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What is diabetic coma?
What is diabetic coma?
Published: 2017/02/25
Channel: Doc my buddy
Diabetic Coma Survivor
Diabetic Coma Survivor
Published: 2016/03/28
Channel: Charles Carpenter
Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy
Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy
Published: 2015/05/15
Channel: khanacademymedicine
Waking up from a diabetic coma
Waking up from a diabetic coma
Published: 2016/10/11
Channel: Zoe's World
What can cause a diabetic coma ? | Best Health Channel
What can cause a diabetic coma ? | Best Health Channel
Published: 2017/11/04
Channel: All About Diabetes and Related
Causes of Diabetic Coma
Causes of Diabetic Coma
Published: 2013/04/10
Channel: Diabetes.co.uk
Jail police Allows Woman 2 Die in Diabetic Coma after Refusing Requests 2 Test Blood Sugar
Jail police Allows Woman 2 Die in Diabetic Coma after Refusing Requests 2 Test Blood Sugar
Published: 2016/11/08
Channel: charlottecountyflcopwatch2
RABBI JEW BARKER MEDICAL EMERGENCY Key Largo Ambulance Saves my Man In Diabetic Coma 1of3
RABBI JEW BARKER MEDICAL EMERGENCY Key Largo Ambulance Saves my Man In Diabetic Coma 1of3
Published: 2013/10/14
Channel: HoodwinkedbyanAngel Michael Fazio
Learn the signs of diabetic shock
Learn the signs of diabetic shock
Published: 2014/08/10
Channel: LOCAL 12
Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications
Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications
Published: 2013/01/09
Channel: MedCram - Medical Lectures Explained CLEARLY
How long can you be in a diabetic coma ? |Long Live Facts
How long can you be in a diabetic coma ? |Long Live Facts
Published: 2017/11/03
Channel: All About Diabetes and Related
Diabetic Coma
Diabetic Coma
Published: 2015/05/17
Channel: PugsPeeves
My Diabetic Coma/How I was diagnosed.
My Diabetic Coma/How I was diagnosed.
Published: 2015/05/29
Channel: Karah Kay
I Was Sinking Into a Diabetic Coma | Health
I Was Sinking Into a Diabetic Coma | Health
Published: 2008/08/26
Channel: Health Magazine
Diabetic coma and Insulin shock
Diabetic coma and Insulin shock
Published: 2015/12/16
Channel: Home Remedies and medical tips
Diabetic Coma
Diabetic Coma
Published: 2017/04/07
Channel: Elissa O'Neill
What Is The Definition Of Diabetic coma - Medical Dictionary Free Online
What Is The Definition Of Diabetic coma - Medical Dictionary Free Online
Published: 2014/09/28
Channel: Medical Dictionary Online
علامات غيبوبة السكري الناتج عن ارتفاع السكر بالدم - سكرعالي #1103 | Diabetic coma high
علامات غيبوبة السكري الناتج عن ارتفاع السكر بالدم - سكرعالي #1103 | Diabetic coma high
Published: 2013/09/28
Channel: أبونور أحمدي
What causes someone to go into a diabetic coma ? | Best Health Channel
What causes someone to go into a diabetic coma ? | Best Health Channel
Published: 2017/11/08
Channel: All About Diabetes and Related
VANILLA CHEX DIABETIC COMA
VANILLA CHEX DIABETIC COMA
Published: 2016/02/26
Channel: Solidrev
new diabetic coma symptoms type 2 2017
new diabetic coma symptoms type 2 2017
Published: 2017/08/21
Channel: Станислав Юдашкин
What are the symptoms of a diabetic coma ? | Health for All
What are the symptoms of a diabetic coma ? | Health for All
Published: 2017/11/04
Channel: All About Diabetes and Related
diabetic coma - غيبوبة السكر
diabetic coma - غيبوبة السكر
Published: 2014/01/20
Channel: تعلم الإسعافات الأولية
Diabetic Coma - Diabetes Campaign 2015
Diabetic Coma - Diabetes Campaign 2015
Published: 2015/12/30
Channel: EPSF-Tanta
TOP 5 Magic Kingdom Snacks to Induce a Diabetic Coma
TOP 5 Magic Kingdom Snacks to Induce a Diabetic Coma
Published: 2016/07/24
Channel: DIS Unplugged
Early Warning Signs of Diabetic Shock
Early Warning Signs of Diabetic Shock
Published: 2014/08/06
Channel: TriHealth Cincinnati
Hyperosmolar Hyperglycemic State, Diabetic HHS vs DKA, Animation
Hyperosmolar Hyperglycemic State, Diabetic HHS vs DKA, Animation
Published: 2017/10/31
Channel: Alila Medical Media
Can You Recover From A Diabetic Coma?
Can You Recover From A Diabetic Coma?
Published: 2017/09/13
Channel: Question Box
Diabetic Coma - How to Eat to Avoid Insulin Spikes
Diabetic Coma - How to Eat to Avoid Insulin Spikes
Published: 2017/04/28
Channel: RukDo
Man Slips Into Diabetic Coma; Dog Wakes Wife For Help
Man Slips Into Diabetic Coma; Dog Wakes Wife For Help
Published: 2011/05/06
Channel: WTAE-TV Pittsburgh
Paramedic or EMT What
Paramedic or EMT What's The Difference? Diabetic Coma
Published: 2016/10/11
Channel: Central County Fire & Rescue
Signs and Symptoms of Diabetic Ketoacidosis - Symptoms of diabetic coma
Signs and Symptoms of Diabetic Ketoacidosis - Symptoms of diabetic coma
Published: 2017/12/08
Channel: Get Health
Instant diabetic coma
Instant diabetic coma
Published: 2015/10/10
Channel: Lena Workman
Diabetes: Dog Saves Man from Diabetic Coma
Diabetes: Dog Saves Man from Diabetic Coma
Published: 2007/05/15
Channel: dLife
What Can Cause A Diabetic Coma?
What Can Cause A Diabetic Coma?
Published: 2017/09/13
Channel: Question Box
How Long Does It Take To Get Out Of A Diabetic Coma?
How Long Does It Take To Get Out Of A Diabetic Coma?
Published: 2017/09/14
Channel: Question Force
Scary Prank on kids causes a Diabetic Coma!!!
Scary Prank on kids causes a Diabetic Coma!!!
Published: 2017/12/29
Channel: Brandon Hurley
What does a diabetic coma look like ? | Life Care Health Channel
What does a diabetic coma look like ? | Life Care Health Channel
Published: 2017/11/08
Channel: All About Diabetes and Related
46 Types of diabetic coma Diagnosis of DM Dr Abbas   D Of Medi
46 Types of diabetic coma Diagnosis of DM Dr Abbas D Of Medi
Published: 2017/09/22
Channel: D of Medi
Diabetic Coma Challenge
Diabetic Coma Challenge
Published: 2015/07/04
Channel: Boo and Saki Lol
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What It's Like: Going into a diabetic coma (2013-10-18)
Published: 2018/01/09
Channel: The Oklahoman Video Archive
Diabetic Coma at SISR.MPG
Diabetic Coma at SISR.MPG
Published: 2010/01/08
Channel: Aaron Ferrell
Aint nobody got time for a diabetic coma
Aint nobody got time for a diabetic coma
Published: 2013/01/23
Channel: Kandace O'Connell
Diabetes and Coma
Diabetes and Coma
Published: 2012/07/21
Channel: Diabetes.co.uk
new type 1 diabetic coma symptoms 2017
new type 1 diabetic coma symptoms 2017
Published: 2017/08/15
Channel: Никита Коновалов
How do you treat a diabetic coma ? | Health Ideas
How do you treat a diabetic coma ? | Health Ideas
Published: 2017/11/01
Channel: All About Diabetes and Related
Diabetic Coma - Good Ole
Diabetic Coma - Good Ole' Straight Edge Fun
Published: 2008/06/30
Channel: MistressSovereignty
What Are The Symptoms Of A Diabetic Coma?
What Are The Symptoms Of A Diabetic Coma?
Published: 2017/10/01
Channel: But But But
DKA Diabetic Shock The Continuation 2014 After the Coma
DKA Diabetic Shock The Continuation 2014 After the Coma
Published: 2014/03/29
Channel: LowerEastSideRomance
PAULA DEEN PARODY: DIABETIC COMA CAKE!
PAULA DEEN PARODY: DIABETIC COMA CAKE!
Published: 2016/02/24
Channel: Jay Blaize
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WIKIPEDIA ARTICLE

From Wikipedia, the free encyclopedia
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Diabetic coma
Specialty endocrinology

Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency.[1]

Three different types of diabetic coma are identified:

  1. Severe low blood sugar in a diabetic person
  2. Diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock, and exhaustion
  3. Hyperosmolar nonketotic coma (usually type 2) in which an extremely high blood sugar level and dehydration alone are sufficient to cause unconsciousness.

In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. An example might be a physician working in an emergency department who receives an unconscious patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify them as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered.

An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia.

Types[edit]

Severe hypoglycemia[edit]

People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause unconsciousness during sleep. Predisposing factors can include eating less than usual or prolonged exercise earlier in the day. Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia.

Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms. Twitching or convulsions may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat: all signs of the adrenaline response to hypoglycemia. The individual is not usually dehydrated and breathing is normal or shallow. Their blood sugar level, measured by a glucose meter or laboratory measurement at the time of discovery, is usually low but not always severely, and in some cases may have already risen from the nadir that triggered the unconsciousness.

Unconsciousness due to hypoglycemia is treated by raising the blood glucose with intravenous glucose or injected glucagon.

Advanced diabetic ketoacidosis[edit]

Diabetic ketoacidosis (DKA), if it progresses and worsens without treatment, can eventually cause unconsciousness, from a combination of a very high blood sugar level, dehydration and shock, and exhaustion. Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation.

In the early to middle stages of ketoacidosis, patients are typically flushed and breathing rapidly and deeply, but visible dehydration, pale appearance from diminished perfusion, shallower breathing, and a fast heart rate are often present when coma is reached. However these features are variable and not always as described.

If the patient is known to have diabetes, the diagnosis of DKA is usually suspected from the appearance and a history of 1–2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis.

Treatment of DKA consists of isotonic fluids to rapidly stabilize the circulation, continued intravenous saline with potassium and other electrolytes to replace deficits, insulin to reverse the ketoacidosis, and careful monitoring for complications.

Nonketotic hyperosmolar coma[edit]

Nonketotic hyperosmolar coma usually develops more insidiously than DKA because the principal symptom is lethargy progressing to obtundation, rather than vomiting and an obvious illness. Extremely high blood sugar levels are accompanied by dehydration due to inadequate fluid intake. Coma from NKHC occurs most often in patients who develop type 2 or steroid diabetes and have an impaired ability to recognize thirst and drink. It is classically a nursing home condition but can occur in all ages.

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.

Identifying the cause[edit]

Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers were not universally available in hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. Other conditions that can cause unconsciousness in a person with diabetes are stroke, uremic encephalopathy, alcohol, drug overdose, head injury, or seizure.

Fortunately, most episodes of diabetic hypoglycemia, DKA, and extreme hyperosmolarity do not reach unconsciousness before a family member or caretaker seeks medical help.

Treatment[edit]

Treatment depends upon the underlying cause:

  • Hypoglycaemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously.
  • Ketoacidotic diabetic coma: intravenous fluids, insulin and administration of potassium and sodium.
  • Hyperosmolar diabetic coma: plenty of intravenous fluids, insulin, potassium and sodium given as soon as possible.

References[edit]

  1. ^ Richard S. Irwin; James M. Rippe (2008). Irwin and Rippe's intensive care medicine. Lippincott Williams & Wilkins. pp. 1256–. ISBN 978-0-7817-9153-3. Retrieved 20 November 2010. 

External links[edit]

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