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Why Does Ketoacidosis Cause Coma

> Hyperglycemia And Diabetic Ketoacidosis

> 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 Ketoacidosis And Hyperosmolar Coma.

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 >>

Diabetic Coma

Diabetic Coma

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 >>

Understanding And Preventing Diabetic Coma

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 >>

Diabetic Coma Symptoms

Diabetic Coma Symptoms

A diabetic coma is one of the most life-threatening complications of diabetes. The main symptom is unconsciousness. A diabetic coma can be the result of having a blood glucose level that is too high (hyperglycemia) or a blood glucose level that is too low (hypoglycemia). The diabetic in a diabetic coma is unconscious and can die if the condition is not treated. Symptoms of Diabetic Coma Before you lapse into a diabetic coma, there are usually warning signs of blood sugar levels that are too low or blood sugar levels that are too high. For example, if the blood sugar is too high, the you may experience tiredness, abdominal pain, shortness of breath, increased urination, increased thirst, a rapid heart rate, a dry mouth, and a fruity smell to your breath. If the blood sugar is too low, you may experience signs and symptoms of hypoglycemia, including weakness, tiredness, anxiety, tremulousness, nervousness, nausea, confusion, problems communicating, light-headedness, hunger, or dizziness. If you have had diabetes for many years, you may not have many symptoms of low blood sugar and won’t know you have the condition prior to falling into a coma. If you suspect that you have either high blood sugar or low blood sugar, you need to check your blood glucose levels and do what your doctor has recommended for you to treat the disease. If you don’t feel better after trying home remedies, you need to call 911 and get some kind of emergency care. Causes of Diabetic Coma The main cause of a diabetic coma is an extremely high blood sugar or an extremely low blood sugar. The following medical conditions can cause a diabetic coma: Diabetic hyperosmolar syndrome. This is a condition in which the blood sugar is as high as 600 mg/d: or 33.3 mmol per liter. There are no ketones in the u Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common 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?

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 >>

Diabetic Emergencies (ketoacidosis And Coma)

Diabetic Emergencies (ketoacidosis And Coma)

The blood glucose (sugar) level is maintained with a narrow range that is sufficient for the cells to have an adequate supply of nutrition for energy production. High glucose levels can damage or even destroy cells over time while low levels will prevent cells from functioning optimally and lead to key systems in the body shutting down. Glucose like all other nutrients are derived from the food we eat. The food is digested and absorbed within the alimentary tract that runs from the mouth to the anus. The stomach and intestines (gastrointestinal tract) are the main sites for digestion and absorption. The nutrients then enter the bloodstream and travel to the liver where it is processed further. Other organs like the pancreas play a role in managing the nutrient levels within the body and its availability to the body’s cells. The pancreas specifically impacts on the blood glucose levels by secreting the hormone insulin which lowers blood glucose levels by promoting the cells to take up more glucose from the bloodstream and stimulating the liver to convert the glucose into other storage forms like glycogen and even fat. What is a diabetic emergency? Diabetes mellitus is a clinical condition which is characterized by high blood sugar levels (hyperglycemia) due to absolute (type 1 diabetes) or relative (type 2 diabetes) deficiency of insulin. This means that the body lacks insulin, secretes too little insulin or the body cells becomes resistant to the effects of insulin. The elevated blood glucose levels gradually diminishes different cells and organs. Diabetic emergencies can occur due to very high or very low blood sugar levels (hypoglycemia). They may arise in a person undergoing diabetes treatment but can also occur in new diabetic cases. Types of Diabetic Emergencies Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. Continue reading >>

What You Should Know About Recovery From Diabetic Coma

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

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 >>

Ketoacidosis And Hyperosmolar Coma

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 Recovery: What You Need To Know

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 >>

Your Intensive Care Hotline - Diabetic Coma

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 >>

Cranberry Sparkler

Cranberry Sparkler

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 >>

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