Diabetic Coma
Diabetic coma is a life threatening conditions if left untreated

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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,

• extreme thirst

• lethargy

• frequent urination

• nausea

• vomiting

• abdominal pain

• progressive drowsiness

• deep, rapid breathing

• a fruity or acetone smell on the breath may also be present.

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,

• trembling

• palpitations

• weakness

• sweating

• intense hunger

• confusion, altered behavior, drowsiness or coma may occur if the blood glucose becomes very low.

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:

• Medical history.

• Physical examination.

• Blood tests, including glucose and ketones.

• Urine tests.

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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