Jul 07, 2018
The most dangerous complication of a sugar disease is the diabetic coma .In the Russian translation, the word "coma" means a deep sleep. But it differs from deep sleep in that it can not be awakened by a person with light, sound, or mechanical influence.
Diabetic coma always occurs against the backdrop of a sharp increase in blood sugar levels. But the main reason for this complication is not hyperglycemia, but severe poisoning of the body, and in the first place - the central nervous system, excessive accumulation in the blood of products of incomplete distribution of fats. These decay products, the so-called keh-yun bodies, lead to the release of acetone in the urine and through the lungs with exhaled air.
A diabetic coma is preceded by a precomatous condition. It is characterized by a growing general weakness, complete lack of appetite, nausea, vomiting, headache and drowsiness. In the exhaled air there is a smell of acetone( it resembles the smell of wet apples or pear essence).Due to the muscle weakness and dryness of the mucous membranes, speech in a person is slow, indistinct. Patients with difficulty walk, consciousness is preserved. If the medical measures are not taken in a timely manner, the condition continues to worsen, and the diabetic coma develops. There is a violation of movement, breathing becomes deep and noisy( Kussmaul's breathing).In exhaled sick air - a sharp smell of acetone. When examining the patient, one can note the dryness of the skin and mucous membranes, the grayness of the face. The tone of the eyeballs is lowered, the pulse is frequent, blood pressure is kept at the lowest digits. The nausea intensifies, there is a vomiting. The blood sugar content is usually 350 mg%, glycosia. The level of ketone bodies in the blood can reach 100 mg%.Some patients have sharp pains in the lower abdomen, the abdominal press is strained, painful with pressure. Consciousness in the initial stage of diabetic coma is preserved, but a person with difficulty answers questions. With the progression of ketosis, there is a loss of consciousness.
Diabetic coma is a serious complication of diabetes mellitus, but nowadays it is quite rare, because the cultural level of people who have a wide opportunity for any occasion connected with the deterioration of health, has immeasurably grown, seek medical advice, medical help, which protects againstcomplications.
Timely received energetic, proactive measures to remove a patient from a precomatous or comatose state, usually end safely. Medical care must be provided immediately. The favorable outcome of a diabetic coma depends on the period that has elapsed since the patient fell into unconsciousness, until the time when help is provided. The earlier measures are taken to eliminate the coma, the more favorable the outcome. Medical assistance should be provided to
no later than the first 6-8 hours after the onset of a diabetic coma. Treatment of diabetic coma should be carried out only in a hospital. Attempts to treat a patient at home can be unsuccessful.
It should be remembered that not every coma is diabetic. In a patient with diabetes mellitus, comatose state of non-diabetic origin( uremic coma) and connection with kidney disease, cerebral hemorrhage( aioplectic), etc., may be present in patients with diabetes mellitus, this requires the referral to a hospital where it is possible to correctly recognize the character of coma and providequalified medical care.
The main drug that is used by official medicine to combat diabetic coma is insulin. It is administered not only subcutaneously or intramuscularly, but for the most rapid effect and intravenously. In order to prevent hypoglycemia due to the administration of large lo I insulin, intravenous infusion of 40% glucose solution is used to improve metabolic processes and eliminate cardiovascular insufficiency. Enter 10% solution of sodium chloride, saline solution and apply cardiac agents( camphor, caffeine, etc.).When providing medical care to a patient in a coma, it is necessary to exercise great efficiency. The assistance should be carried out under the control of laboratory tests( determination of blood sugar level, urine test for sugar and ketone bodies).By providing these requirements, unremitting careful care, one can save the life of a person who is in a coma.
Modern methods of treatment are aimed at reducing elevated blood sugar levels to normal levels.