A coma is a profound and prolonged state of unconsciousness. During a coma, a person is unaware of their surroundings and does not respond to internal or external stimuli. This means they cannot communicate, react to stimuli like sound or touch, or move consciously.
A coma can result from several conditions, including severe traumatic head injury, stroke, brain inflammation, organ damage, drug overdose, and metabolic disorders like ketoacidosis or hypoglycemia.
Causes of coma in diabetics
A coma in diabetics is known as a diabetic coma. This is a serious medical emergency and can be life-threatening. Several conditions can lead to a diabetic coma, including:
Diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a serious complication that is more common in people with type 1 diabetes. This condition occurs when the body's cells do not have enough insulin to transport glucose into them.
Instead, the body begins breaking down fat for energy, producing ketone acids as a byproduct. The accumulation of ketones in the blood can change the acidity of the body and cause electrolyte imbalances, leading to serious complications.
Symptoms of diabetic ketoacidosis typically appear within 24 hours and include:
- Extreme thirst
- Frequent urination
- Nausea
- Abdominal pain
- Body weakness or fatigue
- Shortness of breath
- Fruity-smelling breath
- Confusion
As symptoms progress, self-awareness will decline, potentially leading to a coma.
Hyperosmolar hyperglycemic state (HHS)
HHS is a complication of hyperglycemia, particularly in type 2 diabetes. Hyperglycemia is a condition where blood glucose levels are extremely high.
HHS occurs when blood sugar levels remain extremely high for an extended period of time, exceeding 600 mg/dL. This condition can result in severe dehydration, confusion, and impaired consciousness.
Other factors that can cause HHS include:
- Insulin resistance or insufficient insulin production to regulate blood glucose levels.
- Infections or other diseases that cause high blood sugar levels.
- Increased consumption of sugar-rich foods and beverages.
HHS is typically characterized by several symptoms, including:
- Severe dehydration
- Difficulty breathing
- Rapid pulse
- Frequent urination
- Confusion and impaired consciousness
Severe hypoglycemia
People with diabetes can also experience hypoglycemia, where blood sugar levels drop below normal levels or below 70 mg/dL. This condition is common among people who use antidiabetic medications like insulin or other blood sugar-lowering drugs.
Hypoglycemia is usually accompanied by several symptoms, including:
- Trembling
- Anxiety and confusion
- Sweating
- Impatience
- Rapid heart rate
- Dizziness
- Feeling of hunger
- Nausea
- Drowsiness
- Pale and dry skin
- Feeling of weakness and lack of energy
- Blurred vision
- Tingling in the lips, tongue, or cheeks
- Headache
- Nightmares or crying during sleep
- Seizures
If hypoglycemia progresses and becomes severe, it can lead to complications such as coma or other life-threatening conditions. Severe hypoglycemia is a life-threatening condition that must be treated immediately.
Ketoacidosis, hyperglycemia, and hypoglycemia should not be ignored. If your blood sugar levels are too high or too low and you experience fainting, seek medical attention immediately. Consult your doctor about managing your blood sugar levels to reduce the risk of a diabetic coma.
If you need medical advice or consultation, you can either visit a doctor or make use of the consultation features that are available in the Ai Care application by downloading the Ai Care application from the App Store or Play Store.
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- Sean Edbert Lim, MBBS