Haemostatic changes in diabetic coma

The "third coma" in diabetes: diabetic coma without ketoacidosis.

THE COMPLEXITIES of the diabetic syndrome are underlined by the fact that diabetic coma may occur without obvious ketoacidosis. The position has recently been summarised in a leading article in the British Medical Journal (1965). To the first two comas met with in diabetes, namely diabetic coma with ketosis and hypoglycaemic coma due to excess insulin, must then be added a third type of coma. T...

The management of diabetic coma.

Reinterpretation of hyperamylasemia in diabetic coma.

Serum enzyme activity was sequentially determined in 10 consecutive patients with diabetic ketoacidosis, of whom all had increased -glucuronidase activity, eight had increased amylase activity, and four had increased acid phosphatase activity. Activity of amylase and that of the two lysosomal enzymes were poorly correlated, irrespective of whether peak activities or activities of all samples we...

Cardiac enzyme changes in myxedema coma.

A 74-year-old man with myxedema and hypothermia had increased activities in plasma of creatine kinase (CK; EC 2.7.3.2), aspartate aminotransferase (AST; EC 2.6.1.1), and lactate dehydrogenase (LD; EC 1.1.1.27) and increased proportions of CK-MB (up to 20% of total CK) and LD1 isoenzymes, but no clinical or investigational evidence of associated myocardial infarction. This case illustrates that ...

Hyperosmolar non-ketotic diabetic coma and rhabdomyolysis.

Rhabdomyolysis is a rare but potentially fatal complication of hyperosmolar states. We report a case of severe hyperosmolar non-ketotic diabetic coma causing rhabdomyolysis in a young man. Despite very high levels of creatine kinase there was no detectable myoglobinuria. Creatine kinase estimation should be a standard investigation in all patients presenting with a hyperosmolar state.