Hypoglycemic coma is provoked by prolonged habitual hypoglycemia or a sharp drop in sugar. They can be caused by the following factors.
With diabetic neuropathy and alcohol intoxication, the first manifestations of hypoglycemia are difficult to feel, so you can skip a small decrease in sugar and bring your condition to a coma.
Also, the erasure of symptoms is observed in patients with frequent mild hypoglycemia. They begin to feel trouble in the body when the sugar drops below 2 mmol / l, so they have less time for emergency care.
Conversely, diabetics with persistently high blood sugar begin to feel signs of hypoglycemia when the sugar becomes normal.
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Symptoms of hypoglycemia do not depend on the cause that caused it. In all cases, the clinical picture of the development of coma is the same. With a decrease in glucose to 2.7, the brain begins to starve, neurogenic symptoms are added to the autonomic symptoms. Their appearance means the beginning of damage to the central nervous system. With a sharp drop in sugar, both groups of signs occur almost simultaneously.
It becomes difficult for the patient to concentrate, navigate the area, thoughtfully answer questions. He begins to have a headache, dizziness is possible. There is a feeling of numbness and tingling, most often in the nasolabial triangle. Doubling of objects, convulsions are possible. With a serious lesion of ventolin online nervous system, partial paralysis, speech impairment, and memory loss are added. At first, the patient behaves inappropriately, then he develops severe drowsiness, he loses consciousness and falls into a coma. When in a coma without medical assistance, blood circulation and respiration are disturbed, organs begin to fail, and the brain swells.
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Vegetative symptoms are easily eliminated by taking a serving of fast carbohydrates. In terms of Albuterol, 10-20 grams is usually enough. It is not recommended to exceed this dose, since an overdose can cause the opposite condition - hyperglycemia. To raise blood glucose and improve the patient's condition, a couple of sweets or pieces of sugar, half a glass of juice or sweet soda are enough. Diabetics usually carry fast carbohydrates with them in order to start treatment on time. Note! If the patient is prescribed acarbose or miglitol, sugar will not be able to stop hypoglycemia, since these drugs block the breakdown of sucrose. First aid for hypoglycemic coma in this case can be provided with pure glucose in tablets or solution.
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When a diabetic is still conscious, but can no longer help himself on his own, to stop hypoglycemia, he is given any sweet drink, making sure that he does not choke. Dry foods at this time are dangerous with the risk of aspiration. If there is a loss of consciousness, you need to call an ambulance, lay the patient on his side, check whether the airways are free and whether the patient is breathing. If necessary, begin to do artificial respiration. Hypoglycemic coma can be completely eliminated even before the arrival of doctors; this requires a first aid kit. It includes the drug glucagon and a syringe for its administration.
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Ideally, every diabetic should carry this kit with him, and his relatives should be able to use it. This tool is able to quickly stimulate the production of glucose in the liver, so the consciousness returns to the patient within 10 minutes after the injection. Exceptions are coma due to alcohol intoxication and multiple excess doses of insulin or glibenclamide. In the first case, the liver is busy cleansing the body of alcohol breakdown products, in the second case, the glycogen stores in the liver will not be enough to buy cheap generic ventolin.
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Signs of hypoglycemic coma are not specific. This means that they can be attributed to other conditions associated with diabetes. For example, diabetics with persistently high blood sugar may feel hungry due to severe insulin resistance, and diabetic neuropathy may cause palpitations and sweating. Convulsions before the onset of a coma are easily mistaken for epilepsy, and panic attacks have the samevegetative symptoms, as hypoglycemia. The only reliable way to confirm hypoglycemia is with a laboratory test that measures plasma glucose levels.
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The diagnosis is made under the following conditions. Glucose is less than 2.8, while there are signs of hypoglycemic coma. Glucose is less than 2.2 if there are no such signs. A diagnostic test is also used - 40 ml of glucose solution (40%) is injected into a vein. If blood sugar has dropped due to a lack of carbohydrates or an overdose of drugs in diabetes, the symptoms immediately subside. Part of the blood plasma taken upon admission to the hospital is frozen. If, after the elimination of the coma, its causes are not identified, this plasma is sent for a detailed analysis.
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