What happens when a diabetic doesn't get enough hydration?
Hyperosmolar nonketotic syndrome is a syndrome that happens in adults generally with diabetes where they don't actually have enough access to water. Unlike diabetic ketoacidosis, which happens in people with type 1 diabetes where they're very suddenly sick, adults that get hyperosmolar nonketotic syndrome get gradually sick; say over a week, and I often see it in people, say for example they're in a nursing home and can't get to enough water. They're sort of out of it, and their blood sugars instead of being the normal 100 go to 200 and then 400 and then 600 and then to 1000. These are very, very, very sick people, and often they've had a heart attack or they have an infection and it often kills them. On the other hand, they're very simple to treat in a way; they really just need gentle hydration, and a little bit of insulin and they'll come back down to normal. I have seen younger people with this; just the other day I saw a 45 year-old with hyperosmolar nonketotic syndrome who was admitted to a hospital. He hadn't really taken care of or noticed his symptoms over a week and got very sick, came to my clinic after being discharged from the hospital and is now doing fine. So, hyperosmolar nonketotic syndrome is really a state of the body just becoming extremely dehydrated due to high blood sugar levels, but because it happens in elderly people who are also sick for other reasons it can be very serious.
