Step I Non Ketotic Hyperosmolar Coma

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Kluver_Bucy

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What causes this in type 2 diabetics? Does it mean the patient is noncompliant with the diabetes drug? Can illnesses push someone over even if they were taking diabetic drugs?
 
It's when a TII diabetic with hyperglycemia either gets an infection or neglects to drink water.

The glucosuric osmotic diuresis leads to dehydration. Circulating insulin most likely suppresses ketogenesis, not allowing progression to frank DKA.

BTW, it's usually not a coma