Ketoacidosis And Hyperosmolar Coma
There are two acute conditions that can develop from the combination of high blood sugars and dehydration. The first is called diabetic ketoacidosis, or DKA. It occurs in people who make virtually no insulin on their own (either type 1 diabetics or type 2 diabetics who have lost nearly all beta cell activity). Very low serum insulin levels, combined with the insulin resistance caused by high blood sugars and dehydration, result in the virtual absence of insulin-mediated glucose transport to the tissues of the body. In the absence of adequate insulin, the body metabolizes stored fats to produce the energy that tissues require to remain alive. A by-product of fat metabolism is the production of substances called ketones and ketoacids. One of the ketones, acetone, is familiar as the major component of nail polish remover. Ketones may be detected in the urine by using a dipstick such as Ketostix (see Chapter 3, “Your Diabetic Tool Kit”). Ketones may also be detected on the breath as the aroma of an organic solvent, which is why unconscious diabetics are often mistaken for passed-out drunks. Ketones and ketoacids are toxic in large amounts. More important, your kidneys will try to eliminate them with even more urine, thereby causing further dehydration. Some of the hallmarks of severe ketoacidosis are large amounts of ketones in the urine, extreme thirst, dry mouth, nausea, frequent urination, deep labored breathing, and high blood sugar (usually over 350 mg/dl). The other acute complication of high blood sugar and dehydration, hyperosmolar coma, is a potentially more severe condition, and occurs in people whose beta cells still make some insulin. (“Hyperosmolar” refers to high concentrations of glucose, sodium, and chloride in the blood due to inadequate water to di Continue reading >>
Diabetic Coma Causes
Diabetics with prolonged blood-sugar extremes (either too high or too low blood-sugar level) may lead to a diabetic coma. Causes of Diabetes coma Many condition diabetes conditions lead to the cause of diabetes coma. They are: Diabetic ketoacidosis (DKA) - If the muscle cells become energy starved, and the body may respond by breaking down stored fats. Breaking down of fats produces a toxic acid known as ketones and this breakdown is called as ketoacidosis. If it left untreated, DKA can lead to a diabetic coma. DKA is most common among diabetes type 1, but can also affect the type 2 diabetes or gestational diabetes. Diabetic hyperosmolar syndrome - If the blood-sugar level rises to 600 milligrams per deciliter (mg/dL), or 33 millimoles per liter (mmol/L) it is called as diabetic hyperosmolar syndrome. Such a high level of glucose in blood makes the blood thicker like syrup. This excess sugar level is removed from the blood through the urine, which remove tremendous amounts of fluid from the body causing dehydration. If it left untreated diabetic hyperosomolar syndrome can lead to dangerous dehydration and coma. Hyperosmolar syndrome is more common among type 2 diabetes. Hypoglycemia - Brain needs glucose to function properly. An extreme low blood-sugar level may lead to pass out. Hypoglycemia can be caused by large quantityof insulin or too little of food or vigorous exercise or drinking lot of alcohol. Anyone who has diabetes is at risk of a diabetic coma. Type 1 is more at risk of a diabetic coma caused by: Low blood-sugar (hypoglycemia), and DKA Type 2 is more at risk of a diabetic coma caused by: hyperosmolar syndrome. Diabetic coma risk factors. Some factors can increase the risk of diabetic coma they include: Insulin delivery system problems - If on an insulin pum Continue reading >>
Diabetic coma is a medical emergency in which a person with diabetes loses consciousness because of one of the acute complications of diabetes: Advanced ketoacidosis from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic state, in which extreme hyperglycemia and dehydration alone are enough to cause unconsciousness. Coma is a profound state of unconsciousness and a person in coma does not respond normally to pain or light, does not take any voluntary action, and does not exhibit the normal sleep-wake cycles. It may be a result of several conditions including including intoxication, metabolic abnormalities, central nervous system diseases, acute neurologic injuries such as stroke, and hypoxia. In some cases, it is deliberately induced by administering pharmaceutical agents with a view to preserve higher brain function following another form of brain trauma. Diabetic coma is a condition which may result as a severe complication of diabetes and may take three major forms of complications as indicated above, namely, hyperglycemia (high blood sugar), Diabetic ketoacidosis, and Hyperosmolar nonketotic state. In some case, even hypoglycemia (low blood sugar) may also trigger diabetic coma. Diabetic coma is largely preventable if proper medications as prescribed is taken along with having a healthy diet and maintaining a suitable lifestyle. At the same time, the blood sugar level should be monitored closely to indicate potential problems. Diabetic coma does not strike suddenly - it is preceded by a number warning signs and symptoms. In case of high blood sugar (hyperglycemia the person affected may experience one or more of these signs - frequent urination and increased thirst, dry mouth, vomiting and nausea, and shortness of b Continue reading >>
Your Intensive Care Hotline - Diabetic Coma
What is Diabetic Coma? Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified: Severe diabetic hypoglycemia Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious Patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious Patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. What is diabetes? Diabetic Ketoacidosis (DKA) Hyperosmolar Hypoglycemic Non-Ketotic Coma (HHNKC) Hypoglycemic Coma What happens In Intensive Care? How long will your loved one remain in Intensive Care? Internet Links What is Diabetes? Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.This high blood sugar produces Continue reading >>
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What Is A Diabetic Coma?
Diabetic coma is a rare but serious occurrence. It is important to be aware of the risks of coma in diabetic patients and the possible causes. Diabetes mellitus is typically characterized by high blood sugar and an inability to reduce this sugar level. This may be due to a true (as in type 1) or relative (as in type 2) deficiency of insulin, the hormone responsible for lowering blood sugar. The three most common causes of coma in diabetic patients are: Very low blood sugar or severe hypoglycaemia If the blood sugar level in the brain drops to a critical level (below 3.5 mmol/l), a person is at risk of losing consciousness and falling into a diabetic coma. Normally, as blood sugar begins to fall, the body compensates for this by releasing glucagon, a hormone that opposes the actions of insulin by raising blood glucose. A coma is more likely to occur if an individual has taken an overdose of insulin or other anti-diabetic medications, consumed a lot of alcohol or taken part in an unusual amount of exercise (especially if they are also on insulin). Diabetic ketoacidosis This is mostly seen in people with type 1 diabetes or those who are taking insulin. If there is shortage of insulin, the body fails to use the glucose in the blood for energy and instead fats are broken down to provide it, which forms acidic compounds called ketones. A build up ketones in the body causes a condition called ketoacidosis. Ketoacidosis may occur as a result of a missed dose of insulin or as a result of acute infection, injury or surgery causing a rise in hormones that counteract the effects of insulin. Hyperosmolar hyperglycemic state (HHS) This condition is characterized by severe dehydration and very high blood glucose. A missed dose of insulin, acute infection or injury, and heavy food or s Continue reading >>
Sometimes While Working Out And Trying Hard To Hit Last Reps, I Feel A Taste Of Alcohol In My Mouth. Why Does This Happen?
My theory is that your body is burning fat while you are working out (that is part of the goal, no?) and you are tasting ketones/acetone. When our bodies metabolize fat, ketones (ketone bodies) develop and circulate in our bloodstream. This is a mild, usually harmless, condition called ketosis. Ketones spontaneously break down into acetone. Yes, the same acetone that is paint thinner, finger nail polish remover or adhesive remover/glue dissolver. The ketones and acetone have a very distintive taste and smell. To many people, the taste and smell are very similar to alcohol. So similar that people in ketoacidosis* have been arrested for public drunkeness, because their breath smelled like wine breath (also, ketoacidosis makes a person act drunk). [To me, ketones/acetone tastes like Elmer’s Glue when I was a kid.] *Ketoacidosis or Diabetic Ketoacidosis is a life-threatening condition in people whose bodies don’t make enough insulin to metabolize the glucose in their blood. Ketones and excess glucose make the blood too acidic and this hyperacidic blood can cause coma, liver and kidney damage and (if not treated) death. Continue reading >>
The Scary Experience Of Diabetic Ketoacidosis
Today, we’re excited to share with you another guest blog from Katie Janowiak, who works for the Medtronic Foundation, our company’s philanthropic arm. When she first told me her story about food poisoning and Diabetic Ketoacidosis (DKA), I knew others could benefit from hearing it as well. Thanks Katie for your openness and allowing us to share your scary story so that the LOOP community can learn from it. Throughout this past year, I’ve had the honor of sharing with you, the amazing LOOP community, my personal journey and the often humorous sequence of events that is my life with T1. Humor is, after all, the best (and cheapest) therapy. Allow me to pause today to share with you the down and dirty of what it feels like to have something that is not the slightest bit humorous: diabetic ketoacidosis.You are hot. You are freezing. You are confused. You are blacked out but coherent. You go to talk but words fail you. Time flies and goes in slow motion simultaneously. You will likely smell and look like death. In my instance, this was brought on by the combination of excessive vomiting and dehydration caused by food poisoning and the diabetic ketoacidosis that followed after my body had gone through so much. In hindsight, I was lucky, my husband knew that I had food poisoning because I began vomiting after our meal. But I had never prepped him on diabetic ketoacidosis and the symptoms (because DKA was for those other diabetics.) Upon finding me in our living room with a bowl of blood and bile by my side (no, I am not exaggerating), he got me into the car and took me to emergency care. It was 5:30 p.m. – and I thought it was 11:00 a.m. The series of events that led up to my stay in the ICU began innocently enough. It was a warm summer night and my husband and I walke 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 >>
What You Should Know About Recovery From Diabetic Coma
A diabetic coma occurs when a person with diabetes loses consciousness. It can occur in people with type 1 or type 2 diabetes. A diabetic coma occurs when blood sugar levels become either too low or too high. The cells in your body require glucose to function. High blood sugar, or hyperglycemia, can make you feel lightheaded and lose consciousness. Low blood sugar, or hypoglycemia, can cause dehydration to the point where you may lose consciousness. Usually, you can prevent hyperglycemia or hypoglycemia from progressing to a diabetic coma. If a diabetic coma occurs, it’s likely that your doctor can balance your blood glucose levels and restore your consciousness and health quickly if they can respond to your condition in a timely manner. You can also slip into a diabetic coma if you develop diabetic ketoacidosis. Diabetic ketoacidosis (DKA) is a buildup of chemicals called ketones in your blood. Hypoglycemia The symptoms of hypoglycemia may include: headache fatigue dizziness confusion heart palpitations shakiness Hyperglycemia If you have hyperglycemia, you may experience noticeably increased thirst and you may urinate more frequently. A blood test would also reveal higher levels of glucose in your blood stream. A urine test can also show that your glucose levels are too high. DKA causes high levels of blood glucose. The symptoms also include increased thirst and a frequent need to urinate. Other symptoms of elevated ketone levels include: feeling tired having an upset stomach having flushed or dry skin If you have more severe diabetic coma symptoms, call 911. Severe symptoms may include: vomiting difficulty breathing confusion weakness dizziness A diabetic coma is a medical emergency. It can lead to brain damage or death if you don’t get treatment. Treating hyperg 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 >>
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 >>
What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don't have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or keto acids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations. In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death. Ketoacidosis is always accompanied by dehydration, which is caused by high Continue reading >>
Diabetic Coma Symptoms, What You Need To Know
Diabetic coma symptoms are something we should all be aware of. It is true that type 1 diabetics are more likely to experience them than type 2, but as diabetics are living longer, the chance of experiencing symptoms is greater. One statistic is that up to 15% of diabetics will go into diabetic coma because of severe hypoglycemia. Coma is another word for unconscious. A diabetic is in a coma if he cannot be wakened and can't respond to sounds and sights. It does not mean the person in a coma will die. These days, with swift blood test results and treatment, a diabetic will come out of a coma very fast. Diabetic medical alert bracelets and necklaces keep us from being misdiagnosed as drunk or epileptic when we cannot speak. But just knowing you are a diabetic is not enough. If you are taken to an emergency room, the doctors look for diabetic alert charms. But diabetic coma symptoms still need to be diagnosed correctly so the proper treatment is started, because there are three different types of coma, and the complications of all three are brain damage and death. Oddly, either chronic high blood sugar or sudden low blood sugar can trigger diabetic coma symptoms. That's why it's good to know how we react to both of them. With high blood sugar, or hyperglycemia, you feel thirsty and have to urinate more often. You feel fatigue, and there is always nausea and vomiting, often for days. You can feel short of breath and have stomach pain. There is a fruity or acetone smell to your breath and a fast heartbeat. The symptoms are not sudden. But low blood sugar comes on very swiftly and can wake you out of a sound sleep. You feel shaky, nervous, tired and either hungry or nauseated. You sweat a lot and your heart races. You can get irritated and even aggressive for no reason, and Continue reading >>
Understanding And Preventing Diabetic Coma
Diabetic coma is a serious, potentially life-threatening complication associated with diabetes. A diabetic coma causes unconsciousness that you cannot awaken from without medical care. Most cases of diabetic coma occur in people with type 1 diabetes. But people with other types of diabetes are also at risk. If you have diabetes, it’s important to learn about diabetic coma, including its causes and symptoms. Doing so will help prevent this dangerous complication and help you get the treatment you need right away. Diabetic coma can occur when blood sugar levels are out of control. It has three main causes: Hypoglycemia Hypoglycemia occurs when you don’t have enough glucose, or sugar, in your blood. Low sugar levels can happen to anyone from time to time. If you treat mild to moderate hypoglycemia immediately, it usually resolves without progressing to severe hypoglycemia. People on insulin have the highest risk, though people who take oral diabetes medications that increase insulin levels in the body may also be at risk. Untreated or unresponsive low blood sugars can lead to severe hypoglycemia. This is the most common cause of diabetic coma. You should take extra precautions if you have difficulty detecting symptoms of hypoglycemia. This diabetes phenomenon is known as hypoglycemia unawareness. DKA Diabetic ketoacidosis (DKA) occurs when your body lacks insulin and uses fat instead of glucose for energy. Ketone bodies accumulate in the bloodstream. DKA occurs in both forms of diabetes, but it’s more common in type 1. Ketone bodies may be detected with special blood glucose meters or with urine strips to check for DKA. The American Diabetes Association recommends checking for ketone bodies and DKA if your blood glucose is over 240 mg/dl. When left untreated, DKA can 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 >>