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Why Ketoacidosis Cause Coma

Fatal Coma In Diabetes.

Fatal Coma In Diabetes.

Abstract Analysis of causes of death in a population of 3,113 diabetics was carried out for a period of eight years and those patients dying of some form of diabetic coma identified. Of 1,274 deaths, only 22 (1.73%) were primarily due to coma; 7 hypoglycaemia, 8 ketoacidosis, 3 hyperosmolar coma and 4 lactic acidosis. Three of the ketoacidosis patients may have died from other causes. Most deaths occurred in patients with long-standing diabetes. In the hypoglycaemic group all were on insulin and several had been difficult to control for many years. Infection was an important precipitating factor for ketoacidosis and hyperosmolar coma. Phenformin was the cause of all cases of fatal lactic acidosis. It is reassuring that death from coma is a comparatively rare event in known treated diabetic patients. Continue reading >>

How Does A Diabetic Ketoacidosis State Differ From A Hyperosmolar Hyperglycemic State?

How Does A Diabetic Ketoacidosis State Differ From A Hyperosmolar Hyperglycemic State?

A difficult question to answer, but try to put it in a simple way. Both are same but slightly differ. The root cause of DKA and HHS is lack of insulin effect, so the first key aim of treatment is insulin. While subcutaneous insulin may suffice in less severe cases, intravenous administration is to be preferred in more severe cases because severe dehydration and hypovolemia may interfere with the absorption of subcutaneous insulin. Use of insulin pumps must be carefully monitored by trained staff. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Hyperglycaemia is the dominant feature of the hyperglycaemic hyperosmolar state, causing severe polyuria and fluid loss and leading to cellular dehydration. Progression from uncontrolled diabetes to a metabolic emergency may result from unrecognised diabetes, sometimes aggravated by glucose containing drinks, or metabolic stress due to infection or intercurrent illness and associated with increased levels of counter-regulatory hormones. Since diabetic ketoacidosis and the hyperglycaemic hyperosmolar state have a similar underlying pathophysiology the principles of treatment are similar (but not identical), and the conditions may be considered two extremes of a spectrum of disease, with individual patients often showing aspects of both. Electrolyte disturbances result from loss of water usually in excess of salt loss; hypovolaemia and severe intravascular dehydration will be accompanied by tachycardia and may give rise to thromboembolic complications (such as stroke or myocardial infarction), whereas cellular dehydration may ultimately cause the hyperosmolar coma. My Mother died on July 13th -2017 7.56 PM because of the same. Diabetic ketoacidosis is the characteristic metabolic emergency of t Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Tweet Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. DKA is most commonly associated with type 1 diabetes, however, people with type 2 diabetes that produce very little of their own insulin may also be affected. Ketoacidosis is a serious short term complication which can result in coma or even death if it is not treated quickly. Read about Diabetes and Ketones What is diabetic ketoacidosis? DKA occurs when the body has insufficient insulin to allow enough glucose to enter cells, and so the body switches to burning fatty acids and producing acidic ketone bodies. A high level of ketone bodies in the blood can cause particularly severe illness. Symptoms of DKA Diabetic ketoacidosis may itself be the symptom of undiagnosed type 1 diabetes. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration An unusual smell on the breath –sometimes compared to the smell of pear drops Deep laboured breathing (called kussmaul breathing) or hyperventilation Rapid heartbeat Confusion and disorientation Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period if blood glucose levels become and remain too high (hyperglycemia). Causes and risk factors for diabetic ketoacidosis As noted above, DKA is caused by the body having too little insulin to allow cells to take in glucose for energy. This may happen for a number of reasons including: Having blood glucose levels consistently over 15 mmol/l Missing insulin injections If a fault has developed in your insulin pen or insulin pump As a result of illness or infections High or prolonged levels of stress Excessive alcohol consumption DKA may also occur prior to a diagnosis of type 1 diabetes. Ketoacidosis can occasional Continue reading >>

Diabetic Coma Causes

Diabetic Coma Causes

Diabetes also called diabetes mellitus is a life-long health condition that is caused by the problems in insulin hormone production in the body. Diabetes may cause health problems like blurred vision, kidney disease, weak immune system and also a life threatening condition diabetic coma. Diabetic coma may be caused by extremely high and extremely low blood sugar levels even blood sugar level may be higher than 600 mg/dL. These extreme high and low blood sugar levels may be caused by these conditions ; Diabetic ketoacidosis Diabetic ketoacidosis (DKA) occurs in type-1 diabetes if your muscles needs energy and can’t find enough insulin to use glucose and uses body fatty acids to produce energy. Ketones are produced as a result of this process and ketones are harmful for our body. Diabetic ketoacidosis is a life theratening condition. Diabetic hyperosmolar syndrome Diabetic hyperosmolar syndrome occurs if your blood sugar level is higher than 600 mg/dL. Also it can be caused by extreme dehydration.This very high sugar amount causes your blood to become more concentrated and thick. Body tries to remove this high sugar by urine and loses more water. Diabetic hyperosmolar syndrome must be treated as soon as possible. Hypoglycemia ( severe) Severe hypoglycemia ( low blood sugar) may be caused by too much insulin intake, drinking too much alcohol, strenous exercies. Hypoglycemia may cause loss of consciousness and diabetic coma. Diseases and surgery Some kind of diseases, surgery or trauma may cause hyperglycemia and diabetic ketoacidosis. This may be a reason of diabetic coma. Drugs Some kind of drugs may cause hyperglycemia and diabetic coma. Continue reading >>

Diabetic Coma Causes

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 Symptoms, What You Need To Know

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Diabetic Coma

Diabetic Coma

Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency.[1] Three different types of diabetic coma are identified: Severe low blood sugar in a diabetic person Diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma (usually type 2) in which an extremely high blood sugar level 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 they have 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 them 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. Types[edit] Severe hypoglycemia[edit] People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause un 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 >>

Cause Of Diabetic Coma

Cause Of Diabetic Coma

Diabetic coma is a dangerous condition that can lead to unconsciousness and even death. Diabetic coma may affect 2% to 15% of all diabetics at least once in their lifetime and the condition that most commonly causes the coma is severe hypoglycaemia or low blood sugar. There are three main causes of coma in people with diabetes: diabetic ketoacidosis, severe hypoglycaemia and hyperglycaemic hyperosmolar state. However, despite the increased prevalence of diabetes across the globe, improved diagnosis and early treatment of these causative conditions has lessened the risk of death due to diabetic coma. A glucometer, for example, can detect high or low blood sugar in an unconscious diabetic patient within seconds and this can be confirmed in the laboratory within an hour. Furthermore, due to the widespread warnings and knowledge regarding the possibility of the three conditions, most patients are brought to an emergency unit before the onset of coma. The three causes of diabetic coma Severe hypoglycaemia If an individual’s sugar level in the blood and the brain drops to below 3.5 mmol/l, they are at risk of losing consciousness and falling into a diabetic coma. This risk is greater if an excess dose of insulin or other anti-diabetic medications has been taken, if alcohol is in the person’s body while they are hypoglycemic, or if vigorous exercise has depleted the body’s supply of glycogen. Diabetic ketoacidosis (DKA) This condition is more common among people with type 1 diabetes or those with type 2 diabetes 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 in the liver to form acidic compounds called ketones. These ketones build up in the body causing DKA. The condition Continue reading >>

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 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 >>

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 >>

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

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