Three further cases of hyperosmotic non-keto-acidotic and non-lactic-acidotic diabetic coma have been described. A favourable outcome in these patients emphasizes the importance of recognizing this condition in its early stages. This may be difficult as there is no ketosis and no hyperventilation—features that one normally associates with diabetic coma. The signs are those of increasing drowsiness, gross dehydration, and occasionally of circulatory collapse, focal seizures and abdominal pain.
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