Diabetic coma is an emergency in which a type one diabetic becomes unconscious because of complications with diabetes. This condition is life threatening and should be taken seriously.
Such complications include
• Very low blood sugar also known as hypoglycemia
• A combination of hyperglycemia or high blood sugar, dehydration, exhaustion and shock
• Hyperosmolar coma
In a medical context, diabetic coma is the uncertainty posed to a doctor with a patient who is unconscious. No other information on the patient is available. Therefore, the doctor has to find ways of knowing the cause.
Severe hypoglycemia
Very low blood sugar levels lead to unconsciousness and coma. In many cases, when a patient has very low sugar levels, the body releases glucagon in order to raise the sugar level. Severe hypoglycemia is likely to happen in a hypoglycemic patient due to
• Alcohol in the body when a patient has low sugar levels
• Insulin overdose
• A lot of exercise which uses up all glycogen supply
Hypoglycemic unconsciousness can occur within a period of thirty minutes. Convulsions may happen. The unconscious patient is usually pale in color, sweating profusely and has a quick heartbeat.
Diabetic ketoacidosis
It is a state of having high blood sugar level with a combination of high ketone levels. Ketoacidosis occurs in people with type 1 diabetes. The body in this case runs out of insulin. Insulin prevents sugar spillage to the urine. Diabetics should never miss their dose.
Symptoms of high blood sugar include vomiting, disorientation, dehydration and difficulty in breathing. Illness in a type one patient can lead to high sugars. Blood glucose level is tested.
Hyperosmolar coma
It occurs in patients with type 2 diabetes. The amount of insulin secreted by the body is little thus preventing ketone levels from rising. However, if the patient has very high glucose levels then a hyperosmolar hyperglycaemic state can occur. The symptoms include disorientation, extreme thirst, vomiting and nausea.
Diabetic coma can be prevented by:
• Frequent testing of glucose levels especially during illness
• Diabetic patients monitoring low and high blood sugars
• Drinking alcohol responsibly
• Avoiding alcohol after difficult exercise
• Performing frequent tests for ketones
Identifying the cause
It normally takes a few questions to the people who have brought in the patient, a quick look and testing of the patient's sugar levels to know the cause of the loss of consciousness.
Other conditions that may cause unconsciousness include head injury, stroke and seizure. Fortunately, early treatment for most diabetic patients prevents the comatose state.
Treatments
In case of hypoglycemic coma, give glucose intravenously to help raise sugar levels or administer the hormone glucagon.
For ketoacidotic coma, administer insulin to help tissues absorb sugars, intravenous fluids to hydrate the patient, electrolytes such as sodium and potassium to help cells function appropriately.
For hyperosmolar coma, administer potassium and sodium electrolytes, insulin, and many intravenous fluids.
Family members should be actively involved in the care of diabetic patients.
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