North Carolina EMT State Practice Exam

Which condition is more commonly associated with type 2 diabetes patients?

1. Ketoacidosis

2. Hypermolar hyperglycemic nonketotic coma

3. Diabetic coma

4. Insulin shock

The correct answer is: Hypermolar hyperglycemic nonketotic coma

The condition more commonly associated with type 2 diabetes patients is hyperosmolar hyperglycemic nonketotic coma. This condition occurs primarily in individuals with type 2 diabetes and is characterized by extremely high blood sugar levels without the presence of significant ketosis or acidosis. In type 2 diabetes, the body's insulin resistance leads to inadequate glucose utilization, which causes elevated blood sugar levels. When combined with factors such as dehydration, infections, or other illnesses, this can escalate to hyperosmolar hyperglycemic state, where glucose levels become critically elevated. Hyperosmolar hyperglycemic nonketotic coma differs from diabetic ketoacidosis, which is more frequently seen in type 1 diabetes and is defined by the presence of ketones and acidosis due to insufficient insulin levels. Diabetic coma is a general term that might refer to a severe state due to complications from diabetes but does not specify the underlying biochemical reasons. Insulin shock, caused by an excess of insulin leading to dangerously low blood sugar, is also less common in type 2 diabetes, where insulin production may still be significant compared to type 1. Overall, understanding the typical complications associated with type 2 diabetes helps in effective management and recognition of potential emergencies.