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Diabetic Seizure Death

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment protocols, as well as prompt identification and treatment of the precipitating cause, are important factors affecting outcome. The two most common life-threatening complications of diabetes mellitus include diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction in the net effective concentration of circulating insulin coupled with a concomitant elevation of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes. DKA is reported to be responsible for more than 100,000 hospital admissions per year in the United States1 and accounts for 4–9% of all hospital discharge summaries among patients with diabetes.1 The incidence of HHS is lower than DKA and accounts for <1% of all primary diabetic admissions.1 Most patients with DKA have type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness.2 Contrary to popular belief, DKA is more common in adults than in children.1 In community-based studies, more than 40% of African-American patients with DKA were >40 years of age and more than 2 Continue reading >>

Diabetic Emergencies: Hypoglycemia Caused By Insulin, Part 3

Diabetic Emergencies: Hypoglycemia Caused By Insulin, Part 3

Consequences of acute hypoglycemia Acute hypoglycemia can lead to health damage either directly (from deleterious effects of low blood glucose supply to the brain) or indirectly, usually via trauma due to loss of consciousness or seizures. As an example, hypoglycemia may occur during driving and may obviously cause road traffic accidents…. In the vast majority of cases, recovery from a severe hypoglycemic event, even if it manifests with seizures or coma, is complete. Sometimes, neurologic abnormalities can be observed immediately after recovery of consciousness and improve afterwards. Hypoglycemic hemiplegia is an uncommon condition that has been described as a hemiparetic state, presenting in the morning when the patient awakens after a nocturnal hypoglycemic event. The episode typically resolves after a few minutes or hours and may recur. 28 Permanent neurologic damage and death have been reported rarely, 29 especially after massive insulin overdose and delayed restoration of normoglycemia. 30 Another possible mechanism of acute health damage, including sudden death, due to hypoglycemia is via the induction of cardiovascular events. Hypoglycemia has been implicated in the so-called "dead-in-bed syndrome," the unexpected death of a young person with Type 1 diabetes found dead in an undisturbed bed. 29 It has also been suggested that the increased total mortality risk observed in the intensive glycemic control arm of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study might be due to the high rate of hypoglycemic events. 18 However, this insinuation has not been verified in post hoc analysis of the trial data. 31 It has been shown that hypoglycemia, especially in patients with pre-existing cardiovascular disease, induces multiple proarrhythmic change Continue reading >>

Exorcising The Specter Of Overnight Hypoglycemia

Exorcising The Specter Of Overnight Hypoglycemia

For millions of people with diabetes who take insulin or medicines that stimulate the pancreas to release more insulin, hypoglycemia (low blood glucose) is an ever-present threat lurking in the shadows. And few things instill more fear in parents of children with diabetes and partners of adults with diabetes — not to mention people with diabetes themselves — than hypoglycemia that occurs in the middle of the night. Most people feel confident in their ability to deal with lows that occur while they are awake. The symptoms, even if subtle, can usually be recognized in time to down some rapid-acting carbohydrate and fix the problem. But the very thought of dropping low while sleeping gives many a feeling of complete helplessness. Will the symptoms be strong enough to wake me? Will I have the ability to get up and treat it? Or will I just lie there, unable to do anything about it? Sometimes people are completely oblivious to periods of low blood glucose that occurred while they were sleeping. The only clues left behind might be sheets or pajamas that are soaked with sweat or a rebound high blood glucose level the following morning. Although rare, there have been deaths reported that resulted from hypoglycemia that occurred while sleeping. The reason those deaths are rare is that the body usually reacts to low blood glucose by producing adrenaline, which causes profuse sweating, shaking, and a strong or rapid heartbeat. This will almost always awaken a person who is experiencing hypoglycemia or alert that person’s partner. Adrenaline also stimulates the liver to release some of its stored-up glucose (called glycogen) into the bloodstream. When low blood sugar continues over an extended period, a seizure may occur. The seizure will often alert family members, roommates, Continue reading >>

A Silent Danger: When Blood Sugar Goes Down While You Were Sleeping

A Silent Danger: When Blood Sugar Goes Down While You Were Sleeping

You've heard it before—how taking a snack at nighttime after dinner may not be such a good idea, what with the weight gain that may come with it. But if you're a diabetic, that nighttime snack may spell the difference between life and death—literally. “The absence of a nighttime snack when one is usually taken is one cause of nocturnal hypoglycemia,” said Dr. Richard Elwyn Fernando, president of Diabetes Philippines and consultant at St. Luke's Medical Center and Capitol Medical Center. Nocturnal hypoglycemia, as the name implies, happens at night. “It occurs when blood glucose levels fall below 4 millimoles per liter (mmol/l) or 72 milligrams per deciliter (mg/dl). At 40 mg/dl or below, a person can be comatose... In rare cases, it may lead to death,” Fernando said during a media briefing organized by pharmaceutical company Novo Nordisk last May 27. What makes it dangerous is that the person, being asleep, is not aware of what is happening and is not able to seek help. This poses a real concern for diabetics and their families, said Fernando. In a previous interview, former Health Secretary Esperanza Cabral said the body needs glucose to function well. “Kailangan ng katawan ang sugar for energy, metabolism,” she told GMA News. When the blood sugar drops to low levels, a person may experience dizziness, weakness and even fainting, Cabral said. There may also be confusion and disorientation. Fernando said hypoglycemia may lead to complications affecting the heart (decreased heart rate, decreased cardiac output, myocardial contractility), blood vessels (stroke, myocardial infarction, acute cardiac failure, ventricular arrythmia), and brain (seizures, convulsions, coma). While hypoglycemia may occur in both diabetics and non-diabetics alike—“kapag gutom Continue reading >>

Sudden Death And Hypoglycemia

Sudden Death And Hypoglycemia

Feature Article Simon Heller, BA, MB BChir, DM, FRCP Diabetic Hypoglycemia September 2008, Volume 1, Issue 2: page 2-7 Abstract There is considerable evidence implicating hypoglycemia as a cause of sudden death in patients with both type 1 and type 2 diabetes. Hypoglycemia has been recognized as a potential cause of death, particularly due to cerebral damage, ever since the introduction of insulin therapy. The pathophysiological changes that occur during hypoglycemia may also increase the risk of sudden death in patients with advanced cardiovascular disease. This feature article provides a detailed examination of the potential connection between sudden death and hypoglycemia. It discusses the findings of a number of studies, including the recent ACCORD study, and examines the phenomenon of sudden death in young people with diabetes, reviewing the potential mechanisms and therapeutic interventions. Risk of death from hypoglycemia and the problem of identifying deaths due to hypoglycemia are covered, as is nocturnal hypoglycemia - a common side effect of insulin treatment which is feared by many diabetes patients. The relationship between sudden death and the ‘dead in bed’ syndrome is also reviewed in detail. The review concludes that the risk of hypoglycemia-induced mortality is difficult to calculate accurately, but that there is considerable evidence implicating hypoglycemia as a rare cause of sudden death in individuals with type 1 diabetes. The review also indicates that hypoglycemia may increase the risk of ischemia and sudden death in individuals with type 2 diabetes, but points out that it is unclear whether the same mechanisms as in type 1 diabetes are responsible. Keywords: hypoglycemia, sudden death, cardiovascular disease, cerebral damage Continue reading >>

How To Help Someone In A Coma

How To Help Someone In A Coma

Author's Sidebar: Every once in a while, I'll get a phone call or an email message from a person, who has a relative in the hospital in a diabetic coma. I can usually tell by the tone in their voice that they are desperate, afraid and uncertain what to do. These types of phone calls are difficult, because there's nothing that I can do to help them. Usually, I suggest that the person make sure that they share as much information that they can about the person's health with the doctors and nurses. The more that you know about the person's health, the better it can help the doctors understand what is happening. Another thing that I usually suggest is to keep a notebook or journal of what's going on and ask questions, but be respectful to the medical staff. Use the notebook for taking notes when the doctors tell you things about the patient's condition, etc. Otherwise, you will never remember what was said to relay to other family members. When a large family is involved it gets tiring to keep repeating the same information -- so they can read your notebook. Also, write down all the pertinent phone numbers and emails of people who would need to be contacted when changes in condition occur. There are usually a lot of people who want this information and having email addresses makes it easier than trying to call everyone. Keeping notes is also a good way to keep busy. A journal may not only serve as a method for coping with grief, it may also be helpful for the patient when they come out of the coma -- to realize what happened to them. If the person has a smartphone or similar device, usually I'll suggest that they google phrases like "diabetic coma" to better understand what is going on. If the hospital allows it, bring a small CD player or tape player and play some of the p Continue reading >>

Passengers Sit Beside Dead Body After Woman Suffers Diabetic Seizure On Azur Air Flight

Passengers Sit Beside Dead Body After Woman Suffers Diabetic Seizure On Azur Air Flight

Passengers were forced to sit next to a dead body after a woman suffered a seizure and died on a flight home from holiday. ​The unidentified woman, who reportedly had diabetes, suffered the seizure just 45 minutes into the Azur Air flight from Antalya, Turkey to Moscow. Cabin crew tried to help the 50-year-old passenger, who was flying with her husband, but did not have access to her medication as it was in her checked-in luggage. Read more: * Doctor uses spoon and toothpick to save man suffering from an epileptic fit * 'Doctor Angel' saves unconscious passenger mid-flight * Air New Zealand plane on lockdown after passengers fall ill * Woman gives birth on Jetstar plane, names baby after airline As her condition worsened, the woman soon passed away, the Daily Mail reported. It is believed she had also been previously suffering from acute heart failure. Her husband said that the victim had not taken her medication in her carry-on luggage as she didn't think she would need it, having given herself an insulin injection an hour before. When the woman died, the flight attendants covered her body, which was lying down in the aisle. The pilot made the decision to continue on to their destination in Moscow instead of making an emergency landing. People with diabetes are advised to plan in advance when travelling. More information can be found on diabetes.org.nz Comments on this article have now closed. - Stuff Continue reading >>

Diabetic Seizures In Dogs

Diabetic Seizures In Dogs

Seeing your dog have a seizure can be pretty scary, especially the first time this happens. If the seizure is caused by diabetes complications, the good news is that future seizures can be prevented by controlling the dog's diabetes. Why Seizures Happen Any seizure—in a dog or a human—is caused by a kind of electrical storm in the brain. If a dog has diabetes, her body doesn't produce the right amount of insulin for control of blood sugar levels. Insulin is produced by the pancreas, and diabetes can be caused by too much or too little. Very low blood sugar levels can interrupt the normal functioning of the brain, leading to a diabetic seizure. Hypoglycemia and Hyperglycemia Problems relating to diabetes in dogs usually stem from a state of either hypoglycemia or hyperglycemia. A hypoglycemic dog has very low blood sugar and may experience a seizure as a result. In diabetic dogs, hypoglycemia commonly occurs when an insulin dose is given without sufficient food for the dog's body to utilize the insulin properly. The opposite diabetic state, hyperglycemia, occurs when the dog's blood sugar levels are extremely high. Although hyperglycemia does not typically cause seizures, this is a serious state in which the dog may become depressed, weak and anorexic. Hyperglycemia can cause a dog to become comatose. Seizure Prevention If your dog is diabetic, seizure prevention primarily involves preventing a state of hypoglycemia. Use insulin that is formulated specifically for dogs—Novolin, Vetsulin and Caninsulin are some of the most commonly used forms of canine insulin. Monitor your dog's blood glucose regularly to make sure the insulin dosage is correct and having the desired effect. Monitor your dog's feeding and exercise patterns, if possible with a regular daily schedule Continue reading >>

Diabetes In Dogs

Diabetes In Dogs

Diabetes-Related Emergencies Diabetes in dogs is treated with insulin, much the same way as it is in humans. But if too much or too little insulin is administered, it can be very dangerous for the animal. What To Watch For Diabetes causes high blood sugar levels and is signaled primarily by excessive urination, excessive drinking, increased appetite and weight loss. In cases where the diabetes is not treated promptly and allowed to progress to the point of a crisis, symptoms may include a loss of appetite, weakness, seizures, twitching, and intestinal problems (diarrhea or constipation). Primary Cause Diabetic emergencies can be caused by either injecting too much or too little insulin, or not treating the diabetes in the first place. Both cases are equally dangerous for the dog and can cause coma or death. In cases where the diabetes is not treated, it can progress to diabetic ketoacidosis, a very serious condition that can cause death of your pet. Diabetic ketoacidosis can also be seen in dogs where the diabetes had been regulated and yet in which another condition has developed affecting the body's ability to regulate the diabetes. Immediate Care If signs of an insulin dosage problem are noticed, it should be treated as an extreme emergency. The following steps may provide aid to your dog until you are able to bring her to a veterinarian (which should be as quickly as possible): Syringe liquid glucose into the dog’s mouth. This can be in the form of corn syrup, maple syrup, honey, etc. If the dog is having a seizure, lift its lips and rub glucose syrup on the gums. Be careful not to get bit. Veterinary Care Depending on the cause of the crisis, dogs suffering from diabetic emergencies may need to be given glucose or insulin intravenously. In cases of diabetic ketoa Continue reading >>

Diabetes Complications

Diabetes Complications

Complications caused by diabetes People with diabetes must routinely monitor and regulate their blood sugar. No matter how careful you may be, there’s still a possibility that a problem might arise. There are two types of complications you may experience: acute and chronic. Acute complications require emergency care. Examples include hypoglycemia and ketoacidosis. If left untreated, these conditions can cause: seizures loss of consciousness death Chronic complications occur when diabetes isn’t managed properly. Diabetes causes high blood sugar levels. If not controlled well over time, high blood sugar levels can damage various organs, including the: eyes kidneys heart skin Unmanaged diabetes can also cause nerve damage. People with diabetes can experience sudden drops in their blood sugar. Skipping a meal or taking too much insulin or other medications that increase insulin levels in the body are common causes. People who are on other diabetes medications that do not increase insulin levels are not at risk for hypoglycemia. Symptoms can include: blurry vision rapid heartbeat headache shaking dizziness If your blood sugar gets too low, you can experience fainting, seizures, or coma. This is a complication of diabetes that occurs when your body cannot use sugar, or glucose, as a fuel source because your body has no insulin or not enough insulin. If your cells are starved for energy, your body begins to break down fat. Potentially toxic acids called ketone bodies, which are byproducts of fat breakdown, build up in the body. This can lead to: dehydration abdominal pain breathing problems Diabetes can damage blood vessels in the eyes and cause various problems. Possible eye conditions may include: Cataracts Cataracts are two to five times more likely to develop in people Continue reading >>

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For Slumbering Diabetics, A Way To Detect Low Blood Sugar And Stop Insulin Delivery

For Slumbering Diabetics, A Way To Detect Low Blood Sugar And Stop Insulin Delivery

2014 New research could soon make it easier for people with type-1 diabetes to get a safe night’s sleep, says a Stanford University School of Medicine scientist who led the study. In a large trial conducted in patients’ homes in the United States and Canada, scientists demonstrated that they could predict and prevent dangerously low overnight blood sugars in adolescents and adults with type-1 diabetes. Very low blood-sugar levels can cause seizures or even, in rare cases, death. People with type-1 diabetes often sense warning signs of low blood sugar when they are awake, but not during sleep, explaining why 75 percent of diabetic seizures occur at night. The new study, published online May 7 in Diabetes Care, coupled a glucose sensor worn under the skin to an insulin pump that was connected wirelessly to a computer at the bedside. The computer ran an algorithm that calculated when a low blood-sugar level might occur and then temporarily suspended insulin delivery until the sugar level was trending upward. This occurred without waking the patient. The shutoffs reduced the cumulative time patients spent with low blood sugars during sleep by 81 percent, with only a minimal increase in nighttime glucose levels. “A system like this should dramatically decrease diabetics’ risk of having a seizure overnight,” said Bruce Buckingham, MD, professor of pediatric endocrinology at Stanford, who led the trial and is a co-author of the study. “Patients and parents will be able to have a better night’s sleep, knowing that there is a much lower risk of severe hypoglcyemia at night.” Buckingham is also a pediatric endocrinologist at Lucile Packard Children’s Hospital Stanford. Searching for nighttime solutions Diabetics who use insulin pumps usually receive a low dose o Continue reading >>

What Is A Diabetic Seizure?

What Is A Diabetic Seizure?

Diabetes is known to cause a number of severe problems, including seizures and comas. A diabetic seizure occurs when the body receives a number of different signals from the brain that happen at the same time and contradict each other. Seizures in general can be caused by a number of different problems, including high or low blood glucose levels. A seizure is a serious condition and can result in death in some cases. Although a person may be alert during a diabetic seizure, he or she often will not be fully aware of what is going on. For this reason, it can be difficult for surrounding people to know how to treat the condition, since the person having the seizure cannot provide any advice. Emergency medical officials should be contacted immediately, unless the person caring for the patient is experienced and knows how to handle the problem. There are a number of different symptoms of a diabetic seizure caused by high or low blood glucose levels. The seizure often induces violent and sudden convulsions although these aren’t always present. Muscle weakness, confusion, sweating and a lack of awareness are other common signs. There are a large number of different types of seizures which are categorized according to the type of symptoms they induce. Many of these seizures have unknown causes. Some types of seizures may not induce the shaking and convulsions which many people associate with the problem. For example, a seizure can cause the person to smell a strange scent when no on else can or suffer from alterations in his or her vision. Sometimes a seizure will last for no longer than a few seconds, while other times it will not stop on its own. A common mistake among people trying to treat a diabetic seizure for low blood glucose levels is to attempt to feed the person. Continue reading >>

Dead In Bed Syndrome

Dead In Bed Syndrome

Tweet Dead in bed syndrome (DIB) is a term used to describe the sudden unexplained deaths of young people with type 1 diabetes. The syndrome is characterised as when someone with insulin dependent diabetes has gone to bed seemingly perfectly fine and has been found dead in an undisturbed bed. How common is dead in bed syndrome? The syndrome is relatively rare but is thought to account for about 6% of cases of all deaths in under 40 year old people with type 1 diabetes. By comparison, diabetic ketoacidosis is a significantly more common cause of death, accounting for around 2% to 3% of all deaths in diabetic patients. What causes dead in bed syndrome? A lack of detailed post-mortem notes has meant that the cause or causes of dead in bed syndrome have not been confirmed with certainty. The evidence that has been available suggests that deaths could be caused by night time hypoglycemia triggering disturbances in heart rhythm or cardiac autonomic neuropathy (damage to nerves that control the functioning of the heart).[140] Hypoglycemia-associated autonomic failure (HAAF) is also thought to play a part. HAAF means patients have a reduced counter-regulatory response to hypos and reduced hypo awareness. The reduced counter-regulatory response means that the body has reduced ability to produce the adrenaline (epinephrine) or glucagon in response to a hypo. Glucagon is the body’s blood glucose raising hormone, and so a lack of glucagon response takes away a key life saving mechanism. Dead in bed syndrome and human insulin It has been noted that dead in bed syndrome became more commonplace since the introduction of human (synthetic) insulin within the 1980s. Research indicates that synthetic insulin has a reduced stress response in comparison to animal insulin. [141] This could Continue reading >>

Dead In Bed Syndrome

Dead In Bed Syndrome

Twitter recently got in a twit about a statement someone found on the Internet: "One in 20 type 1 diabetics die in their sleep due to a sudden drop in their blood sugar." That’s quite a statistic, and one that raises all sorts of questions. Where did this strange and disturbing statistic come from? Does this mean that of all T1 PWD who die, 1 in 20 (5%) die in their sleep from something relating to dropping blood sugar? Does "sudden drop" mean any kind of drop - for instance, from high to normal, or only if it goes low? What’s the evidence that these deaths are indeed due to low blood sugar? And what can we do to prevent such a death? The "Dead in Bed Syndrome" is quite a problem, both for parents of kids with diabetes, and their physicians. One pediatric endocrinologist said "my patients are totally freaked out about this (as am I). My problem is that we have about 1200 patients in our practice with type 1 dm- does that mean statistically 6 patients in my practice will_ __eventually _drop dead in their sleep." A thorough discussion with multiple references, is on-line at the Children With Diabetes website, at The Dead in Bed Syndrome. It should be noted that different authors have developed different definitions for the Dead in Bed Syndrome (sometimes abbreviated DIB), and partially as a result of the differing definitions, and probably mainly as a result of differing patient populations (e.g., country where the study was done, degree of diabetes control of the patients, age breakdown, etc.) the rate of DIB varies widely. The Dead in Bed Syndrome was first discussed in 1991 when the Professional Advisory Committee of the British Diabetic Association published a report, Unexplained deaths of type 1 diabetic patients. They evaluated 50 autopsied deaths of people with Continue reading >>

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