Risk Factors And Symptoms Of A Diabetic Coma
It is important for diabetics to keep track of their blood sugar levels because any discrepancies that result in dangerously high or low levels can lead to a diabetic coma. A diabetic coma is a life-threatening complication associated with the disease that causes unconsciousness. If left untreated, a diabetic coma can be fatal. Risk Factors for a Diabetic Coma Anyone who has diabetes is at risk of experiencing a diabetic coma. If you suffer from type 1 diabetes, you're at risk of a diabetic coma due to low blood sugar or diabetic ketoacidosis. If you have type 2 diabetes, you're at risk of a diabetic coma due to diabetic hyperosmolar syndrome, particularly if you're middle-aged or older. Both type 1 and type 2 diabetics are at risk due to insulin delivery problems as well. It is important to know that even if you're on an insulin pump, you have to check your blood sugar frequently. Always ensure that there are no kinks in your insulin pump tubing, as this could cause all insulin delivery to stop. Even tubeless pumps can occasionally cause problems that can cause insulin delivery to stop. There are other risk factors that diabetics should be aware of as well, such as illness, trauma or surgery. When you are sick or injured, your blood sugar levels tend to rise. This sudden rise may cause diabetic ketoacidosis if you have type 1 diabetes and don't increase your insulin intake to compensate. Congestive heart failure or kidney disease can also increase your risk of diabetic hyperosmolar syndrome, which can lead to a diabetic coma. Diabetes management is absolutely key to staying healthy, and if you do not monitor your blood sugar properly or take your medications as directed, you are increasing your risk of developing long-term complications and diabetic coma. Deliberately Continue reading >>
A state of profound unconsciousness from which a person cannot be aroused. It may be the result of trauma, a brain tumor, loss of blood supply to the brain (as from cerebrovascular disease), a toxic metabolic condition, or encephalitis (brain inflammation) from an infectious disease. In people with diabetes, two conditions associated with very high blood glucose may cause coma; these are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Severe hypoglycemia, or very low blood glucose, may also lead to coma. It’s important for all people with diabetes to learn to recognize these conditions and respond accordingly. Diabetic ketoacidosis is a serious imbalance in blood chemistry causing about 100,000 hospitalizations each year, with a mortality rate of under 5%. It typically occurs when a person has high blood sugar and insufficient insulin to handle it. Without adequate insulin, the body breaks down fat cells for energy, flooding the bloodstream with metabolic by-products called ketoacids. Meanwhile, the kidneys begin filtering large amounts of glucose from the blood and producing large amounts of urine. As the person urinates more frequently, the body becomes dehydrated and loses important minerals called electrolytes. If not treated, these serious imbalances can eventually lead to coma and death. Hyperosmolar hyperglycemic state most commonly affects elderly people. Like DKA, HHS starts with high blood glucose and insulin deficiency and causes people to urinate frequently and become dehydrated. HHS also impairs the ability of the kidneys to filter glucose from the bloodstream, making the blood glucose level rise even higher. Because of the extreme dehydration, HHS can be life-threatening, with a mortality rate of 15%, and can be even more difficul Continue reading >>
Tweet Coma is relatively rare in diagnosed diabetes but it is very important to be aware of the situations that increase risk of coma. Causes of diabetic coma The main causes of coma occurring in people with diabetes are as a result of very low or very high blood glucose levels. The three most common causes of coma in people with diabetes are: Severe hypoglycemia and coma Severe hypoglycemia (very low blood glucose levels) can lead to loss of consciousness and coma if not treated. In most cases the body will restore blood sugar levels to normal by releasing glucagon to raise blood sugar levels. Coma is more likely to occur from low blood glucose levels if: A large insulin overdose is taken Alcohol is in the body during hypoglycemia Exercise has depleted the body’s glycogen supply Diabetic ketoacidosis and coma Diabetic ketoacidosis is a dangerous state of having very high blood glucose levels (typically above 17 mmol/L) in combination with high ketone levels. Ketoacidosis is able to occur if the body runs out of insulin and is therefore a factor for people with type 1 diabetes to be aware of. Insulin can prevent ketone levels rising and this is the key reason why people with diabetes are advised never to miss their long term (basal) insulin injections. The symptoms of ketoacidosis include nausea, vomiting, dehydration, disorientation and deep, laboured breathing. If someone with diabetes is displaying these symptoms call for emergency medical help as loss of consciousness and coma could follow. Illness in type 1 diabetes can lead to high blood glucose and ketone levels. It is advisable to test for ketones during periods of illness to prevent ketoacidosis developing. Diabetic coma at diagnosis of type 1 diabetes If the symptoms of type 1 diabetes are not spotted soon e Continue reading >>
What Is Diabetic Ketoacidosis?
Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death. What can I expect in the hospital? You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include: Monitoring You will be checked often by the hospital staff. You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home. A heart (cardiac) monitor may Continue reading >>
> Hyperglycemia And Diabetic Ketoacidosis
When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>
Diabetic Coma Recovery: What You Need To Know
In people with diabetes, a diabetic coma occurs when severe levels of either high or low uncontrolled blood sugar are not corrected. If treated quickly, a person will make a rapid recovery from a diabetic coma. However, diabetic coma can be fatal or result in brain damage. It is important for people with diabetes to control their blood sugars and know what to do when their blood sugar levels are not within their target range. The severe symptoms of uncontrolled blood sugar that can come before a diabetic coma include vomiting, difficulty breathing, confusion, weakness, and dizziness. Recovery from diabetic coma If a diabetic coma is not treated within a couple of hours of it developing, it can cause irreversible brain damage. If no treatment is received, a diabetic coma will be fatal. In addition, having blood sugar levels that continue to be too low or too high can be bad for long-term health. This remains true even if they do not develop into diabetic coma. Recognizing the early signs of low or high blood sugar levels and regular monitoring can help people with diabetes keep their blood sugar levels within the healthy range. Doing so will also reduce the risk of associated complications and diabetic coma. What is diabetes? Diabetes is a long-term condition in which the body is unable to control the level of a sugar called glucose in the blood. Diabetes is caused by either a lack of insulin, the body's inability to use insulin correctly, or both. In people who don't have diabetes, insulin usually ensures that excess glucose is removed from the bloodstream. It does this by stimulating cells to absorb the glucose they need for energy from the blood. Insulin also causes any remaining glucose to be stored in the liver as a substance called glycogen. The production of insul Continue reading >>
Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>
What Is Diabetic Ketoacidosis?
Diabetic ketoacidosis, or DKA, is a serious health problem that can happen to a person with diabetes. It happens when chemicals called ketones build up in the blood. Normally, the cells of your body take in and use glucose as a source of energy. Glucose moves through the body in the bloodstream. Insulin is a hormone that helps your cells take in the glucose from the blood. If you have diabetes, your cells can’t take in and use this glucose in a normal way. This may be because your body doesn’t make enough insulin. Or it may be because your cells don’t respond to it normally. As a result, glucose builds up in your bloodstream and doesn’t reach your cells. Without glucose to use, the cells in your body burn fat instead of glucose for energy. When cells burn fat, they make ketones. High levels of ketones can poison the body. High levels of glucose can also build up in your blood and cause other symptoms. Ketoacidosis also changes the amount of other substances in your blood. These include electrolytes, such as sodium, potassium, and bicarbonate. This can lead to other problems. Ketoacidosis happens most often in a person with type 1 diabetes. This is a condition where the body does not make enough insulin. In rare cases, ketoacidosis can happen in a person with type 2 diabetes. It can happen when they are under stress, like when they are sick, or when they have taken certain medicines that change how their bodies handle glucose. Diabetic ketoacidosis is pretty common. It is more common in younger people. Women have it more often than men do. What causes diabetic ketoacidosis? High levels of ketones and glucose in your blood can cause ketoacidosis. This might happen if you: Don’t know you have diabetes, and your body is breaking down too much fat Know you have dia Continue reading >>
Diabetic Ketoacidosis And Hyperosmolar Coma.
Abstract DKA-hyperosmolar coma is a readily diagnosed and easily treated, potentially catastrophic emergency that regularly occurs in both Type I and Type II diabetics. This review emphasized that diabetic ketoacidosis and hyperosmolar coma can, and very frequently do, occur concurrently, but it is the hyperosmolar state rather than the DKA that is the primary cause of coma and death in this condition. One must therefore vigorously treat the hyperosmolarity and resulting dehydration, especially when total calculated osmolarity exceeds 230 to 240 mOsm/L. The major aim of treatment is to rapidly replace the major water loss that is responsible for this clinical condition and to stimulate glucose metabolism with insulin. The diagnosis of this dangerous condition is relatively simple. The therapy, in most regards, is equally apparent. There are good data demonstrating that the prompt recognition of DKA-hyperosmolar coma and the simple institution of rapid rehydration have continued to reduce the mortality and complications of this potentially disastrous complication of diabetes mellitus. Continue reading >>
Print Overview A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. If you lapse into a diabetic coma, you're alive — but you can't awaken or respond purposefully to sights, sounds or other types of stimulation. Left untreated, a diabetic coma can be fatal. The prospect of a diabetic coma is scary, but fortunately you can take steps to help prevent it. Start by following your diabetes treatment plan. Symptoms Before developing a diabetic coma, you'll usually experience signs and symptoms of high blood sugar or low blood sugar. High blood sugar (hyperglycemia) If your blood sugar level is too high, you may experience: Increased thirst Frequent urination Fatigue Nausea and vomiting Shortness of breath Stomach pain Fruity breath odor A very dry mouth A rapid heartbeat Low blood sugar (hypoglycemia) Signs and symptoms of a low blood sugar level may include: Shakiness or nervousness Anxiety Fatigue Weakness Sweating Hunger Nausea Dizziness or light-headedness Difficulty speaking Confusion Some people, especially those who've had diabetes for a long time, develop a condition known as hypoglycemia unawareness and won't have the warning signs that signal a drop in blood sugar. If you experience any symptoms of high or low blood sugar, test your blood sugar and follow your diabetes treatment plan based on the test results. If you don't start to feel better quickly, or you start to feel worse, call for emergency help. When to see a doctor A diabetic coma is a medical emergency. If you feel extreme high or low blood sugar signs or symptoms and think you might pass out, call 911 or your local emergency nu Continue reading >>
Diabetic Coma Different From Insulin Shock, Role Of Hyperglycemia And Hypoglycemia Crucial
The role of hyperglycemia and hypoglycemia are crucial in diabetic coma. A diabetic coma is a complication of diabetes that leads to unconsciousness. A diabetic coma can result from both hyperglycemia – high blood sugar – or hypoglycemia – low blood sugar. A person in a diabetic coma is still alive, but they do not respond to light, sound, touch or any stimulation. If left untreated a diabetic coma can be fatal. A diabetic coma can be confused with an insulin shock, but although the two may appear similar, they do contain their own unique differences. Diabetic coma vs. insulin shock Insulin shock is the body’s reaction to a drop in blood sugar – or hypoglycemia – as a result of too much insulin. Even though the condition is called insulin shock, there is no shock involved and insulin isn’t the main culprit. Even people without diabetes can experience insulin shock if their blood sugar drops low enough. The condition is called a shock because it makes the body react similarly to when blood pressure drops – a fight or flight response. Symptoms of insulin shock are fast breathing, rapid pulse, dizziness, headache, numbness and hunger. Diabetic coma, on the other hand, causes unconsciousness that can occur over the course of days or even weeks and also cause dehydration. Although both conditions must be treated immediately, diabetic coma can be fatal. Causes of diabetic coma There are various causes of diabetic coma, including diabetic ketoacidosis, diabetic hyperosmolar syndrome, and hypoglycemia. Diabetic ketoacidosis: This is a condition where muscles become starved for energy, so the body begins breaking down fat from storage. This forms a toxin known as ketones and, if untreated, can contribute to diabetic coma. Diabetic hyperosmolar syndrome: Diabetic Continue reading >>
Diabetic Coma: Causes, What Happens When You Go Into A Diabetic Coma?
What is Diabetic Coma and What Happens When You go Into a Diabetic Coma? Diabetic coma is a fatal complication that leads to unconsciousness. Any diabetic person with extremely high (hyperglycemia) or low (hypoglycemia) level of blood sugar can be affected by diabetic coma. A person who has slipped into diabetic coma will not be able to respond to any physical stimulation except for being alive. Diabetic coma can cause death when left untreated or not properly treated on time. There are very less chances of hopes in case of diabetic coma. However one can control his or her health conditions to avoid occurrence of diabetic coma. One should follow their diabetes management plan strictly to avoid a turn towards diabetic coma. Diabetic coma is of three types, ketoacidosis coma, hyperosmolar coma and hypoglycemic coma. Emergency medical facility is required in case of a diabetic coma Hyperglycaemia or hypoglycaemia is caused by huge rate of fluctuation in the blood sugar level leading to diabetic coma. Whenever there is any extreme fluctuation in the glucose level of the blood, the same has to be reported to the doctor immediately. Never forget that "prevention is better than cure". Make yourself more aware on diabetes and learn the likely consequences of the disease to keep yourself alert. Frequently Asked Questions (F.A.Q's) on Diabetic Coma A person can fall in to diabetic coma while suffering from Diabetic ketoacidosis (DKA). The person will not remain conscious in this sleep-like state. This state which can be caused by hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose), can remain for long time or sometimes lead to death. "Ketones" are generated in the human body when it uses body fat for energy. Ketones are also generated when there is minimum insu Continue reading >>
What You Should Know About Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>
The three types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. Diabetic coma is a medical emergency and needs prompt medical treatment. Uncontrolled blood glucose levels may lead to hyperglycaemia or hypoglycaemia. Low or persistently high blood glucose levels mean your diabetes treatment needs to be adjusted. Speak to your doctor or registered diabetes healthcare professional. Prevention is always the best strategy. If it is a while since you have had diabetes education, make an appointment with your diabetes educator for a review. On this page: Diabetes mellitus is a condition characterised by high blood glucose (sugar) levels. Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. The three types of coma associated with diabetes are diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. Diabetic ketoacidosis coma Diabetic ketoacidosis typically occurs in people with type 1 diabetes, which was previously known as juvenile diabetes or insulin dependent diabetes mellitus (IDDM), though it can occasionally occur in type 2 diabetes. This type of coma is triggered by the build-up of chemicals called ketones. Ketones are strongly acidic and cause the blood to become too acidic. When there is not enough insulin circulating, the body cannot use glucose for energy. Instead, fat is broken down and then converted to ketones in the liver. The ketones can build up excessively when insulin levels remain too low. Common causes of ketoacidosis include a missed dose of insulin or an acute infection in a person with type 1 diabetes. Ketoacidosis may be the first sign that a person has developed type 1 diabetes. Symptoms of ketoacidosis Symptoms of ketoacidosis are: extreme thirst lethargy frequent urination ( Continue reading >>
Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. Diabetic ketoacidosis (DKA) is the leading cause of mortality in childhood diabetes.The primary cause of DKA is absolute or relative insulin deficiency: Absolute - eg, previously undiagnosed type 1 diabetes mellitus or a patient with known type 1 diabetes who does not take their insulin. Relative - stress causes a rise in counter-regulatory hormones with relative insulin deficiency. DKA can be fatal The usual causes of death are: Cerebral oedema - associated with 25% mortality (see 'Cerebral odedema', below). Hypokalaemia - which is preventable with good monitoring. Aspiration pneumonia - thus, use of a nasogastric tube in the semi-conscious or unconscious is advised. Deficiency of insulin. Rise in counter-regulatory hormones, including glucagon, cortisol, growth hormone, and catecholamines. Thus, inappropriate gluconeogenesis and liver glycogenolysis occur compounding the hyperglycaemia, which causes hyperosmolarity and ensuing polyuria, dehydration and loss of electrolytes. Accelerated catabolism from lipolysis of adipose tissue leads to increased free fatty acid circulation, which on hepatic oxidation produces the ketone bodies (acetoacetic acid and beta-hydroxybutyric acid) that cause the metabolic acidosis. A vicious circle is usually set up as vomiting usually occurs compounding the stress and dehydration; the cycle can only be broken by providing insulin and fluids; otherwise, severe acidosis occurs and can be fatal. Biochemical criteria The biochemical criteria required for a diagnosis of DKA to be made are Continue reading >>