Hyperosmolar nonketotic hyperglycemic coma is a crisis in type 2 diabetes primarily, where the sugar levels rise very, very high, and the blood in a sense becomes so thick that normal cognitive processes are not possible. You’re not thinking clearly anymore, and you gradually slip into a sleep or coma, and there can be consequences for the body as well.

This happens typically slowly. So a person with type 2 diabetes is getting a large amount of nutrients, but is not getting enough water, enough fluid. So when you are, for example, taking over the nutrition for somebody who is sick, you have to be sure to not give them just food, you have to give them enough water to balance out the essentially osmolar load, glucose load of their food.

It is primarily treatable, again, in the hospital by fluid. That’s the big rescue agent, although the sugar may be very, very high in this condition, the real problem is volume, is fluid. Typically, tiny amounts of insulin will bring the blood sugar down quite effectively as long as you’re giving large amounts of fluid and the fluid means not just water, it means saline, it means salt and water.