Diabetic Coma: Symptoms, Causes & Treatment | Wockhardt Hospitals

Diabetic Coma: Symptoms, Causes & Treatment

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Diabetes is a common health condition in patients in which the blood glucose level rises. Diabetes-related coma or diabetic coma is a life-threatening condition that leads to unconsciousness or unresponsiveness as a result of a very high blood glucose level (hyperglycemia) or very low blood glucose level (hypoglycemia) in a diabetic person. Diabetic coma requires immediate medical attention to be treated with success. However, it is best to prevent it by managing diabetes well. 

What is a Diabetic Coma?

A diabetic coma is a diabetes-related complication that occurs as a result of unregulated blood glucose. It can occur due to very high, unregulated blood sugar levels, also known as hyperglycemia, or may also be caused by very low blood glucose levels, also known as hypoglycemia. Diabetic coma leads to a prolonged state of deep unconsciousness. 

Diabetic Coma Causes

Generally, three types of diabetes-related complications may lead to diabetic coma, which may include:

  • Diabetes-related ketoacidosis (DKA): A life-threatening complication of diabetes that may affect persons with type-1 diabetes more than those with type-2 diabetes in which the body starts breaking down fats to compensate for glucose due to lack of insulin in the body, leading to the release of ketones into the bloodstream. 
  • Hyperosmolar hyperglycemic state (HHS): Also a life-threatening state of diabetes, particularly type-2 diabetes, in which the blood glucose levels are high for a prolonged period, often leading to severe dehydration along with a state of confusion.
  • Severe case of low blood sugar level or hypoglycemia is also one of the major diabetic coma causes

Diabetic Coma Symptoms 

The symptoms of high or low blood sugar in a person are usually present before the condition worsens and leads to a diabetes-induced coma. 

Symptoms of high blood glucose levels may include:

  • Frequent urination
  • Increased thirst
  • Very dry mouth 
  • Tiredness or weakness
  • Blurred vision
  • Headache
  • Nausea or vomiting
  • Fruity breath
  • Shortness of breath

Symptoms of low blood glucose level may include:

  • Weakness, tiredness, or fatigue
  • Drowsiness
  • Insatiable hunger
  • Shakiness
  • Headache
  • Sweating
  • Blurred vision
  • Difficulty in speaking
  • Loss of consciousness
  • Confusion 

These symptoms may worsen over time and lead to diabetic coma if diabetes of any kind is not managed and controlled properly. Diabetic coma symptoms mainly include three indications mentioned below.

  • Unconsciousness: This is a condition of profound sleep.
  • Lack of ocular response: The eyes of the unconscious person stay closed. Even if the eyelids are held open, it does not cause the unconscious person to react to it. However, the eye may still have some reflex responses to stimuli like light.
  • Lack of motor response: The person in a coma may not be able to move consciously but may still have some reflex responses.

While the person is entirely unresponsive, there may still be some form of reflex response without storing any active memory of it.

Since DKA (or Diabetic Ketoacidosis) may also lead to diabetic coma, it may exhibit some severe symptoms before it leads to a coma.

  • Fruity smelling breath
  • Nausea and/or vomiting
  • Tiredness or weakness
  • Rapid breathing 
  • Decreased alertness
  • Feeling confused or disoriented

HHS (or Hyperosmolar Hyperglycemic State) is another condition that may lead to diabetic coma symptoms, such as

  • Dry mouth and extreme thirst
  • Blurry or loss of vision
  • Frequent urination
  • Mental confusion 
  • Weakness
  • Sometimes, even paralysis on one side

Risk Factors of Diabetic Coma

Undiagnosed or unregulated diabetes leading to severely low or high blood glucose levels may lead to diabetic coma. The risk of diabetic coma depends on the type of diabetes:

  • Type-1 diabetes: People with type-1 diabetes are at a higher risk of diabetic coma due to diabetes-related ketoacidosis or very low blood sugar. They have a higher requirement of insulin and have a wider range of blood sugar levels than those with type-2 diabetes.
  • Type-2 diabetes: People with type-2 diabetes have a higher risk of diabetic coma as a result of HHS.

There are many other factors that may increase the risk of diabetic coma, which may include the following.

  • Illness
  • Injury or trauma
  • Surgery
  • Insulin delivery problem
  • Skipping doses of insulin or taking too much of it
  • Not managing diabetes properly
  • Alcohol or substance abuse
  • Hypoglycemia unawareness which is a condition of experiencing typical symptoms of mild to moderate low blood sugar

Diabetic Coma Diagnosis

A diabetic coma or diabetes-related coma is a medical emergency that requires medical intervention in the hospital. Healthcare providers or doctors may be able to diagnose diabetic coma by knowing the patient’s medical history and performing a blood glucose test that confirms the glucose level in the blood. They may also perform other tests to look for the level of ketones in the blood and the patient’s overall health condition.

Diabetic Coma Treatment 

Diabetic coma treatment depends on the condition that has caused it. However, almost all cases of diabetic coma require medical treatment in the hospital. Diabetic coma caused by DKA or HHS may be treated by:

  • Intravenous fluids to replenish electrolyte imbalances 
  • Insulin therapy using an IV fluid or a syringe injection 
  • Treatment of infection or other associated conditions 

Diabetic coma caused by high blood sugar may be treated by:

  • Intravenous fluids to restore water and electrolytes
  • Supplements of potassium, sodium, or phosphate to help the cells work properly
  • Insulin helps regulate the absorption of glucose in the body
  • Treatment for any infection or other conditions

Diabetic coma treatment of diabetic coma caused by low blood sugar may include giving a boost of glucagon, which can help the blood sugar level rise quickly. 

Preventing Diabetic Coma

Managing diabetes is extremely crucial to prevent diabetic coma or any other complication of diabetes, for that matter. 

  • Follow a diabetes-friendly diet to control your blood sugar level
  • Monitor blood sugar regularly to get alerted before it falls too low or rises too high
  • Take medications as directed by the doctor
  • Check for ketones when the blood sugar level is high
  • Drink alcohol with caution
  • Keep a fast-acting revival kit to treat low or high blood sugar.

At Wockhardt Hospitals, medical emergencies and routine procedures are promptly attended to by a well-experienced team of primary care and emergency care doctors and specialists 24×7 to tend to all kinds of medical emergencies. Our specially dedicated ward of ICU and emergencies caters to every need of our patients, who are well taken care of by capable nurses and other supporting healthcare professionals for optimal recovery and management of the health problem. 

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