The role of race and environment in the development of hyperosmolar hyperglycaemic non-ketotic coma.

Introduction It has been reported that hyperosmolar hyperglycaemic non-ketotic coma (HHNC) occurs more commonly in black patients (Pyke, 1969) and this has become an accepted part of clinical teaching on the subject (Oakley, Pyke and Taylor, 1978; Jackson and Vinik, 1977). Recently this point has been further emphasized (Nikolaides et al., 1981; Wright et al., 1981). Our personal observations however suggested that poor social circumstances might be more important than racial factors in the aetiology of HHNC. A retrospective analysis of patients with the condition presenting to Dudley Road Hospital, Birmingham, a district general hospital serving a substantial immigrant population, was thus undertaken.