Under diabetic coma is necessary to understand the complication and consequences of diabetes mellitus. This condition develops quite sharply and can be easily reversible. It is believed that a diabetic coma can cause excessive blood sugar levels in a sick person (hyperglycemic state). In addition, coma can be observed with the disease:
- hypoglycemic (occurs in type 2 diabetes);
- ketoacidotic (more common in diabetes mellitus type 1).
The main reasons for the development of the pathological condition
The main factors that lead to the beginning of the development of diabetic coma, are too rapid increase in the sugar content in the blood of a sick person. This can be caused, for example, by the consequences of not following a medical diet. Patients are aware of how diabetes begins, the signs are hard not to notice, but they often ignore its manifestations, which is fraught with coma.
The lack of internal insulin and the wrong treatment for a disease can also trigger a hyperglycemic coma. The consequences of this are that insulin does not flow, which prevents glucose from being processed into substances important to the human body.
The liver in such a situation begins the unauthorized production of glucose, believing that the necessary elements did not enter the body because of its insufficient level. In addition to this, active production of ketone bodies begins, which, if glucose is excessively accumulated in the body, leads to loss of consciousness and coma.
In such situations, the presence of ketone bodies along with glucose goes on such a large scale that the body of a sick person is simply not able to adequately respond to such a process. The result is ketoacid coma.
There are cases when, together with sugar, the body saves lactates and other substances, which provoked the onset of hyperlactacidemic (hyperosmolar) coma.
It is important to note that not all cases in which diabetic coma is suppressed in diabetes are caused by an excessive level of glucose in the blood, because an overdose of insulin can sometimes be. In such conditions, there is a sharp decrease in blood sugar to a level below the possible norm, and the patient falls into a state of hypoglycemic coma.
Symptoms of the onset of coma
Symptoms of coma in diabetes are similar to each other, which leads to accurate conclusions only after appropriate laboratory studies. To start the development of a sugar coma, it is necessary to mark the level of glucose in the blood above 33 mmol / liter (3.3-5.5 mmol / liter is considered to be the norm).
Symptoms of the beginning of coma:
- frequent urination;
- pain in the head;
- decreased appetite;
- increased thirst;
- general well-defined weakness;
- nervous excitement, which turns into drowsiness, symptoms that are difficult not to notice;
- vomiting (not always).
If these symptoms last from 12 to 24 hours without adequate and timely medical care, then the patient may fall into a state of true coma. It is typical for her:
- complete indifference to people around and what is happening;
- disturbed consciousness;
- dry skin;
- complete lack of consciousness and reactions to any stimuli;
- soft eyes;
- decrease in pulse;
- the smell of acetone from the patient's mouth;
- drop in blood pressure.
If we are talking about hypoglycemic coma, it will be slightly different, demeonstrirovanie other symptoms. In such situations there will be a sharp feeling of hunger, fear, anxiety, trembling in the body, a lightning-fast feeling of weakness, sweating.
It is possible to arrest the beginning of the development of such a state by using a small amount of sweet, for example, sugar. If this is not done, then there may be a loss of consciousness and the onset of seizures. Muscles at the same time will be in good shape, and the skin will become wet.
How is diabetic coma diagnosed?
In order to detect coma in diabetes, it is necessary not only to see a doctor, but also to conduct important laboratory tests. These include complete blood count, biochemistry of urine, blood, as well as analysis of the level of sugar content.
Any type of coma with the disease will be characterized by the presence of sugar in the blood of more than 33 mmol / liter, as well as in the urine glucose will be detected. With hyperglycemic coma, there will be no other symptoms characteristic of it.
For ketoacidotic coma is characterized by the presence of ketone bodies in the urine. For hyperosmolar, an excessive plasma osmolarity level. Hyperlactacidemic is characterized by an increase in blood levels of lactic acid.
How is the treatment?
Any diabetic coma involves their treatment, first of all it is necessary to restore the optimal level of sugar in the blood, here the exact symptoms are important.
This can easily be achieved by administering insulin (or glucose for hypoglycemia). In addition, produce a course of infusion therapy, which provides for droppers and injections with special solutions that can eliminate violations of the electrolyte composition of the blood, to remove dehydration and lead to a normal state of acidity.
All these procedures are carried out in conditions of resuscitation for several days. After that, the patient can be transferred to the department of endocrinology, where his condition will be stabilized, and then he must clearly adhere to the state in which glucose, blood sugar will be in a normal state.
Diabetic coma - effects
As in any other cases, subject to timely treatment for qualified medical care, it will be possible to avoid not only disturbance and loss of consciousness, but also qualitatively restore the condition of the sick person in the initial stages of diabetic coma. If this is not done, then the patient may die soon enough. According to current medical statistics, mortality in the development of such complications of diabetes is about 10 percent of the total number of patients with this disease.