Fatty Acid and Carbohydrate Metabolism in Nonketotic Hyperosmolar Coma (NKHC).

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Abstract
Despite increasing recognition of nonketotic hyperosmolar coma, the pathophysiology of this syndrome, particularly the absence of ketoacidosis (KA), remains obscure. Thirty-two episodes were studied in 30 patients; in 16 of these determinations were made of plasma free fatty acid (FFA), growth hormone (HGH), immunoreactive insulin (IRI), ketones, osmolity (Osm), and blood glucose. FFAs were determined by the method of Dole, HGH and IRI by radioimmunoassay, ketones by Acetest tablets, and Osm by freezing-point depression. In all cases the plasma acetone was < 2 + at a 1:1 dilution; blood sugar, > 600 mg/100 ml (av 1173 ± 306); and serum

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