diabetic coma :Causes-Symptoms-Diagnosis-Treatment
What is a diabetic coma?
If you have diabetes, diabetic coma is a life-threatening emergency. In this state, you are unconscious and unable to respond to your environment. You may be suffering from high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). If you go into a diabetic coma, call for medical help right away.
Diabetic acidosis generally happens in folks with type one diabetes, that was antecedently referred to as growth-onset diabetes or hormone dependent diabetes mellitus (IDDM), though it will sometimes occur in type a pair of diabetes. This sort of coma is triggered by the build-up of chemicals referred to as ketones. Ketones are powerfully acidic and cause the blood to become too acidic.
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Once there's not enough insulin circulating, the body cannot use aldohexose for energy. Instead, fat is lessened and so reborn to ketones within the liver. The ketones can build up to a fault when insulin levels stay too low.
Common causes of acidosis embrace a lost dose of hormone or associate acute infection during a person with sort one diabetes. acidosis is also the primary sign that an individual has developed type 1 diabetes.
Medical terms
- A diabetic coma is a critical polygenic disease complication that causes unconsciousness. If you've got diabetes, perilously high glucose (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can cause a coma. If you lapse into a diabetic coma, you're alive — however you'll be able to awaken or respond purposefully to sights, sounds or different varieties of stimulation. Left untreated, a diabetic coma is often fatal. The thought of a diabetic coma is scary, but you can take steps to assist in stopping it. begin by following your diabetes treatment plan.
- is a life threatening condition Diabetic coma is a life-threatening condition that is caused by severe hyperglycemia It results from insulin deficiency or ineffective insulin action which leads to high blood glucose levels in the body Insulin regulates glucose metabolism in the liver muscle and fat cells so without it these cells fail to take up glucose effectively This causes an increase in glucose concentration of the blood (hyperglycemia) Diabetic coma can occur at any age but it usually occurs between the ages of 30 and 60 years old.
A diabetic coma is a serious condition in which high blood sugar levels lead to an insufficient supply of oxygen to the brain Diabetic comas can lead to permanent brain damage and death The best way to prevent a diabetic coma is by monitoring blood glucose levels following your doctor's orders for diet and exercise taking insulin or other medications regularly and keeping good records of your health history.
What is diabetic hyperosmolar syndrome?
Diabetic hyperosmolar syndrome is a disorder that occurs when a person with diabetes has very high blood sugar levels It can occur in people with type 2 diabetes when they have not been able to keep their blood sugar under control People with type 1 diabetes however may develop this condition at all stages of their disease In both cases the high blood sugar levels can lead to dehydration and an imbalance in the body's electrolytes If left untreated diabetic hyperosmolar syndrome can lead to kidney failure and death.
Is HHS worse than DKA?
Hyperglycemic hyperosmolar nonketotic (HHNK) syndrome is a severe complication of diabetes that can lead to serious long-term consequences if not detected quickly and treated properly This condition occurs when blood glucose levels are extremely high usually due to undiagnosed or poorly controlled type 2 diabetes Although it's less common than diabetic ketoacidosis (DKA) HHNK shares many of the same symptoms and treatment requirements as DKA It is important to know the signs of HHNS so that you can seek medical attention immediately if you suspect that you or someone you love has this condition.
Symptoms Diabetic Coma
If you have any of the following symptoms, your blood sugar might be too high or too low.
If you experience any of these symptoms, check your blood sugar. If it is too high or too low, treat it as your healthcare provider directs to prevent a diabetic coma. If you have diabetes for a long time, you may fall into a coma without displaying any signs.
Before developing a diabetic coma, you'll usually experience signs and symptoms of high blood sugar or low blood sugar.
High blood sugar (hyperglycemia)
If your blood sugar level is too high, you may experience:
Increased thirst
Frequent urination
Fatigue
Nausea and vomiting
Shortness of breath
Stomach pain
Fruity breath odor
A very dry mouth
A rapid heartbeat
Low blood sugar (hypoglycemia)
Signs and symptoms of a low blood sugar level may include:
Shakiness or nervousness
Anxiety
Fatigue
Weakness
Sweating
Hunger
Nausea
Dizziness or lightheadedness
Difficulty speaking
Confusion
Some people, particularly those who've had polygenic disorder for an extended time, develop a condition referred to as hypoglycemia unconsciousness and won't have the warning signs that signal a visit to glucose. If you experience any symptoms of high or low blood sugar, take a look at your blood sugar and follow your diabetes treatment set up to support the test results. If you don't begin to feel higher quickly, otherwise you start to feel worse, you need emergency help.
When to see a doctor
A coma could be a medical emergency. If you are feeling extreme high or low blood glucose signs or symptoms and assume you would possibly pass out, decide 911 or your native emergency number. If you're with somebody with polygenic disorder who has passed out, necessitate emergency help, and make certain to let the emergency personnel apprehend that the unconscious person has diabetes.
Causes Diabetic Coma
Blood sugar that's either too high or too low for too long may cause various serious conditions, all of which can lead to a diabetic coma.
Diabetic coma is caused by a high or low blood sugar level. In people with Type 2 diabetes, this condition is called diabetic hyperosmolar syndrome.If you have this condition:
Your blood sugar could be over 600 mg/dL.
Your urine will not usually contain ketones.
Your blood will be thicker than usual.
Diabetic ketoacidosis is a condition that is more common in people with type 1 diabetes. Things to know about this condition include:
Low blood sugar can happen at any level, depending on the person.
Your body uses fatty acids to provide energy instead of glucose.
Your urine and bloodstream will have ketones (a type of energy) when you are fasting.
Diabetic ketoacidosis. If your muscle cells become starved for energy, your body could respond by breaking down fat stores. This method forms hepatotoxic acids called ketones. If you've got ketones (measured in blood or urine) and high blood sugar, the condition is named diabetic acidosis. Left untreated, it will result in a diabetic coma. Diabetic ketoacidosis is commonest in kind one polygenic disease however generally happens in type two diabetes or physiological condition diabetes.
Diabetic hyperosmolar syndrome. If your glucose level tips above 600 milligrams per metric capacity unit (mg/dL), or 33.3 millimoles per liter (mmol/L), the condition is termed diabetic hyperosmolar syndrome. Severely high blood sugar turns your blood thick and syrupy. The surplus sugar passes from your blood into your urine, which triggers a filtering method that pulls tremendous amounts of fluid from your body. Left untreated, this will cause grave dehydration and a diabetic coma. Concerning twenty five to fifty % of individuals with diabetic hyperosmolar syndrome develop a coma.
Hypoglycemia. Your brain desires glucose to function. In severe cases, low blood glucose could cause you to pass out. symptoms are often caused by an excessive amount of internal secretion or not enough food. effort too smartly or drinking too much alcohol will have identical effects.
Risk factors Diabetic Coma
There are many risks for people who have diabetes, depending on the type of diabetes they have.
People with Type 1 diabetes are at a greater risk of going into a diabetic coma as a result of diabetic ketoacidosis or hypoglycemia. This is because people with Type 1 diabetes always require insulin and have wider blood sugar levels than people with Type 2 diabetes.
People with Type 2 diabetes have a greater chance of going into a coma from diabetic hyperosmolar syndrome than from any other type of diabetic complication.
There are other risks that can lead to diabetic coma in anyone who has diabetes, including:
Surgery.
Trauma.
Illness.
Insulin delivery problems.
Poor diabetes management.
Drinking alcohol.
Skipping doses of insulin.
Using illegal substances.
Anyone who has diabetes is at risk of a diabetic coma, but the following factors can increase the risk:
Insulin delivery problems. If you're on an associate degree endocrine pump, you've got to envision your glucose frequently. Endocrine delivery will stop if the pump fails or the tube (catheter) is twisted or falls out of place. A scarcity of insulin can cause diabetic ketoacidosis.
An illness, trauma or surgery. When you're sick or injured, glucose levels tend to rise, generally dramatically. This might cause diabetic diabetic acidosis if you have got one polygenic disorder and don't increase your hormone indefinite quantity to compensate. Medical conditions, reminiscent of symptom failure or urinary organ disease, additionally may increase your risk of diabetic hyperosmolar syndrome.
Poorly managed diabetes. If you don't monitor your glucose properly or take your medications as directed, you'll have a better risk of developing semipermanent complications and a diabetic coma.
Deliberately skipping meals or insulin. Sometimes, individuals with polygenic disorder who even have associate degree disorder select to not use their internal secretion as directed with the hope of losing weight. This can be a dangerous, dangerous application that will increase the danger of a diabetic coma.
Drinking alcohol. Alcohol can have unpredictable effects on your glucose. Alcohol's sedating effects might create it more durable for you to grasp once you're having low blood sugar symptoms. This will increase your risk of a coma caused by hypoglycemia.
Illegal drug use. Illegal drugs, such as cocaine and ecstasy, can increase your risk of severe high blood sugar levels and conditions linked to diabetic coma.
What happens when someone goes into diabetic coma?
Diabetic coma also known as diabetic ketoacidosis or DKA is a serious complication that results from untreated diabetes In DKA the body produces higher than normal levels of blood acids called ketones because it is not getting enough insulin to convert sugars and starches into energy Without insulin blood sugar levels rise to dangerous levels DKA can be life-threatening unless the person is treated promptly in an intensive care unit People with type 1 diabetes are at greater risk for developing DKA than their counterparts with type 2 diabetes.
Do you give insulin for diabetic coma?
Yes Insulin is a hormone produced in the pancreas an organ located behind the stomach and between the intestines Insulin helps keep blood sugar levels within a normal range by moving excess sugar out of your bloodstream and into your body’s cells When you have type 1 diabetes you don’t produce enough insulin to do this job Without insulin blood sugar builds up in your blood instead of going where it needs to go When blood sugar rises too high it can cause symptoms such as extreme thirst and hunger; frequent urination; weight loss; nausea or vomiting; and blurred vision If high blood glucose is not treated for an extended.
How is hypoglycemia coma treated?
The treatment for hypoglycemia coma is to give something to raise the blood sugar level such as glucagon glucose syrup honey or orange juice If the person is unconscious then glucagon injection should be given intravenously After giving this injection notify the doctor immediately.
What is end stage diabetes?
End stage diabetes is a condition in which the pancreas no longer produces enough insulin to control blood sugar levels After about 10 years of diabetes the body’s cells become resistant to insulin which means that more and more are needed to get glucose into cells Eventually this causes the pancreas to fail and there isn't enough insulin produced for the body's needs resulting in high blood glucose levels (hyperglycemia).
How do you know you are dying from diabetes?
When you have diabetes your body doesn’t produce enough insulin or can’t use it properly This causes glucose (sugar) to build up in the blood instead of being absorbed into the body’s cells for energy If a person has had diabetes for a long time his or her doctor may be able to tell by performing a physical examination and looking at factors such as weight loss thirst and frequent urination However if a person has diabetes and is not aware of it there may be no symptoms until the condition becomes very serious.
At what level blood sugar is a diabetic coma?
If you are a diabetic you have the potential of slipping into a coma if your blood glucose level goes too low This can happen to those who skip their insulin shots or those who have poor control over their diabetes While it is possible for anyone with diabetes to go into a coma the risk is greater in people with type 1 diabetes than in people with type 2 diabetes When controlling your blood sugar it is important that you do so carefully and consistently to avoid this problem.
Complications diabetic coma
If a diabetic has a coma, there can be serious complications, including permanent brain damage and death.
Left untreated, a diabetic coma can lead to:
Permanent brain damage
Death
Prevention diabetic coma
If you have diabetes, taking steps to keep your blood sugar in a healthy range is important. Meeting with a certified diabetes educator (CDE) can help you be aware of signs that your blood sugar is high or low. There are various levels of care that can be taken to manage your condition.
It is important for your family and friends to know how to help you if you experience low or high blood sugar levels. Let them know about the signs of high and low blood sugar levels.
Here are some tips for preventing diabetic coma: -Drink plenty of fluids and avoid sugary drinks -Eat foods that are high in carbohydrates and fiber, such as whole grains, legumes, and fruits -Avoid fasting or going too long without eating
Understand the foods that affect your blood sugar and find a meal plan that is best for you.
Don’t skip meals.
If you have low blood sugar, carry supplies with you at all times (such as four glucose tabs in a small juice box or five Life Savers).
Avoid drinking too much alcohol.
If you ever experience severe low blood sugar, ask your healthcare provider to prescribe a glucagon kit. You'll also need to have someone knowledgeable about how to use it in case of an emergency.
Here are some other things that may help you manage your blood glucose levels:
Follow the instructions from your healthcare provider about checking blood sugar levels at specific times.
Follow the instructions for taking medications and insulin in a proper and timely manner.
Exercise has different effects on blood sugar levels.
When blood sugar levels are high, check your urine for ketones. Ketones are chemicals that are produced when the body is trying to use energy from food instead of glucose.
When and how often should you test your blood for ketones? Ask your healthcare provider.
When you have symptoms of diabetic ketoacidosis, such as nausea, vomiting, and breathlessness, you should check your urine for ketones.
If you are monitoring your sugar levels with a continuous glucose monitor, you might get an alert if your sugar levels drop or rise too much.
Learn how to manage stress.
If you have diabetes, wear a medical identification necklace or bracelet to let first responders know.
Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind:
Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.
Keep an eye on your blood sugar level. Frequent blood glucose tests will tell you whether or not you're keeping your blood sugar level in your practice range — and provide you with a warning of dangerous highs or lows. Checking a lot oftentimes if you've exercised as a result of exercise can cause blood sugar levels to drop, even hours later, particularly if you don't exercise regularly.
Take your medication as directed. If you have frequent episodes of high or low blood sugar, let your doctor know. He or she might have to regulate the dose or the temporal order of your medication.
Have a sick-day plan. Illness will cause a sudden amendment in glucose. If you're sick and unable to eat, your blood sugar could drop. Before you get sick, speak along with your doctor concerning a way to best manage your blood sugar levels. take into account storing a minimum of 3 days' value of polygenic disorder and an additional internal secretion kit just in case of emergencies.
Check for ketones when your blood sugar is high. Check your excretory product for ketones once your glucose level is over 250 mg/dL (14 mmol/L) on over 2 consecutive tests, particularly if you're sick. If you have an outsized quantity of ketones, consult your doctor for advice. decide your doctor straight away if you have any level of ketones and are vomiting. High levels of ketones can cause diabetic ketoacidosis, which may lead to coma.
Have glucagon and fast-acting sources of sugar available. If you're taking hypoglycemic agents for your diabetes, ensure you have got AN up-to-date endocrine kit and fast-acting sources of sugar, love glucose tablets or orange juice, without delay offered to treat low blood glucose levels.
Consider a continuous glucose monitor (CGM), especially if you have got the hassle of maintaining stable blood glucose levels otherwise you don't feel symptoms of low blood sugar (hypoglycemia unawareness). CGMs are devices that use an attiny low detector inserted beneath the skin to trace trends in your blood sugar levels and transmit the data to a wireless device. These devices will provide you with a warning once your blood sugar is hazardously low or if it's dropping too fast. However, you continue to take a look at your blood sugar levels employing a blood glucose meter albeit you're using a CGM. CGMs are costlier than conventional aldohexose observation methods, however they'll assist you in managing your glucose better.
Drink alcohol with caution. Because alcohol will have a random impact on your blood sugar, make sure to own a snack or a meal after you drink, if you decide on drinking at all.
Educate your loved ones, friends and co-workers. Teach wanted ones and different shut contacts the way to acknowledge the first signs and symptoms of blood glucose extremes and the way to present emergency injections. If you pass out, somebody ought to be able to necessitate emergency help.
Wear a medical ID bracelet or necklace. If you're unconscious, the ID will give valuable info to your friends, co-workers et al — together with emergency personnel.
Diagnosis Diabetic Coma
If you experience a diabetic coma, prompt identification is essential. The emergency medical team can do a physical test and should raise people who are with you regarding your medical history. If you've got diabetes, you'll need to wear a medical ID bracelet or necklace.
If you are experiencing any of the following conditions, please call a healthcare provider:
If your blood sugar is high two times in a row for an unknown reason, you may have diabetes.
If you have low blood sugar and it has not improved after three treatments, call your healthcare provider or 911.
If you see someone with diabetes who looks confused, they may be having a low blood sugar episode. Untreated, this can lead to a diabetic coma. If the person is still able to follow instructions, give them something to drink or eat and call for an ambulance or 911.
If you see someone with diabetes become unresponsive, call 911.
If someone has diabetes and can't speak for themselves, tell the responders that fact. If you have diabetes, you may want to wear something that identifies you as having diabetes, like a bracelet or necklace.
When you go to a healthcare facility, providers will do a physical examination and take blood to measure levels of glucose and ketones.
Lab tests
At the hospital, you may need various lab tests to measure:
Your blood sugar level
Your ketone level
The amount of nitrogen or creatinine in your blood
The amount of potassium, phosphate and sodium in your blood
Treatment Diabetic Coma
Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.
If you go into a diabetic coma, you need treatment right away. If there is any delay in seeking medical help, you are at risk for brain damage or even death.
If your blood sugar is too high, you'll experience:
Intravenous fluids.
Certain supplements are necessary for healthy bones. These include phosphate sodium and potassium.
Insulin.
If your blood sugar is too low, you will feel symptoms such as dizziness, shakiness, and a fast heartbeat.
Glucagon is a hormone that increases blood sugar.
Intravenous fluids.
50% dextrose solution.
High blood sugar
If your blood sugar level is too high, you may need:
Intravenous fluids to restore water to your tissues
Potassium, sodium or phosphate supplements to help your cells function correctly
Insulin to help your tissues absorb the glucose in your blood
Treatment for any underlying infections
Low blood sugar
If your glucose level is simply too low, you will have an endocrine injection, which can cause your blood sugar level to quickly rise. Blood vessel glucose additionally is also given to lift blood glucose levels.
Preparing for your appointment
A comatose ness may be a medical emergency that you just won't have time to organize for. If you are feeling the symptoms of extraordinarily high or low blood sugar, decision 911 or your native emergency variety to create certain assistance is on the approach before you pass out. If you're with somebody with polygenic disease who has passed out or is acting strange, presumably as if he or she has had an excessive amount of alcohol, involve immediate medical help.
What you can do in the meantime
If you have got no coaching in polygenic disease care, look ahead to the emergency care team to arrive. If you're acquainted with diabetes care, check the unconscious person' blood glucose and follow these steps:
If the blood sugar level is lower than 70 mg/dL 3.9 mmol/L), offer the person AN injection of glucagon. don't try to give fluids to drink and do not give endocrine to somebody with low blood sugar.
If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. Don't give sugar to someone whose blood sugar isn't low.
If you called for medical help, let the emergency care team know about the diabetes and what steps you've taken, if any.
General summary
A diabetic coma or insulin shock is a potentially life-threatening condition that can occur when an individual with diabetes has low blood sugar Insulin is the hormone that allows cells in the body to use glucose as fuel When there isn't enough insulin to move glucose into cells where it can be used for energy or if the body doesn't produce any insulin at all (type 1 diabetes) blood sugar levels rise to dangerous levels.
