Non-Ketotic Hyperosmolar Coma in Diabetics

Non-Ketotic Hyperosmolar Coma in Diabetics

This coma is associated with nursing home patients but can occur in all ages. The principal symptom is lethargy that progresses to behavior that mimics one with less than  normal mental capacity. Vomiting is not, ordinarily, associated with this type of coma.

Extreme hyperglycemia is accompanied by dehydration when the person doesn't drink enough fluids. This coma occurs most often in people who develop Type II diabetes and they have an impaired ability to recognize when they are thirsty. They need to drink and, instead, slip into a state of dehydration from lack of fluids.

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When the person exhibits mental confusion that is not characteristic, the physician may order a chemical screen. The screen, with this type of coma, may show extreme hyperglycemia ( 1800 mg/dl - 100 mM) and dehydration. 

Treatment consists of insulin and gradual rehydration with intravenous fluids.

Diabetic Ketoacidosis Coma

Diabetic Ketoacidosis Coma

This coma begins innocently when you have flushing and rapid breathing and dehydration. A coma is near or begins when you have visible sweating and vomiting, your face appears gray from diminished perfusion, shallow breathing and rapid heart rate.   Symptoms differ from person to person. Don't wait until all the symptoms appear to seek help or advise others, if you can, to seek help for you.

If these symptoms continue and worsen, without treatment, they could cause unconsciousness. That is the result of hyperglycemia, dehydration, shock and exhaustion.

Coma happens after worsening vomiting and hyperventilation. If you are diabetic, the diagnosis of ketoacidosis is made from your appearance and continuous vomiting over a span of one to two days. Blood chemistry confirms ketoacidosis by the presence of hyperglycemia and severe metabolic acidosis. 

Treatment consists of isotonic fluids administered orally, if awake, or intravenously if you are still in a coma, to stabilize your blood circulation. Simultaneously you continue with the iV with saline that contains potassium and other electrolytes to reverse the ketoacidosis. The physician or emergency staff will keep an eye on you for further complications.

Diabetic Coma

Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. There are three types of coma: 

• Severe Diabetic Hypoglycemia
• Diabetic Ketoacidosis
• Nonketotic Hyperosmolar Coma

I

Severe Diabetic Hypoglycemia

If you suffer from hypoglycemic comas and are diabetic with Type I Diabetes and full replacement doses of insulin recovery is easy to induce.

Recovery is initiated by eating or drinking carbohydrates. In some situations the blood glucose falls fast and low enough to produce unconsciousness before your condition is recognized.

Medical Emergency personnel have no idea that you are diabetic unless you wear a Diabetic Tag or are accompanied by a friend or family member who tells them you are diabetic.

For example, in camping experiences (Diabetic Camps) the high level of exercise combined with a more sedentary lifestyle before camp may bring on the unconscious state quickly. The burning of blood sugar by your body increases and drops the available blood glucose level lower than what are used to before a camping experience. Your dose of insulin is adjusted downward due to the increased activity. If you eat less than usual your normal dose of insulin may initiate hypoglycemia that results in a coma.

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Twitching or convulsions may occur. You may appear pale, have a rapid heartbeat and soaked in sweat which are signs of your adrenalin response to hypoglycemia. You're not usually dehydrated and breathing is normal or shallow. If you passed the deepest portion of hypoglycemia, a glucose meter may show a low but not the severe level of hypoglycemia that caused your state of unconsciousness.

They treat unconsciousness due to hypoglycemia by waking you up and have you drink orange juice or other citrus juice. If you don't wake they raise your blood glucose with intravenous glucose or injected glucagon. 

Sweet Tea - A Southern Type II Diabetes Problem

Sweet Tea - Increase or Decrease onset of Type II Diabetes

Living in South Carolina, where the weather is the finest is a haven for potential Type II Diabetes. 

Sweet tea is a very popular beverage. In earlier posts, the pancreas controls the blood level of glucose through the production of insulin. The sugar in sweet tea stretches the ability of the pancreas to keep blood sugar under control. The cells in the pancreas begin to hypertrophy. When they enlarge they begin to lose their ability to produce insulin. This is the onset of Adult Diabetes or Type II Diabetes.

Unfortunately, a good portion of the population appears overweight. This combination of two factors, sugar intake in foods and drinks and obesity, research has identified as building blocks for the onset of Type II Diabetes.

Our Nation is exploding into a population of obese people that will, in the  future, pose problems for our strained health care system as the diabetic population rises dramatically.

The folks here don't like to give up "traditions."  If that attitude persists health care will strain to the breaking point.

If you can help, in some way, to educate the people in your local communities about Type II Diabetes that may begin to turn the tide toward a healthy lifestyle and freedom from the dangers of Diabetes.