Diabetic coma

Diabetics should pay special attention to their blood sugar levels and adjust their insulin dose according to their meals and activities. If the metabolism is derailed, it can lead to diabetic coma come.

What is the diabetic coma?

The diagnosis of diabetic coma is usually made by the emergency doctor who has been called. If the patient is attentive, he may already be able to recognize from the warning signs that his metabolism has derailed and take appropriate countermeasures.
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A diabetic coma can occur in people with diabetes mellitus. After a metabolic derailment, they lose consciousness and fall into a coma. This condition is an emergency situation that requires urgent treatment.

If a patient with what is known as diabetic coma is left untreated, it can lead to death. There are a number of signs that the patient should respond to as early as possible to avoid a diabetic coma. These include loss of appetite and vomiting, but also an increased feeling of thirst with a simultaneous increase in the amount of urine excreted.

General weakness, an increased breathing rate and the signs that the body is beginning to dehydrate are also among the warning signs of a diabetic coma.

causes

The causes of diabetic coma are different. However, this is always a problem that can be traced back to the underlying diabetes mellitus. Coma is caused either by low blood sugar or too much sugar.

With hypoglycaemia, also known as severe hypoglycemia, the cells in the brain and the red blood cells can no longer fall back on enough glucose. This form occurs mainly in type 1 diabetics if their insulin dose was too high or if they did not eat enough. Diabetic ketoacidosis is another cause of a coma and can be felt on the person's breath before it occurs. This smells strongly of acetone.

As a result, the blood becomes acidic, which, if left untreated, leads to a coma. Type 2 diabetics are more likely to have high glucose levels, which can lead to hyperosmolar coma. The body excretes too much fluid and dries out over the long term. If left untreated, a permanent excess of sugar also leads to a diabetic coma.

Symptoms, ailments & signs

A diabetic coma leads to serious complaints that have a very negative impact on the health of the person concerned. For this reason, this condition must be treated by a doctor. Those affected primarily suffer from a very strong and above all unpleasant bad breath. There is a smell of rotten apples from the patient's mouth.

The thirst of the patient also increases, so that he has to go to the toilet more often. There is therefore an increased urge to urinate at night and this may lead to sleep problems and irritation in the patient. Furthermore, this disease can also lead to permanent nausea and fatigue, so that those affected can no longer actively participate in everyday life.

This often leads to vomiting and severe abdominal pain. The heart is also negatively affected by the disease, which can lead to low blood pressure. As a result, some patients suffer from disorders of consciousness and continued loss of consciousness. The muscles of the person affected are significantly weakened, so that there can be severe restrictions in everyday life. If left untreated, the condition can also reduce the patient's life expectancy.

diagnosis

The diagnosis of diabetic coma is usually made by the emergency doctor who has been called. If the patient is attentive, he may already be able to recognize from the warning signs that his metabolism has derailed and take appropriate countermeasures. In severe hypoglycemia, this is the immediate intake of sugar, such as glucose.

In any case, the doctor will first measure the blood sugar level to determine whether there is hypoglycaemia or hypoglycaemia. In addition, various blood values ​​are analyzed to determine what type of diabetic coma it is.

Complications

The dialectical coma leads to various complaints and complications that can extremely restrict the everyday life of the person affected. In most cases, there is an unpleasant halitosis that cannot be avoided by brushing your teeth or using mouthwashes. The patient also suffers from frequent urination, which occurs due to increased thirst.

There is a general feeling of illness and also a fever. Due to the fatigue that occurs, many activities in everyday life are restricted and no longer possible. The tiredness cannot be compensated by sleep. Often there is also muscle wasting and pain in the abdominal region. The patient's quality of life is extremely reduced by the dialectical coma.

In the worst case, it can also lead to unconsciousness. During the course of treatment, the patient will usually be given IV fluids and medication to relieve symptoms. An emergency doctor is usually also called and the person concerned has to stay in the hospital for a few days. If the diabetes continues to be treated properly, there will be no further complications or symptoms.

When should you go to the doctor?

In patients suffering from diabetes mellitus, metabolism can be derailed, which is accompanied by disturbances of consciousness up to complete unconsciousness. Often an incorrect insulin dosage is the cause. Diabetic coma can also affect people who do not know they have diabetes and are therefore not receiving treatment.

As soon as the diabetic coma manifests itself, the person affected is usually unable to act and relies on the people around him to react correctly. A diabetic coma is a medical emergency. The first aiders must immediately call an ambulance so that the patient can be taken to the nearest hospital as quickly as possible. If the patient is unconscious, he should be brought into the stable side position until the rescue team arrives. Under no circumstances are first-aiders allowed to administer insulin on their own.

People who know they have diabetes mellitus shouldn't let it get that far and consult a doctor at the first sign of an acute metabolic disorder. A diabetic coma is usually preceded by a series of symptoms. Typical are, for example, lazy breath, great thirst, which otherwise only occurs after very salty or very spicy meals, or frequent urination. Diabetics who notice such signs should always see a doctor promptly.

Doctors & therapists in your area

Treatment & Therapy

The diabetic coma is usually treated by an emergency doctor and later by an internist. In severe hypoglycaemia, glucose must be supplied immediately.

This is usually done via an infusion or a so-called emergency injection, which the patient carries with him for this purpose. If the person concerned is still able to eat something, the administration of glucose also helps against the symptoms of hypoglycaemia. With this type of diabetic coma, a relative can take the necessary measures before the emergency doctor arrives.

In a ketoacidonic coma, insulin is first supplied and then the acidification of the blood is balanced out by means of infusions with electrolytes. In the case of hyperosmolar coma, in addition to the administration of insulin, it is also important to give the patient additional fluid via an infusion in order to counteract further dehydration.

In both ketoacidonic and hyperosmolar coma, the presence of a doctor for first aid is imperative, as there are no emergency measures that laypeople could take with these types of diabetic coma.

Outlook & forecast

The diabetic coma is an emergency situation. The prognosis depends on the time of medical care and the duration of the coma. In severe cases, the patient dies. Approximately 10% of those affected experience complete loss of consciousness. In 20%, no disorders of consciousness are perceived. The remaining 70% of patients are awake, but have limited or clouded consciousness.

The prognosis worsens if there is a lack of fluids, hyperacidity, a high loss of electrolytes and a persistently high blood sugar level. The diabetic coma develops over several days. In this increase, all symptoms gradually increase until they ultimately lead to a breakdown. There is a risk of dehydration, as there is a loss of appetite over several days and patients ingest too little fluid.

As soon as the diabetic coma is fully developed, immediate action must be taken to ensure the patient's survival. If a significant drop in blood sugar levels can be achieved within 4-8 hours, the patient has a favorable prognosis. The lack of fluids should be compensated slowly within 48 hours so as not to overburden the organism. The prospect of a cure must always be checked individually. If kidney failure occurs, the prognosis worsens.

prevention

To prevent diabetic coma, diabetics should carefully monitor their blood sugar levels and adjust their daily insulin dose according to their meals and activities. It is also important to remember the warning signs of a diabetic coma in the event of changes in your health and to take immediate countermeasures, to consult a doctor or to call emergency services.

Aftercare

A diabetic coma is a possible acute secondary disease of diabetes mellitus.In this case, after treatment with insulin and fluids, the patient should be observed for some time to see whether the switch to a lower level of sugar in the blood is well tolerated and the patient remains stable. In general, the patient should also be informed about a recurrence of the diabetic coma and accordingly provided with medication in order to be prepared in an acute case.

Relatives should also be informed about the disease in order to recognize a recurrence of the diabetic coma and to be able to act if the patient does not respond. Furthermore, the patient should be well controlled when the diabetes is first diagnosed and trained in the use of the medication. The patient should also be informed about the regular follow-up appointments.

This includes, for example, annual check-ups by the ophthalmologist, who can use fundoscopy to identify changes in the fundus, the retina, in order to prevent possible blindness from diabetes mellitus. The patient should also have his or her foot inspected by the family doctor more often, as a diabetic foot is not a rare complication of unchecked diabetes mellitus. Follow-up care by the nephrologist or neurologist is also necessary, since diabetes can also damage these organs.

You can do that yourself

Adjusting the behavior in everyday life in people suffering from diabetes makes a significant contribution to preventing a diabetic coma. It arises from a metabolic imbalance due to an excess of sugar, which cannot be broken down due to a lack of insulin or due to an insulin resistance of the body cells. It is therefore particularly important that excessive blood sugar - the trigger factor for diabetic coma - is avoided under all circumstances.

Diabetic coma is an immediately life-threatening condition that corresponds to an acute emergency situation and requires clinical treatment. In addition to having good blood sugar and urinary acetone controls, it is advisable to watch out for certain body warning signs that appear just before the coma begins. If the usual symptoms such as a strong feeling of thirst, urge to urinate and unusual tiredness are accompanied by other signs such as nausea, vomiting and abdominal pain, which can also be misinterpreted, the highest alert level applies.

If possible, blood sugar can be measured to check. If a value of over 250 milligrams per deciliter is displayed, immediate action is required. To avert the life-threatening situation, emergency care must be carried out in a clinic. Due to the acidification, the air we breathe is enriched with acetone, which gives off an odor reminiscent of rotting apples.