Hyperglycemic hyperosmolar nonketoacidotic coma developed in a twenty-year-old female with uremia when treated for hypertension with intravenous diazoxide. Low circulating serum insulin concentrations were found in this patient as well as in four others with this syndrome, thus supporting the recent hypothesis that these concentrations of insulin are adequate to block lipolysis but insufficient to prevent hyperglycemia. In view of the recognized inhibitory effect of diazoxide on pancreatic insulin release and peripheral glucose nietabolism, it is recommended that patients receiving intravenous diazoxide be observed for possible severe disturbances of carbohydrate metabolism and resulting hyperosmolarity.

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