Abstract
Clinical data on seven cases of hyperosmolar nonketotic coma with hyperglycemia (HNC) of the aged were reported. The age at onset of the disease was 66 to 89. Of particular interest was the fact that the diagnosis of cerebrovascular disease was made in four cases when they were admitted. As the underlying diseases, diabetes and dementia were noted in four and six cases respectively. It was emphasized that dementia played a causative role in the occurence of HNC, since the water intake in these patients was very poor probably due to the decreased thirst sensation. The characteristic signs and symptoms of the patients were dehydration, disturbance in consciousness and seizures. The average blood sugar level was 635.4mg/dl and the average serum osmolality was 372.9 mOsm/1. Urinary ketone body was negative and serum Na, Cl and BUN were elevated in many cases. The patients were treated with 28-130 units of regular insulin and 3-10.8 liters of isotonic or hypotonic solutions. Mortality rate was as high as 43 %.
