A diabetic coma is a serious, life-threatening complication of diabetes in which the patient falls into a state of unconsciousness. It constitutes a medical emergency if left untreated, since it may result in permanent brain damage or death, as MayoClinic.com notes. Death rates can be as high as 50 percent. A diabetic coma occurs mainly due to severe and constant fluctuations in the patient’s blood sugar level. There are also several other causes and attendant symptoms associated with diabetic coma.
What is Diabetic Coma?
Diabetic coma is a reversible form of coma that is associated with diabetes. It arises mainly as a consequence of diabetes that is left unchecked. There are three variants: ketoacidotic coma, hypoglycemic coma and hyperosmolar coma. The particular symptoms of the diabetic coma depend largely on the conditions that give rise to it, Better Health Channel explains. Treatment options for this condition will therefore vary for the same reasons. However, in every case, diabetic coma is considered a medical emergency that requires immediate attention.
Symptoms of Ketoacidotic Coma
Ketoacidotic coma occurs mostly in patients with Type 1 diabetes, Diabetes.co.uk reports. It is caused by the build-up of ketones – by-products of fat breakdown – that cause the blood to become excessively acidic. When insulin is lacking, the body switches to using fat instead of glucose for energy, causing the ketone build-up. Usually, this is brought about or worsened by an infection or missed insulin dosage. Symptoms include fatigue, lethargy, extreme thirst, nausea, confusion, difficulty in breathing, vomiting, stomach pain, frequent urination and fruity smell on the breath.
Symptoms of Hypoglycemic Coma
Extremely low blood sugar levels, or hypoglycemia, can lead to unconsciousness and diabetic coma when left untreated, MayoClinic.com explains. This usually occurs when a patient on diabetes medication takes an extra or larger dose of insulin, misses a meal, drinks too much alcohol, drinks alcohol without eating food or exercises without eating food. Symptoms of this particular variant include weakness, sweating, extreme hunger, confusion, palpitations, trembling, confusion, altered behavior and drowsiness.
Symptoms of Hyperosmolar Coma
Hyperosmolar coma is the reverse of hypoglycemic coma. It is caused by excessively high levels of blood glucose and severe dehydration, as Better Health Channel notes. Typically, it happens when a patient is sick with another disease such as pneumonia or flu, misses out on an insulin or diabetes medication dosage, or consumes an increased amount of sugar-laden foods or drinks. Symptoms include frequent urination, fatigue, increased thirst, nausea, vomiting, stomach pain, fast heartbeat and fruity breath odor.
In cases of ketoacidotic coma and hyperosmolar coma, patients are given intravenous fluids, insulin, and plenty of potassium and sodium as soon as possible. Hypoglycemic coma, on the other hand, necessitates the administration of glucose intravenously, or alternatively, glucagon hormone to counter the effects of excess insulin in the patient’s system.
It is important to note that some patients do not experience any warning signs signaling a drop in their blood glucose, a condition known as hypoglycemia unawareness, MayoClinic.com notes. In most cases, however, patients experience excessive thirst, urination, and signs of high or low blood sugar before diagnosis.