Diabetes refers to endocrine diseases.It is of two types.Diabetes mellitus is insulin-dependent first type and second type of diabetes is insulin dependent.
coma in diabetes - one of the most severe complications of the disease.The condition can occur due to insulin deficiency, as well as metabolic disorders.The main types of diabetes when someone allocated in the amount of two pieces:
hypoglycemic coma in diabetes
This condition can develop in a patient, if the sharp decline in glucose levels occur in his blood.The indicator is below 2-1 mmol / l.Coma occurs when an overdose of insulin, eating disorders or hormonal tumor.
glucose - the main source of energy for the brain.The nervous system of the human consumption of about 20% glucose, which circulates in the human blood.The brain can not be stored glucose, that are capable of many other body systems.Therefore, if a maximum of seven minutes in the brain cells are fed glucose in the brain undergoes irreversible cha
manifested a state of loss of consciousness, motor and psychomotor impairment.The patient can not be excluded hallucinations and tonic convulsions.The skin and mucous membranes dramatically turn white, become wet, sweat acts, there is tachycardia.
This is important!When the patient is in such condition, it is important not to confuse the hypoglycemic and hyperglycemic coma.Doctors are advised to always use one rule: if you pinpoint the type of coma is difficult, it must first be considered as a hypoglycemic.
After determining the type of coma, you must enter the patient 80ml 40% glucose solution.If possible, the need to measure the blood glucose.It should be in the range 8-10 mmol / l.Administered to a human, who is in a state of coma can also hydrocortisone, ascorbic acid, glucagon, adrenaline.The choice of drug depends on the particular indication.To
after or as a result of the coma to avoid such complications as brain swelling, you must enter the patient ventilation in the mode of hyperventilation and intravenous infusion of 20% mannitol.
hyperglycemic coma in diabetes
Sometimes blood glucose concentration exceeds the limit and reaches 55 mmol / l.Then there is this kind of coma, a person with diabetes.This condition is characterized by loss of consciousness, dryness of skin and mucous membranes.Sometimes you can feel bad breath.Eye patient apples are sunken and soft, it quickens the pulse.Possible convulsions and increased reflex activity.
There are three types of coma:
- Hyperosmolar neketoatsidoticheskaya;
When diagnosing certain types of coma are important not only clinical data, but also laboratory tests.For example, the rise is not only the blood sugar levels under hyperglycemic coma, but is also developing hyperosmolar syndrome.In the extracellular space the liquid is moved from the cells.Therefore, there are signs of dehydration of the cell which lead to neurological symptoms.Also, increased levels of sugar in urine.Indicator can reach 250 mg / dL.
As a result, the body loses its coma to twelve liters of fluid.However, it displays the body potassium and sodium, magnesium and calcium.As a result of these processes develops gipoelektrollitemiya.blood ketone bodies off the scale, the number increased to ten times.Especially in a large amount can be detected in urine.
This is interesting!Coma in diabetes mellitus: the consequences can be severe, but lasts a long time the state can.Most long case fixed in modern medicine: man lay in a diabetic coma for more than forty years.
to rapidly bring a person out of this coma patient must enter the insulin.Best of all, if the hand would be "managed" insulin.The most effective will drip.The amount of glucose in the blood must be constantly monitored.It is usually necessary to administer such a quantity of insulin to blood glucose decreased every hour for 3-4 mmol / hr.As a result, blood sugar levels should be at the level of 8-10 mmol / l.
patients also need to be given plenty of fluids, administered sodium.The rate of the fluid in the body depends on the state of the patient's cardiovascular system of the person, of the proper operation of the kidney.It is best to introduce a two-liter of fluid in the first hour, the second and third tea - half a liter, and in one hour - 250 milliliters.The total volume of fluid that is required to enter the patient within 24 hours is 7.4 liters.
This is important!If at a reception at the dentist person with diabetes, suddenly lost consciousness, the first thing you need to assume the state of hypoglycemia.Perform all necessary actions and immediately call an ambulance.
If a diabetic knows how to behave and look after their health, the state of coma can be avoided with a high probability.Be careful not to extremes!