Coma is a medical emergency or a state of unconsciousness calling for immediate evaluation to determine its cause. It is only when sugar in blood is being used properly that fat can also be oxidized or burnt to provide heat and energy; when fat cannot be utilized a condition called acidosis develops and when this is present to a serious extent it affects the nervous system and causes diabetic coma.
Causes of Diabetic Coma:
Diabetic coma usually results from:
* Neglect of prescribed insulin
* Neglect of prescribed diet
* Other infections
Classification of Diabetic Coma:
There are several types of coma that results directly from diabetes mellitus or its treatment.
Hyperglycemic coma: Associated with severe insulin deficiency or mild to moderate insulin deficiency.
Hypoglycemic coma: Results from excessive doses of insulin.
Diabetic ketoacidosis: In insulin dependent diabetes due to missing of proper treatment with insulin the requirements for insulin increases. In these cases body uses fats as energy since glucose is absent. This leads to formation of ketone bodies which when excess leads to coma.
Clinical features of Diabetic Coma:
* Dehydration
* Acidotic breathing
* Flushed and dry skin
* Abdominal pain
* Nausea and vomiting
* Drowsiness, proceeding to unconsciousness
Treatment for Diabetic Coma:
It is better to give glucose orally or by intravenous route rather than giving insulin which may be fatal. Within few minutes the patient will definitely feel better and sit up and talk. If in doubt or when response is not satisfactory the individual has to be hospitalized.
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