Diabetic coma

Diabetic coma is a series of disorders that appear in diabetic patients, which are considered a medical emergency because they endanger the patient's life. In them, the person with diabetes suffers an alteration of consciousness because the glucose level in their blood (glycemia ) is greater than 170 or less than 50 (very high or very low).

In cases where the blood glucose level is very low (less than 70 mg/dL), they are called hypoglycemia, being the most serious of the acute complications of diabetes. If, on the other hand, the blood glucose level is elevated, it is called hyperglycemia and may be caused by diabetic ketoacidosis or nonketotic hyperosmolar coma.

All patients with diabetes can suffer any of these complications, however those with type 1 diabetes mellitus suffer more frequently from ketoacidosis; those who are on insulin treatment or suffer from renal failure are susceptible to hypoglycemia; and hyperosmolar coma is often seen in older adults.

Hypoglycemia

In this case, the symptoms develop in a matter of hours or minutes, progressing from mild manifestations such as headache, feeling anxious, weak, intense hunger, nervousness or irritability, to dizziness, nausea, vomiting, abnormal sensations, slurred language and disorientation, culminating in loss of consciousness. Likewise, some signs such as paleness, tremors, palpitations and "cold" sweating can be observed.

In the event that the person suffering from hypoglycemia has lost consciousness, since they cannot be given glucose orally, a dose of glucagon will be required to be injected urgently, so that the blood glucose levels return to normal and the patient regains consciousness. Hypoglycemia can be suspected when the person is taking insulin, has gone a long time without eating, has performed unusual physical activities, or suffers from some other illness; however, the only way to confirm a drop in blood glucose is through a blood glucose test or test, which requires a special machine, so if hypoglycemia is suspected, you should go to urgent medical assistance.

The urgency of care is due to the rapidity with which hypoglycemia progresses, affecting mainly the nervous system, leading the patient to coma or even death in some cases.

Ketoacidosis and hyperosmolar coma

In both disorders, coma is preceded by a period of premonitory symptoms that can last from a few hours to several days. The person initially loses their appetite (a rare symptom in diabetics), suffers nervousness, headache, weakness or apathy that progressively increases, presenting in more severe cases excessive sleepiness, disorientation and coma. Intense thirst, frequent urination, and abdominal pain, which can even be confused with peritonitis or appendicitis, are also frequent at the beginning. Signs seen are primarily of dehydration: dry tongue and mouth, sunken eyes, rapid pulse, rapid breathing, frequent urination, and visible weight loss.

The course of coma in hyperglycemia is usually slower than in hypoglycemia. However, it is still considered an emergency, since it is usually accompanied by alterations such as dehydration, acidosis, infections, sepsis or shock, which can make its evolution unpredictable and fatal.

Recommendations

• Every diabetic must always bring with it a badge or a card that identifies it as such. This measure will be very helpful in case of a diabetic complication.
• Carefully meet the dosage and schedule of medications, whether oral hypoglycemic or insulin.
• Take care of your eating habits and physical activity. Many episodes of diabetic coma can be prevented like this.
• Tell your family, coworkers and friends about your illness and what to do in case of urgency.
• Take a good time. Banal or mild infections in normal people can trigger complications in people who suffer from diabetes.
• Control your BMI (body mass index)

First Aid

• Request or seek help.
• Identify the degree of consciousness of the person. Gravity is greater when the patient is disoriented (he does not know where he is or what he is called), his speech is confusing, seems to be asleep and wakes up with difficulty talking to or moving him, or simply does not respond.
• If hypoglycemia is suspected or identified, the first aid will be to give you a sweet drink, a caramel, or a spoonful of sugar. This should only be done if the person is aware and accepts aid. If you have any degree of decrease in consciousness or resist being helped, NO you must be forced by the risk of asphyxiation, in such cases you will need to seek an alternative to raise the level of blood glucose such as providing a glucagon injection.
• If dehydration is observed and the patient is aware and accepts aid liquids can be provided. If you have any degree of disorientation or decrease of consciousness or resist being helped, NO he must be forced by the risk of asphyxiation.
• Important a prompt search for medical care.

Only professional medical help can help you cope with a diabetic coma