Cardiovascular

Patients have varying degrees of dehydration and hypovolemia. Hyperglycemia and osmotic diuresis leads to intracellular and interstitial depletion, with sunken eyes, dry mucous membranes, and loss of skin turgor. Hypovolemia is common, and is manifested by hypotension, tachycardia, oliguria, poor peripheral perfusion, and lactic acidosis.

Patients with hyperosmolar non-ketotic coma have usually suffered greater fluid depletion than patients with diabetic ketoacidosis because they have been hyperglycemic for longer and consequently have had greater water and electrolyte loss from osmotic diuresis. These patients also often have restricted access to oral fluids.

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