2023 Author: Josephine Shorter | [email protected]. Last modified: 2023-05-24 11:52
Diabetic coma signs and emergency care
What is a diabetic coma?
Diabetic coma is an extremely severe degree of decompensation of diabetes mellitus. It leads to disruption of all metabolic processes in the body. In the presence of certain predisposing factors, coma can develop in both insulin-dependent and non-insulin-dependent diabetes mellitus. It doesn't matter if they are treated or even not yet diagnosed.
Signs of a diabetic coma
Diabetic coma does not develop instantly, its precursor is the pre-coma state. The patient has increased thirst, headaches and weakness, discomfort in the abdomen, accompanied by nausea and, quite often, vomiting. Blood pressure drops, body temperature is below normal. The pulse is rapid, threadlike.
Over time, the emerging weakness and drowsiness increase, disturbances in the functioning of the central nervous system appear in the form of complete or partial loss of consciousness, the skin loses its normal turgor, muscle tone decreases. Blood pressure can drop to very low numbers.
A specific sign of the development of a diabetic coma is the appearance of the smell of acetone (overripe apples) from the mouth. If at this stage the patient is not provided with adequate assistance, after a while there will be a complete loss of consciousness, and he may die. All these signs can appear, grow and worsen over several hours or even days.
Causes of a diabetic coma
The reasons for the development of diabetic coma can be the untimely introduction of the next dose of insulin or refusal to use it, an error in the appointment of insulin therapy - an incorrectly selected dose, the replacement of one type of insulin with another, to which the patient was insensitive.
A gross violation of the diet in diabetes mellitus can also lead to the development of coma, if the patient has consumed more sugar than he needs; various serious diseases (including infectious diseases), nervous shocks, pregnancy and childbirth, surgery.
Symptoms of a diabetic coma
At the initial stage of development of a diabetic coma, patients develop diabetic ketoacidosis, the characteristic signs of which are: severe dry mouth and unbearable thirst, polyuria, gradually turning into anuria, sometimes itching is noted. Signs of general intoxication of the body appear in the form of an increasing general weakness, increased fatigue, increasing headache, nausea and vomiting.
If treatment is not started on time, the dyspeptic syndrome is aggravated, vomiting becomes repeated and does not bring relief, abdominal pain of varying degrees of intensity appears, there may be diarrhea or constipation. Drowsiness, lethargy, apathy increase, the patients become disoriented in time and space, their consciousness gets confused. In the exhaled air, the smell of acetone is felt, the skin is dry, blood pressure drops, tachycardia develops, and Kussmaul's noisy breathing. Stupor and stupor give way to coma.
Consequences of a diabetic coma
A significant increase in blood glucose levels and, as a result, developing tissue hunger cause pathological changes in the body. The developing diabetic polyuria (an increase in the daily amount of urine) leads to severe dehydration of the body, despite the fact that the amount of fluid consumed by the patient increases. The volume of blood circulating in the vessels, due to this, decreases, and the pressure drops sharply, leading to a violation of the trophism of all organs and tissues, including the brain.
Together with water, electrolytes are usually removed from the body. First of all, these are such macronutrients as potassium and magnesium, which leads to serious disruptions in the work of all organs and systems. To compensate for excess glucose in tissues, the body begins to actively break down fat and glycogen stores. In this regard, the number of ketone bodies and lactic acid in the blood significantly increases, hyperacidosis develops.
Emergency care for diabetic coma
Knowing the initial symptoms of the development of a diabetic coma, it is possible to prevent its development and stabilize the situation by administering insulin. Typically, patients with diabetes mellitus are informed about the possibility of complications and the necessary treatment. It is recommended to limit carbohydrate intake, start taking potassium and magnesium supplements, drink alkaline mineral waters - all this will help eliminate hyperacidosis.
If the patient's condition is already severe and is approaching fainting, an ambulance must be called urgently. In this situation, only qualified assistance provided on time can help, hospitalization in a medical institution is necessary.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
