Diabetic non-ketotic hyperosmolar coma (hypertonic coma) is another clinical type of acute metabolic disorder in diabetes mellitus. The clinical features are severe dehydration, hyperglycemia, high plasma osmolality and neuropsychiatric symptoms. I. Diagnostic points 1. Clinical manifestations: drinking and urination, but anorexia or less food. With the aggravation of dehydration, neuropsychiatric symptoms appear, such as irritability, drowsiness, hallucinations, disorientation, partial blindness, upper limb tapping-like coarse tremor, etc., and finally coma. 2. Laboratory tests: strong positive urine glucose, negative or weak positive urine ketones. The prominent manifestation is a significant increase in blood glucose, generally 33.3-66.6 mmol/L, blood sodium can be as high as 155 mmol/L, plasma osmolality is significantly increased up to 330-460 mOsm/Kg?H2O, blood urea nitrogen and creatinine is elevated. 3. Prognosis: The disease is critical, with many complications, mostly in the elderly, preferably aged 50-70 years, about half of the patients do not have a history of diabetes before the onset of the disease, the death rate can be as high as 40% or more. Treatment measures Treatment measures are similar to those for ketoacidosis. Nursing measures The possibility of dehydration of human brain cells turning into cerebral edema should be closely observed, and if found, dehydration treatment should be used. 4. Prevention points Senior patients should avoid triggers that induce this disease such as: infection, acute gastroenteritis various stresses, high intravenous nutrition, certain drugs such as glucocorticoids, diuretics unreasonable application.