It is a life-threatening medical emergency due to stress truama that is more common in old age - usually living alone - Mainly DM 2 Manifestation. Hyperglycemia causes to ↑ water loss (osmotic diuresis) with little sodium loss → severe dehydration and hyperosmolarity.
Treatment: similar to DKA except in:
- Fluids: rapid and aggressive i.v. isotonic saline: the principal treatment.
- Insulin is needed in smaller amount than in DKA. Insulin used without concomitant vigorous fluid replacement increases the risk of shock.
- Hypokalemia is usually less marked .
- Low dose of heparin to prevent thrombotic complications.