Contents
Definition of hyperglycemic coma
Hyperglycemic coma is the most severe and life-threatening complication of diabetes mellitus. It develops as a result of an increase in insulin deficiency and a significant decrease in the utilization of glucose in the blood.
In the body of a sick person, a profound metabolic disorder occurs with the formation of a large number of ketone bodies, with the development of acidosis (disturbance of the acid-base balance), with intoxication of the central nervous system.
Signs of the development of hyperglycemic coma
Hyperglycemic coma is characterized by gradual development over several hours or days. The harbingers of its formation, the so-called prodromal period, are headache, weakness, apathy, drowsiness, and intense thirst.
Often the patient is disturbed by nausea, accompanied by vomiting. After a few hours or days, the smell of acetone appears from the mouth, shortness of breath, accompanied by very deep, frequent and noisy breathing. After this, there is a violation of consciousness up to its complete loss and the development of the actual coma.
Causes
The reasons for the development of hyperglycemic coma include untimely diagnosed diabetes mellitus, its improper treatment, insufficient insulin administration, below the dose prescribed by the doctor, diet violations in diabetes mellitus, various infections, mental trauma, surgical operations, stress. This complication practically does not occur in type XNUMX diabetes mellitus.
Symptoms
The development of hyperglycemic coma is accompanied by a complete or partial impairment of consciousness, a sharp flushing (redness) of the face, dry skin and mucous membranes, a strong smell of acetone from the mouth, a decrease in turgor (tension of the skin-fat fold) of the skin and muscle tone.
The patient’s tongue is dry and coated with a dark brown coating. Reflexes are often slow, the eyeballs are sunken and soft. Kussmaul’s breathing is deep, noisy, not rapid. There are violations of the cardiovascular system, impaired renal function – first polyuria (an increase in the amount of urine excreted per day), then oliguria (a decrease in the amount of urine excreted) and anuria or the complete absence of urine output.
Arterial pressure is reduced, the pulse is frequent, thready, body temperature is below normal. In the urine, ketone bodies are determined, in the blood – hyperglycemia. If during this period the patient does not receive emergency qualified assistance, he may die.
The consequences of the development of hyperglycemic coma
From the first minutes of the development of a diabetic coma, there is a danger that the patient may choke on his own vomit or suffocate due to the retraction of the tongue.
At the last stage, violations of the functions of all vital organs and systems of the body are pronounced, which can lead to the death of the patient. There is a failure of all types of exchange. On the part of the central nervous system, there is a violation of the brain, expressed in loss of consciousness up to its complete oppression, most often occurs in the elderly and threatens with the possibility of paralysis, paresis, and a decrease in mental abilities. Reflexes decrease or disappear completely. The urinary system also suffers, the amount of urine excreted decreases until it is completely absent. With a predominant lesion of the cardiovascular system, blood pressure drops, which can lead to myocardial infarction, the development of vascular thrombosis, and further to trophic ulcers and gangrene.
Emergency First Aid
Basically, patients with diabetes are informed about the possibility of developing hyperglycemic or diabetic coma. Therefore, if the patient’s condition allows, it is recommended to find out from him and provide him with all possible assistance: if there is insulin, help the patient to introduce it.
If the patient is unconscious, then before the arrival of the ambulance team, it is recommended to ensure free airway patency, monitor the pulse. It is necessary to free the oral cavity from removable dentures, if any, turn the patient on his side in order to prevent him from choking on vomit in case of vomiting and to avoid falling of the tongue.
At the first signs of the development of a coma, it is necessary to immediately contact a medical institution for the relief of a crisis and its further treatment, this condition requires urgent emergency qualified assistance. But in all cases, you should immediately seek professional medical help.