental status but continue to have increased urine output what leads to complications such as rhabdomyolisis and malignant hyperthermia. Treatment is directed at restoration of the intravascular volume, followed by correction of deficits of fluids and electrolyte, hyperglycemia and serum hyperosmolality, and through search for conditions that may lead to decompensation. Careful monitoring of glucose levels and ensuring adequate hydration in patients „at risk“ of hyperglycemic hyperosmolar nonketotic state could be a method of effective prophylaxis of this urgent condition
Keyword(s): hyperglycemic hyperosmolar nonketotic state; diabetes mellitus; children
DOI: 10.5200/388
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