Diabetes is among the leading causes of morbidity worldwide, affecting 366 million people and counting. Although it is more common among older adults, recent statistics show that it can affect anyone, regardless of age and gender. While there are medications that can help manage blood sugar levels, there is really no treatment for diabetes. As a matter of fact, even people who are receiving treatment for diabetes are not free from possible life-threatening diabetic emergencies.
Diabetic coma or hyperglycemia occurs when there is not enough insulin in the blood due to problems with the pancreas or not taking adequate dosage of insulin. When there is no sufficient amount of insulin, glucose (sugar) is unable to get into the cells as a result the body uses other stored energy, usually stored fats. However, the utilization of fats results in waste products that makes the blood highly acidic (acidosis). If it not treated, acidosis and dehydration due to the high blood glucose level eventually leads to diabetic coma.
Symptoms of diabetic coma develop gradually. The individual may report dryness of mouth and intense thirst, abdominal pain, vomiting, confusion, and restlessness. The individual also has weak, rapid pulse; dry, warm skin; breath smells acetone or like nail polish remover; and sunken eyeballs. If left untreated, the condition may progress into a loss of consciousness and coma.
Emergency management involves administering supplemental oxygen and immediate transport to a medical facility. Monitor the breathing of the individual while waiting for emergency assistance.
Insulin shock or hypoglycemia occurs when there is an excessive amount of insulin in the body. This may be caused by taking too much insulin, overexerting or over-exercising, and a reduction in sugar intake, causing increased free insulin in the blood.
Regardless of the cause, glucose rapidly enters the cells and leaves the blood. This results in insufficient amounts of glucose for the brain, causing unconsciousness. If sugar is not given immediately, the person can suffer permanent brain damage. Compared to diabetic coma, insulin shock can cause greater damage more quickly.
Symptoms of insulin shock develop quickly, over a period of minutes. The individual may report intense hunger; skin is pale, cold and clammy; excessive perspiration; drooling of saliva; headache or dizziness; aggressive or abnormal behavior; fainting, convulsions or even coma; and rapid pulse.
Emergency management involves administering sugar, such as lifesaver, orange juice, honey, for conscious patients. However, for the unconscious patient, put him over his side and do not give anything. Call 911 and continue monitoring the patient while waiting for help to arrive.
Both of these conditions are considered as emergency and require immediate medical attention. Early and accurate diagnosis is essential in providing appropriate emergency care.