In hyperosmolar hyperglycemic non ketotic coma the blood glucose level is around –
**Core Concept**
Hyperosmolar hyperglycemic non-ketotic coma (HHNK) is a life-threatening complication of diabetes mellitus characterized by severe hyperglycemia, dehydration, and hyperosmolarity. This condition typically occurs in type 2 diabetic patients who are elderly or have underlying comorbidities.
**Why the Correct Answer is Right**
The blood glucose level in HHNK is typically extremely high, often exceeding 600 mg/dL. This severe hyperglycemia leads to an osmotic shift of water from cells to the bloodstream, causing dehydration and hyperosmolarity. The lack of ketone production in HHNK distinguishes it from diabetic ketoacidosis (DKA), which is another severe complication of diabetes.
**Why Each Wrong Option is Incorrect**
**Option A:** This value is too low to be characteristic of HHNK, which typically presents with blood glucose levels above 600 mg/dL.
**Option B:** While this value is higher than normal, it is not representative of the extreme hyperglycemia seen in HHNK.
**Option C:** This option is incorrect because the blood glucose level in HHNK is usually much higher than in a typical case of DKA.
**Clinical Pearl / High-Yield Fact**
HHNK is a medical emergency that requires prompt recognition and treatment to prevent mortality. The key to diagnosis is identifying the extreme hyperglycemia and dehydration in the absence of ketosis.
**Correct Answer: C. 350-600 mg/dL**