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January 29, 2001

Hyperglycemia and DKA

Question from a nurse in Hindman, Kentucky, USA:

Diabetes is one of the most prevalent illnesses that affect people in southeastern Kentucky, Therefore, I am continually looking for updates on this disease. My question involves a situation in which a patient’s blood sugar was 1400 mg/dl [77.8 mmol/L] in the emergency room, but ketones were negative. How is that possible? How long does it take for ketones to spill into the urine? How long did it take for the blood sugar to reach this level?


From: DTeam Staff

This is rather a big subject for an e-mail but you might ask the hospital librarian to look up some reviews for you on PubMed searching under “hyperosmolar, non-ketotic diabetic coma’.”


[Editor’s comment: For a more complete discussion of DKA [diabetic ketoacidosis] and HHNS, please see Acute Complications of Diabetes Mellitus (a slide show).