Types of Diabetic Coma
High blood sugar levels are typical of diabetes mellitus. If diabetes mellitus is not well-managed, coma can occur. The three types of coma linked to diabetes are:
- hypoglycemia coma.
- hyperosmolar coma.
- ketoacidotic coma.
Hypoglycemic Coma
When blood sugar levels are below 3.5mmol/l, hypoglycemia can happen if the patient on diabetes medicine or insulin:
- Take an additional dose or have the dosage increased.
- Do strenuous exercises without consuming extra food or with reduced insulin dosage.
- Forgets to eat according to schedule.
- Takes excessive amount of alcohol or take alcohol without consumption of food.
Due to the above actions, blood sugar level can drop so low that the patient can become hypoglycemic coma (unconscious) and seizures can happen.
Signs of hypoglycemia are:
- Intense Hunger.
- Sweating.
- Weakness.
- Heart Palpitations.
- Trembling.
- Changed behavior, confusion, sleepiness or coma can happen if the level of blood sugar drops too low.
Hypoglycemia ought to be attended to immediately to avoid incidences of coma or prolonged coma.
Hyperosmolar Coma
Serious dehydration and extremely high blood sugar levels are the causes of hyperosmolar coma (hyperglycemia).
High blood sugar levels are due to:
- Missed medications for diabetes or insulin.
- Any kind of infection or sickness, like the pneumonia or flu.
- Excessive consumption of sweet food and drinks.
People who are most susceptible to this type of coma are patients with type two diabetes suffering from any kind of infection or serious sickness, taking less water or using diuretics or steroids.
When there are increased blood sugar levels, the kidneys react by excreting the sugar together with a large amount of fluid. A patient going through diabetic hyperosmolarity experiences great thirst which is difficult to quench as not enough water can be drunk to overcome the loss fluid. Without immediate intravenous fluids, the patient will be dehydrated and go into a coma.
Since hyperosmolar coma takes many days, even weeks, to develop, prevention of coma is possible with the early detection of dehydration or hyperglycemia (high blood glucose levels).
Ketoacidotic Coma
Ketoacidotic coma usually happens to patients with type one diabetes, that was once called IDDM( insulin dependent diabetes mellitus) or juvenile diabetes. This coma is brought about by the increase of certain chemicals known as ketones. Since ketones are very acidic, they make the blood too acidic.
When not enough insulin is available in the body, the amount of ketones, which are by-products in the division of fats into smaller parts, becomes too much. Fats in the process if being broken down change to ketones in the liver. This happens because the body needs the fat for energy when there is insufficient insulin to help the body convert glucose to energy. The usual causes of ketoacidosis are a forgotten insulin dose or a serious infection suffered by a type 1 diabetic.
The following are signs of ketoacidosis:
- Vomiting
- Nausea
- Lethargy
- Abdominal pain
- Extreme thirst
- Progressive drowsiness
- Deep, quick breaths
- The breath has a fruity smell
- The need to urinate often as a result of high blood sugar levels
It is advisable to have monitoring of blood sugar and ketones more often. If possible, it is preferable to get blood ketone testing. Should there be no blood ketone testing in your area, then your next choice ought to be urine testing.
Diabetes and Coma -Video Guide
First aid for diabetic coma
The following first aid is to be given to a patient who is experiencing diabetic coma.
- No food or drink is to be given as choking can occur.
- Turn the body of the patient so that he is lying on his side to ensure nothing obstructs his breathing.
- Until the arrival of the ambulance, follow whatever instructions could have been conveyed to you by the hospital.
- No insulin injection should be given by you.
Diagnosing diabetic coma
Since a coma requires immediate medical treatment, fast diagnosis of the problem can make a difference between life and death. A number of tests can be used to find the reasons for a diabetic coma. The following are necessary.
- Blood tests, such as those for glucose and ketones.
- Medical history.
- Examination of the body for any medical bracelet which can reveal the patient’s problem.
Treatment of diabetic coma
The following are treatment methods for coma linked to diabetes:
- Hypoglycemic coma - Give a glucagon injection, if glucagon is available, to cancel insulin’s effects, or intravenous supply of glucose to the body
- Hyperosmolar coma - Lots of intravenous liquids, insulin, potassium as well as sodium given immediately.
- Ketoacidotic coma - Use of intravenous liquids, insulin, potassium as well as sodium provided to the patient’s body.
Where to get help
- Call 911 for emergency cases.
- Contact the hospital’s emergency department.
- Your medical practitioner.
- A diabetes specialist.
Things to Remember
- There are three types of coma which results from diabetes. They include hypoglycemic coma, hyperosmolar coma, and ketoacidotic coma.
- Diabetic coma needs immediate medical treatment as it is an emergency case.
- Blood sugar levels which are not well managed can result in hyper or hypoglycemia.
- Low or constantly high levels of blood sugar imply that adjustment has to be made to your treatment. Consult your medical practitioner on the matter.
- Since prevention is the best method, go to your diabetes educator for a revision of the knowledge on the matter, especially if the last time you were told about prevention was some time ago.