Hyperosmolar non-ketotic diabetic coma induced by furosemide in modest dosage.

Introduction Thiazides are known to diminish glucose tolerance and precipitate or aggravate diabetes, but that furosemide may do so is not so well appreciated (Walsh and O'Sullivan, 1974; Solvsteen, Olsen and Hansen, 1968; Toivonen and Mustala, 1966; Heimsoth and Bock, 1970). Large doses of furosemide may be a factor responsible in causing hyperosmolar non-ketotic diabetic coma (Tasker and Mitchell-Heggs, 1976). but quite modest or small doses such as are widely prescribed, may also be implicated (Lavender and McGill, 1974). This form of coma may also be brought on in certain circumstances by the consumption of large quantities of sweet drinks (Macaulay, 1971). The case described below shows a combination of these two factors.