Diagnostic criteria for diabetic hyperosmolar coma, including blood glucose ≥33.3 mmol/L and effective plasma osmolality ≥320 Osm/(kg.H₂O).
1. Blood glucose ≥33.3mmol/L.
2. effective plasma osmolality ≥ 320 Osm/(kg.H₂O).
3. serum bicarbonate ≥15 mmol/L or arterial blood pH ≥7.3.
4. Strongly positive urine glucose with concomitant negative, or weakly positive, blood ketone bodies.
If the patient has concurrent lactic acidosis or diabetic ketoacidosis, a discrepancy between items 1, 3, and 4 of the above criteria is not a basis for a negative diagnosis.
Hyperosmolar coma in diabetic patients is a dangerous condition that requires rapid fluid administration to restore blood volume and correct dehydration, as well as lowering blood glucose to correct acid-base imbalances and electrolyte imbalances.
In addition, diabetic hyperosmolar coma is a serious acute complication of diabetes mellitus and must be treated early, otherwise the condition can be life-threatening if left unchecked.