The dictionary definition of a coma is a state of deep and often prolonged unconsciousness, usually the result of disease or injury. Diabetics are at 7 Steps To Health And The Big Diabetes Lie risk of coma if something goes wrong with their management of food intake and liquid intake. You can die from a diabetic coma, so it is important that anyone suffering from a loss of consciousness (especially if you know they have diabetes) should receive urgent attention from a qualified medical practitioner.
There are three different comas that are associated with diabetes: the ketoacidotic coma, the hyperosmolar coma, and the hypoglycemic coma. The ketoacidotic coma is much more likely to occur in Type I rather than Type 2 diabetes. Ketoacidosis is the accumulation of ketones in the blood. This accumulation causes the blood to become acidic. Ketones are chemicals made by the body when it breaks down fat to make energy. This can happen when there isn't enough insulin in the body for it to break down sugars for energy, so it uses fat as a fuel instead.
The brain cannot function with ketones as the only energy source and goes into coma, which can be life threatening. The hyperosmolar coma occurs after excessive loss of fluids. Hyperosmolarity is a condition in which the blood has a high concentration of sodium, glucose, and other molecules that normally attract water into the bloodstream. This can be caused by the diabetic person missing their insulin shot, or consuming foods high in sugar without exercising, or not using medications properly to control their blood glucose. The blood glucose levels could go dangerously high. The kidneys will try to regulate the blood glucose levels by pulling glucose, sodium, and other molecules out of the circulating stream. These different molecules are released from the body, along with large amounts of water by urination.
Following the loss of fluids there is a vicious cycle of increasing blood-glucose levels and increasing dehydration. If intravenous fluids are not administered quickly, huge cell damage can occur. The brain shuts down and creates a life-threatening situation. The hypoglycemic coma is more likely to occur in a diabetic person using insulin to control blood sugar, therefore it is more likely to occur in type 1 diabetes. Hypoglycemic coma occurs when blood glucose levels fall significantly below normal. Hypoglycemic coma can be part of insulin shock that occurs when a large amount of insulin is injected compared to the glucose present in the blood. Blood glucose levels drop rapidly as the body's cells absorb all available sugars; brain cell starvation occurs that can lead to coma.
