Diabetic Coma

Diabetic Coma is a life threatening condition in which a person loses consciousness.

It is a complication caused by diabetes. It can occur either due to dangerously high or low blood sugar levels. People who are in a diabetic coma are unresponsive to any type of stimuli.

If immediate treatment isn't provided, diabetic coma can lead to death. It can be prevented by following the treatment plan for diabetes.

People usually develop signs and symptoms of high or low blood sugar levels before developing a diabetic coma.

Signs and symptoms of high blood sugar (hyperglycemia) include:

• Increased thirst and frequent urination
• Fatigue
• Nausea and vomiting
• Shortness of breath
• Stomach pain
• Fruity breath odor and very dry mouth
• A rapid heartbeat

Signs and symptoms of low blood sugar (hypoglycemia) include:

• Shakiness or Nervousness
• Anxiety
• Fatigue
• Weakness and Ssweating
• Nausea
• Dizziness
• Difficulty speaking
• Confusion

Some patients, especially those who have been suffering from diabetes for a long time can develop hypoglycemia unawareness. This is a condition in which a patient doesn't experience the signs and symptoms of hypoglycemia.

Diabetic coma is caused by abnormally high or low levels of blood sugar.

Conditions that can lead to diabetic coma include:

• Diabetic ketoacidosis which occurs due to increased breakdown of fat stores of the body. This leads to the accumulation of ketone bodies, which are toxic acids. This condition mostly occurs in people with type 1 diabetes.

• Diabetic hyperosmolar syndrome, a condition in which the blood sugar level increases to 600 mg/dL (33.3 mmol/L). Such dangerous levels of blood sugar cause the blood to become thick. The excess amount of is excreted into urine. This triggers the filtering process that draws large amounts of of fluid from the body.

  If diabetic hyperosmolar syndrome is left untreated, it can lead to life-threatening dehydration and diabetic coma.This condition mostly occurs in people with type 2 diabetes.

• Hypoglycemia (low blood sugar) can cause a person to loss consciousness due to reduced supply of glucose to the brain. It can be as a result of insulin overdose, reduced food intake, exercising vigorously and drinking too much alcohol.

A physical exam can be used to diagnose a diabetic coma.

Other tests include lab test to measure the blood sugar level, ketone level, amount of nitrogen or creatinine and sodium, potassium and phosphate in blood.

The treatment for diabetic coma depends on the cause.

• Patients with hyperglycemia are given intravenous fluids to restore water to the tissues and potassium, sodiumor phosphate supplement to help cells to function properly. Insulin can also be given to reduce the level of sugar.
• If a patient has hypoglycemia can be given a glucagon injection which quickly raises the blood sugar levels. Intravenous dextrose can given.

Controlling the amount of blood sugar level can help prevent the development of diabetic coma.

This can be achieved by:

• Following the meal plan reccomended by the doctor.
• Regularly checking the blood sugar levels.
• Taking medications as required.
• Checking for ketones when blood sugar is high.
• Have glucagon and fast-acting sources of sugar available.
• Considering a continuous glucose monitor (CGM).
• Avoiding excessive consumption of alcohol.
• Wearing a medical ID bracelet or necklace.
• Educating relatives and friends how to recognise signs and symptom of blood sugar extremes.

All patients with diabetes have a risk of developing diabetic coma. If left untreated, diabetic coma can lead to permanent brain damage and death.