Early signs of diabetic coma-various aspects-
Introduction-What is diabetic coma ?
A diabetic coma represents a critical medical emergency that leads an individual with diabetes to lose consciousness:
Explanation
A diabetic coma can happen when blood sugar levels reach dangerous highs (hyperglycemia) or dangerous lows (hypoglycemia). It’s a complicated condition that may arise from various complications, including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).
Symptoms
An individual in a diabetic coma remains alive but cannot be awakened or respond to stimuli. Their eyes might remain closed, and they may not consciously move.
In a country like India in such condition we recommend the patient to consult a MD-GENERAL MEDICINE DOCTOR OR ENDOCRINOLOGIST Many people ask then why to read all this text -the reason is that it helps you to understand the pathology better ,you can cooperate with treatment better ,your treating physician is already busy with his patients and he does not have sufficient time to explain you all the things right from ABCD.
Treatment
A diabetic coma can be reversed by addressing the underlying condition and stabilizing blood sugar. The longer you delay treatment, the greater the risk of death or brain damage.
Prevention
The most effective method to avoid a diabetic coma is to adhere to your diabetes treatment plan. If your blood glucose levels are regularly high or low, you should consult your doctor or diabetes healthcare professional.
Early indications of a diabetic coma consist of:
Thirst: Intense thirst or an exceedingly dry mouth
Frequent urination: Increased urination, especially during the night
Blurred vision: Loss of vision or blurred eyesight
Tiredness: Feelings of weakness or fatigue
Nausea and vomiting: Experiencing sickness in the stomach or vomiting
Fruity breath: A scent of fruit or acetone on the breath
Mental changes: Experiences of confusion, delirium, or hallucinations
Additional symptoms include:
Headache
Shortness of breath
Stomach pain
Increasing drowsiness
Rapid, deep breathing
A diabetic coma represents a state of deep sleep in which the individual is unresponsive and unable to move intentionally. However, they might still exhibit some reflexive responses.
Diabetic ketoacidosis (DKA) is a severe condition that may result in a diabetic coma or death. It results from a buildup of ketones in the bloodstream, which causes it to become more acidic.
Overview
A diabetic coma is a critical condition that results in loss of consciousness. If you are diabetic, extremely high blood sugar (hyperglycemia) or extremely low blood sugar (hypoglycemia) can result in a diabetic coma.
If you enter a diabetic coma, you are still alive — but you cannot awaken or respond meaningfully to visual, auditory, or other stimuli. If left untreated, a diabetic coma can lead to death.
Although the concept of a diabetic coma may be frightening, there are actions you can take to help avoid it. One of the most essential steps is to adhere to your diabetes treatment regimen.
Symptoms
Signs of high blood sugar or low blood sugar typically appear before a diabetic coma manifests.
High blood sugar (hyperglycemia)
When your blood sugar level is excessively high, you might experience:
Increased thirst
Frequent urination
Blurred vision
Tiredness or weakness
Headache
Nausea and vomiting
Shortness of breath
Stomach pain
Fruity breath odor
A very dry mouth
Low blood sugar (hypoglycemia)
When your blood sugar is excessively low, you might experience:
Shakiness
Anxiety
Tiredness or drowsiness
Weakness
Sweating
Hunger
A feeling of tingling on your skin
Dizziness or lightheadedness
Headache
Difficulty speaking
Blurry vision
Confusion
Loss of consciousness
Some individuals, particularly those who have had diabetes for an extended period, develop a condition referred to as hypoglycemia unawareness. This means they do not experience warning signs when their blood sugar drops.
If you experience any signs of high or low blood sugar, check your blood sugar immediately. Based on the results, follow your diabetes treatment plan. If you do not start to feel better promptly, or if your condition worsens, seek medical attention immediately.
When to see a doctor ?
A diabetic coma constitutes a medical emergency. If you exhibit symptoms of high or low blood sugar and believe you may lose consciousness, call your local emergency services.
If you are accompanying someone with diabetes who has lost consciousness, seek emergency assistance. Inform the emergency personnel that the unconscious individual has diabetes.
Causes
Blood sugar levels that are either excessively high or low for prolonged periods can result in the following severe health issues, all of which could lead to a diabetic coma.
Diabetic ketoacidosis. When your muscle cells are deprived of energy, your body may begin to break down fat for fuel. This process produces harmful acids known as ketones. If ketones are present (detected in blood or urine) along with elevated blood sugar, the condition is referred to as diabetic ketoacidosis. Without treatment, it may progress to a diabetic coma.
Diabetic ketoacidosis is most frequently seen in individuals with type 1 diabetes. However, it can also appear in those with type 2 diabetes or gestational diabetes.
Diabetic hyperosmolar syndrome. When your blood sugar level exceeds 600 milligrams per deciliter (mg/dL) or 33. 3 millimoles per liter (mmol/L), this condition is termed diabetic hyperosmolar syndrome.
When blood sugar reaches critical levels, the excess sugar transfers from the bloodstream into the urine. This initiates a process that withdraws a significant amount of fluid from the body. If left unaddressed, this can result in life-threatening dehydration and a diabetic coma.
Hypoglycemia. Your brain requires sugar (glucose) to operate effectively. In extreme cases, low blood sugar (hypoglycemia) may cause you to lose consciousness. Insufficient food intake or excessive insulin can trigger low blood sugar. Engaging in intense exercise or consuming large amounts of alcohol can produce a similar outcome.
Risk factors
Anyone diagnosed with diabetes is at risk for a diabetic coma, but these specific factors can heighten the risk:
Insulin delivery problems.
If you’re utilizing an insulin pump, it’s essential to monitor your blood sugar regularly. Insulin delivery may halt if the pump malfunctions or if the tubing (catheter) becomes kinked or dislodged. A deficiency in insulin can result in diabetic ketoacidosis.
An illness, trauma, or surgery. While you are unwell or injured, blood sugar levels can fluctuate, sometimes drastically, raising your risk for diabetic ketoacidosis and diabetic hyperosmolar syndrome.
Poorly managed diabetes. Failing to adequately monitor your blood sugar or follow your health care provider’s medication instructions puts you at a greater risk of developing long-term health complications and increases the risk of a diabetic coma.
Deliberately skipping meals or insulin. Certain individuals with diabetes who also have an eating disorder may choose to forgo their insulin as a means to lose weight. This is a perilous and potentially fatal action that heightens the risk of a diabetic coma.
Drinking alcohol. Alcohol can yield unpredictable effects on your blood sugar levels. The impact of alcohol might make it difficult for you to recognize symptoms of low blood sugar. This can elevate your vulnerability to a diabetic coma due to hypoglycemia.
Illegal drug use. Illicit drugs, such as cocaine, can raise your chances of experiencing severely high blood sugar levels and conditions associated with a diabetic coma.
Complications
If left untreated, a diabetic coma may result in irreversible brain damage and death.
Prevention
Good day-to-day management of your diabetes can assist in preventing a diabetic coma. Keep these suggestions in mind:
Adhere to your meal plan. Regular snacks and meals can aid in managing your blood sugar level.
Monitor your blood sugar level. Regular blood sugar checks can indicate whether you are maintaining your blood sugar level within your target range. It can also warn you of dangerous highs or lows. Test more frequently if you have exercised. Exercise can lead to a drop in blood sugar levels, even hours later, particularly if you don’t engage in regular exercise.
Take your medication as prescribed. If you experience frequent incidents of high or low blood sugar, inform your health care provider. You may need adjustments to the dosage or timing of your medication.
Establish a sick-day plan. Illness can lead to an unexpected shift in blood sugar. If you are ill and unable to eat, your blood sugar may decrease. While you are well, discuss with your doctor how to manage your blood sugar levels best if you become sick. Consider keeping at least a week’s supply of diabetes supplies and an additional glucagon kit for emergencies.
Test for ketones when your blood sugar is elevated. Check your urine for ketones if your blood sugar level exceeds 250 milligrams per deciliter (mg/dL) (14 millimoles per liter (mmol/L)) on more than two consecutive tests, especially if you are unwell. If you find a significant amount of ketones, contact your health care provider for guidance. Contact your health care provider immediately if you have any level of ketones and are vomiting. High ketone levels can result in diabetic ketoacidosis, potentially leading to coma.
Have glucagon and quick sources of sugar accessible. If you use insulin for your diabetes, ensure you have an up-to-date glucagon kit and quick sources of sugar, such as glucose tablets or orange juice, on hand to address low blood sugar levels.
Consider employing a continuous glucose monitor, particularly if you struggle to maintain steady blood sugar levels or do not recognize symptoms of low blood sugar (hypoglycemia unawareness).
Continuous glucose monitors are instruments that use a small sensor inserted beneath the skin to track fluctuations in blood sugar levels and transmit the data to a wireless device, like a smartphone.
These monitors can warn you when your blood sugar is critically low or if it is dropping too quickly. However, you still need to check your blood sugar levels with a blood glucose meter even if you are using one of these monitors. Continuous glucose monitors tend to be pricier than other methods of glucose monitoring, but they may enhance your ability to control your glucose levels.
Continuous glucose monitor and insulin pump
A continuous glucose monitor, located on the left, is an apparatus that checks blood sugar every few minutes via a sensor placed beneath the skin. An insulin pump, secured to the pocket, is a device that is worn externally, featuring a tube that links the insulin reservoir to a catheter that is inserted under the abdomen’s skin. Insulin pumps are set to administer precise quantities of insulin consistently and during meals.
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