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Diabetic Coma is a situation where a person
diagnosed with diabetes mellitus lose consciousness due to either
very high blood sugar (hyperglycemia) or very low blood sugar
(hypoglycemia). If no medical attention seek, diabetic coma is a
life threatening condition.
However, you are capable to prevent diabetes
complications by eating a healthy diet, taking your medication as
prescribed and closely monitoring your blood sugar. There are three
types of coma associated with diabetes - Keotacidotic coma, diabetic
hyperosmolar syndrome and hypoglycaemic coma.
Ketoacidotic Coma
Ketoacidotic coma is more common in people with
Type 1 diabetes. It is a type of coma triggered by the accumulation of
harmful acids known as ketones in the blood. Ketones are by-products produced as a result of fat being broken
down into fatty acids. This occurs when your muscle cells become
starved for energy.
Ketones are strongly acid and
cause the blood to become too acidic. When
the body does not have the help of insulin, ketones build up in the
blood and “spill” over into the urine so that the body can get rid
of them. Ketones that build up in the body for a long time lead to
serious illness and coma.
Symptoms of ketoacidosis include,
Hyperosmolar Coma
Hyperosmolar coma is a complication of type 2 diabetes
caused by severe dehydration and very high blood glucose levels at
around 600 mg/dL without the presence of ketones.
Normally, the kidneys make up for high glucose levels in the blood
by allowing the extra glucose to leave the body in the urine.
However, when water is scarce, the kidneys conserve fluid, and
glucose levels become higher. This results in greater need for
water.
The
blood
is concentrated with sodium, glucose, and other molecules that
normally attract water into the bloodstream. When the kidneys are
conserving water, however, this creates a vicious cycle of
increasing blood-glucose levels and increasing dehydration.
Those at most risk of this type of coma
are people with Type 2 diabetes, who have an infection or acute
illness and have reduced their intake of fluids or are taking
diuretic medication or steroids.
Symptoms of
Hyperosmolar coma include,
Hypoglycemic Coma
Hypoglycemia is a medical term referring to a
pathologic state produced by a lower than normal amount of sugar in
the blood. It happen from an inadequate supply of glucose as fuel to
the brain, can suffer destruction of neurons in the hippocampus and
cerebral cortex, areas of the brain that are essential to memory and
cognition.
Hypoglycemia is
common among people who take too much insulin or skip meals or snacks.
Exercising too vigorously or drinking too much alcohol can have the
same effect. How quickly your blood sugar drops influences the
symptoms of hypoglycemia. For example, if it takes a few hours for
your blood sugar to drop 50 mg/dL, the symptoms may be minimal. If
your blood sugar drops the same amount in a few minutes, the
symptoms will be more pronounced.
Symptoms of Hypoglycemia include,
First aid for diabetic coma:
First aid for someone who has lapsed into a diabetic coma includes:
-
Call 911 (US Only) for immediate medical
care attention by paramedic, or transport to an
emergency room or clinic or doctor's office.
-
Don't try to give unconscious patient
anything to eat or drink, as they may choke.
-
Turn patient onto their side to
prevent obstruction to breathing.
-
NEVER GIVE INSULIN unless you are
completely certain you know what you're doing and are sure the
patient is NOT HYPOGLYCEMIC. Mistakes with insulin can
kill..
-
If medical equipment such as glucose
meters are available, take a blood glucose level reading of the
patient immediately.
-
If the patient is conscious and
suffering from hypoglycemia, give sugar in some form. Fruit juice,
glucose or white sugar dissolved in juice or water, glucose
tablets or gel, BUT NOT diet drinks. Artificial sweetners do
not work. Avoid fatty, oily, or protein rich foods if possible, for
digestion and absorption of the sugar will be delayed. If
suffering from hyperglycemia, do not feed the patient. Push water
while conscious instead. And get the patient to medical treatment
promptly.
Diagnosis methods
The cause of a diabetic coma is diagnosed using a number of tests,
including:
Treatment options
Treatment options for diabetic coma include,
-
Ketoacidotic Coma - intravenous
fluids, insulin, and administration of potassium and sodium.
-
Hyperosmolar Coma - plenty of
intravenous fluids, insulin, potassium and sodium given as soon as
possible.
-
Hypoglycemic Coma - administration of
the hormone glucagon to reverse the effects of insulin, or glucose
given intravenously.
Risk factors
Anyone diagnosed with diabetes is at risk for a diabetic coma.
However, risk factors for the conditions that may lead to a diabetic
coma vary.
For example, diabetic ketoacidosis is most common in people who have
type 1 diabetes. Diabetic hyperosmolar syndrome is most common in
older adults with type 2 diabetes especially those who don't monitor
their blood sugar or who don't know they have diabetes.
Prevention
The best way to prevent a diabetic coma is through day-to-day
control of your diabetes. Keep these tips in mind:
Follow your diet plan with consistent snacks and meals can help you
manage your blood sugar. Closely monitor your blood sugar level, frequent blood sugar tests
can tell you whether you're keeping your glucose levels in your
target range and alert you to dangerous ahead.
Take your medication as per-described by your doctor. If you have frequent episodes of
high or low blood sugar, your doctor may adjust the dosage or timing
of your medication. Your doctor may use a glycated hemoglobin test
to determine how well you're managing your blood sugar.
Educate your loved ones, friends and co-workers how to recognize early signs and symptoms
of blood sugar extremes and how to summon emergency help should you
pass out. It also helps to occasionally review the education
material you were given when you were first diagnosed with diabetes.
Wear a medical ID bracelet or necklace. If you're unconscious, the
ID can provide valuable information to your loved ones, co-workers
and others including emergency personnel.
Above all, keep your perspective. For most people who have diabetes,
the risk of a diabetic coma is small. Take good care of yourself to
help prevent diabetes complications.
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