Hypoglycemic coma
Metabolic Health

What is Hypoglycemic Coma

A diabetic coma is a potentially life-threatening consequence of diabetes that induces unconsciousness. There are two types of diabetic comas, hypoglycemic coma and hyperglycemic coma. The excessively high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) levels that may occur in people living with diabetes can result in this potentially fatal condition. When a person has lapsed into a hypoglycemic coma they will remain alive and death isn’t guaranteed, but they will be unable to wake up or react to sights, noises, or other sorts of external stimuli.

A diabetic coma is potentially lethal if left untreated. The prospect of a hypoglycemic coma is terrifying but there are various preventive measures that can be taken and things one may do to help avoid it. Immediate medical attention must be given to the person who experiences this condition and treatment should be followed exactly how it is prescribed by the doctor. 

Hypoglycemic Coma Symptoms

Low blood sugar symptoms may be split into two primary types. One kind of symptom is those induced by low glucose levels in the brain, which are referred to as neuroglycopenic symptoms. In the second type of symptoms, known as adrenergic symptoms, the body's response to low glucose levels in the brain causes the symptoms.

  • Shakiness or nervousness
  • Anxiety
  • Fatigue
  • Weakness
  • Sweating
  • Hunger
  • Nausea
  • Dizziness or lightheadedness
  • Difficulty speaking
  • Confusion

People experience varied symptoms while they are suffering from hypoglycemia, therefore it is possible that someone suffering from hypoglycemia may not exhibit all of the symptoms mentioned. Symptoms are also known to manifest quite quickly. When someone presents with symptoms of hypoglycemia, it is critical to acquire a blood glucose level as soon as possible in order to correctly diagnose the hypoglycemic episode.

Check your blood sugar levels if you experience any of these symptoms. If it is too high or too low, you should manage it according to your healthcare provider's advice to avoid a diabetic coma from occurring. If you have had diabetes for a long period of time, it is possible that you may lapse into a coma without displaying any of the signs and symptoms. 

On the other hand, hyperosmolar hyperglycemic nonketotic coma are associated with a metabolic consequence of diabetes mellitus that is characterized by severe hyperglycemia, dehydration to the point of shock, hyperosmolar plasma, and altered consciousness.

It happens most often in those with type 2 diabetes, and it frequently occurs in the context of physiologic stress. The presence of severe hyperglycemia and plasma hyperosmolality, as well as the lack of substantial ketosis, indicate the onset of hyperosmolar hyperglycemic nonketotic coma. IV saline solution and insulin are used as treatment. Coma, convulsions, and death are all possible complications.

Hypoglycemic Coma Causes

The sooner we understand what causes or brings on a hypoglycemic coma, the sooner we can focus on getting a diabetic coma treatment. Hypoglycemia is most frequent among people with diabetes using insulin, glinides, or sulfonylureas. Hypoglycemia is uncommon in people who do not have diabetes since there are several regulatory systems in place to maintain a proper balance of glucose, insulin, and glucagon.

  • Diabetic Ketoacidosis : If your muscle cells run out of energy, your body may react by breaking down fat reserves. This reaction produces harmful acids known as ketones. Diabetic ketoacidosis occurs when you have ketones (measured in blood or urine) and high blood sugar. It may lead to a diabetic coma if left untreated.
  • Diabetic Hyperosmolar Syndrome : When your blood sugar level exceeds 600 milligrammes per deciliter (mg/dL) or 33.3 millimoles per liter (mmol/L). Severe hyperglycemia causes your blood to thicken and syrupy. Excess sugar in your blood goes into your urine, triggering a filtration process that removes massive volumes of fluid from your body. If left untreated, this might result in fatal dehydration and a diabetic coma. A coma affects 25 to 50% of persons with diabetic hyperosmolar syndrome.
  • Hypoglycemia : The brain needs glucose in order to operate properly. In extreme circumstances, low blood sugar might result in unconsciousness or passing out. Hypoglycemia may be caused by either an excessive amount of insulin or an insufficient amount of food. Exercising too strenuously or consuming excessive amounts of alcohol might both have the same result.

When hypoglycemia is detected in a person, prompt diabetic coma treatment is required and may save a person's life. The primary objective of therapy is to restore normal blood glucose levels, which is accomplished by several methods of providing glucose, depending on the severity of the hypoglycemia, what is available to treat, and who is administering the treatment.

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Hypoglycemic Coma Risks

  • Insulin supply issues : If you use an insulin pump, you must test often. When a pump malfunctions or the tube (catheter) twists or breaks, insulin delivery stops. Insulin deficiency may cause diabetic ketoacidosis.
  • Disease, injury or surgery : When you're ill or hurt, your blood sugar levels spike substantially. Type 1 diabetics may get diabetic ketoacidosis if they do not raise their insulin dose. Diabetic hyperosmolar syndrome is linked to medical issues such congestive heart failure and renal damage.
  • Mismanaged Diabetes : Failure to adequately monitor blood sugar or take prescribed medicines increases the risk of long-term problems including diabetic coma.
  • Skipping meals or insulin : People with diabetes and an eating problem may choose not to take their insulin as prescribed in order to lose weight. This risky procedure raises the risk of diabetic coma.
  • Alcohol and Drug consumption : Alcohol has variable impacts on blood sugar. Alcohol's sedative effects may make it difficult to detect low blood sugar signs. This may produce a diabetic coma due to hypoglycemia. Cocaine and ecstasy might raise your risk of very high blood sugar and diabetic coma.

Getting a hypoglycemic coma treatment is dependent on the understanding of what caused it.

Complications

Management of hypoglycemic coma must be done to prevent further complications that may arise. If this condition is left untreated, which it should not be under any circumstances, it can lead to severe complications like permanent brain damage and death. It is imperative to consult your doctor as soon as you experience an episode like this. 

Prevention

If you notice or exhibit any hypoglycemic coma symptoms, you can take the following steps for prevention.

  • Maintain a healthy diet on a day to day basis as this may help regulate your blood sugar, even in the long run. 
  • Keep monitoring your blood sugar levels from time to time to get a good measure of how your condition is progressing. 
  • Never skip medication for diabetes and always follow your doctor's advice.
  • Have a plan in place for if and when you experience such an episode and educate your loved ones in detail so they can take care of you. Also keep all necessary supplies ready and on hand. 
  • When your blood sugar is above 250 mg/dL (14 mmol/L) for two tests in a row, particularly if you're ill, check for ketones. Call your doctor if you have a lot of ketones. If you have ketones and are vomiting, call your doctor right away. High ketones may cause diabetic ketoacidosis and coma.
  • If you have diabetes and use insulin, have a glucagon kit and quick-acting sugar sources like glucose tablets or orange juice on hand to treat hypoglycemia.

Bottomline

A diabetic coma is a potentially life-threatening consequence of diabetes that induces unconsciousness. There are two types of diabetic comas, hypoglycemic coma and hyperglycemic coma. Immediate medical attention must be given to the person who experiences this condition. The presence of severe hyperglycemia and plasma hyperosmolality, as well as the lack of substantial ketosis, indicate the onset of hyperosmolar hyperglycemic nonketotic coma. It can cause permanent brain damage and death if left untreated. Continue reading to find out which foods are healthy for people with diabetes. Also read about what is reactive hypoglycemia and it's causes.

FAQs

1. What level of hypoglycemia causes coma?

Hypoglycemia or low blood sugar levels can be fatal. One can reach a comatose stage if the blood sugar levels fall below 40mg/dL. This baseline can be different for different people. At times, a reading as low as 30mg/dL may not lead to fainting or coma. However, low sugars are highly dangerous and can lead to fatal or near-fatal incidents.  

2. Can you recover from a hypoglycemic coma?

If the recovery and treatment for a hypoglycemic coma episode are rapid and efficient, there are very high chances that a person might be able to recover from it fully. However, if the levels reach a stage where the brain is completely deprived of sugar, possible brain damage is likely. Oral or intravenous glucose works best to treat a hypoglycemic coma.

3. What is the difference between diabetic coma and hypoglycemic coma?

The major difference between a diabetic coma and a hypoglycemic coma would be its inherent nature. A hypoglycemic coma occurs when a person skips a meal or takes extra insulin which results in the blood sugar levels dropping too low. A diabetic coma could be induced either with hypo or a hyperglycemic episode – which means if proper steps are not taken to take care of the overall HbA1c levels, one can slip into a diabetic coma.

4. Can hypoglycemia cause permanent brain damage?

Hypoglycemia that is untreated and prolonged can not only result in a coma but can also cause brain damage. Extremely low blood sugar levels can lead to severe deprivation of glucose from the brain. Even frequent low-sugar episodes can cause negative effects. At times, the damage can be permanent and irreversible.

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