Hypo and hyperglycemic coma. Hyperglycemic coma - emergency care

sticking to proper diet and taking medicines, diabetics can live enough full life. But due to certain factors, some patients develop complications. One of the most dangerous is hyperglycemic coma.

Pathogenesis

This condition is caused by a deficiency of insulin in the blood against the background of an increase in glucose concentration. The complication is life-threatening.

The pathogenesis of hyperglycemic coma is explained by impaired metabolic processes in the body of a diabetic. With insufficient synthesis of insulin, a protein hormone necessary for the utilization of glucose, metabolism is disturbed. Glucose does not enter the cells of the body, but remains in the blood. Over time marked high concentration glucose. This condition is called hyperglycemia. Are formed ketone bodies, gluconeogenesis is activated in the liver, acidosis occurs, and CNS intoxication occurs. This leads to a diabetic coma.

Rarely, hyperglycemic coma occurs before diabetes is diagnosed.

There is a classification that allows you to determine the type of complication depending on the etiology and mechanism of development.

In 80% of diagnosed cases, a ketoacidotic coma is established. It most often develops in patients with type 1 diabetes. It usually occurs in young people under 20 years of age. According to statistics, 1 out of 3 patients suffering from the juvenile form of the disease experienced similar condition. This form can be transformed into hyperosmolar and vice versa.

Hyperglycemic coma without ketosis is also isolated. This condition is accompanied by an increase in blood glucose levels, while the body does not begin to break down adipose tissue to get energy. As a result, ketone bodies are not released, as in a ketoacidotic coma.

On average, 4–31% of deaths are recorded. Often, death occurs in the elderly and patients with a weakened body.

Symptoms

Depending on the etiology, hyperglycemic coma develops within hours or days. The body is poisoned by the formed ketones, acid-base balance symptoms of dehydration and hypovolemia appear. This condition is called precoma.

Clinical warning signs:

feeling of thirst, dryness oral cavity and skin;
polyuria;
decreased activity and overall performance;
stomach pain, vomiting, diarrhea;
loss of appetite;
disturbance of consciousness, drowsiness, irritability (develop gradually).

May decline muscle tone. A stench emanates from the patient's mouth - the smell of acetone or rot. Breathing becomes deep and noisy. If this condition lasts for several days, there may be a decrease in body weight.

In 50% of patients with hyperglycemic coma, manifestations of pseudoperitonitis are noted: tension and pain in abdominal wall, painful stomach, peristalsis of moderate intensity. Such symptoms are manifested as a result of the activity of ketones in the gastrointestinal tract.

Signs of complications in adults and children are almost the same.

First aid and therapy

If symptoms of hyperglycemic coma are detected, it is necessary to call ambulance. If the patient is conscious, before the arrival of doctors, it is necessary to carry out the following actions:

lay the patient horizontally on his side;
cover with a warm blanket;
loosen the belt, tie, remove tight clothing;
control the pulse, breathing and the position of the tongue so that it does not sink;
inject a dose of insulin;
give some water;
with a small interval to measure the pressure, if necessary, give drugs.

In case of respiratory arrest, resuscitation should be carried out: heart massage and artificial respiration. An ambulance must be called immediately, even if the patient's condition has been stabilized.

The patient is hospitalized. Before starting treatment, a blood test for sugar and a urine test for the presence of ketone bodies in it are performed. The patient is given insulin. The dose of the hormone is calculated taking into account the severity of the condition.

To warn coronary insufficiency in the elderly, it is recommended to administer more than 50-100 IU of insulin. Half of the first dose is administered intravenously in a stream with 20 ml of saline, the second part - intravenously by drip. With precoma, ½ of the full dose of the hormone will be required. Further, insulin should be administered at intervals of 2 hours. The dosage is set depending on the level of glucose in the blood. Daily dose insulin in hyperglycemic coma varies from 400 to 1000 units.

Assign gastric lavage with a 4% solution of sodium bicarbonate. Administered intravenously saline and Ringer's solution. With an interval of 4 hours, injections of 5% glucose are made. A 4% sodium bicarbonate solution is also prescribed. During the day, young patients are injected with 5-6 liters of liquid, the elderly - no more than 2-3 liters. Every hour, the pressure is measured, if necessary, it is increased.

After initiation of therapy, some patients develop hypokalemia. This condition is characterized by a violation heart rate, muscle cramps, paresis of peristalsis. Temperature fluctuations are observed, which can provoke the penetration of infection.

Causes of hyperglycemic coma

The most common hyperglycemic coma develops in patients with insulin dependent diabetes 1 type. There are rare cases of complications in type 2 disease.

A significant increase in blood glucose is provoked by the following factors:

undiagnosed diabetes or a latent form of the disease;
self-treatment;
refusal of insulin therapy in type 1 diabetes;
insufficient dose, an increase in the intervals between the introduction of the hormone;
taking ineffective drugs that stimulate the synthesis of insulin by the pancreas;
malnutrition: large portions or a lot of sugar-containing foods in the diet;
acceptance of some groups medicines accelerating the excretion of insulin: prednisolone or diuretics.

The indicated causes of hyperglycemic coma are dependent. If you keep them under control, then the complication can be prevented.

In type 2 diabetes, a crisis often occurs due to a malfunction of the pancreas. As a result, the level of insulin in the blood falls, which leads to the accumulation of glucose.

Risk group

Some patients are prone to complications. Among the reasons for this are external or internal factors independent of the diabetic.

Patients suffering from inflammatory or viral diseases bronchi and lungs. These diseases adversely affect metabolism and common work body of a diabetic. Weakened physiological state observed in people who have recently undergone trauma or surgery.

The risk of developing hyperglycemic coma increases in smokers, as well as in patients who violate the diet and drink alcohol.

Probability of development diabetic coma high in pregnant women during gestation and during childbirth. This happens especially often if a woman suffers hidden form diabetes.

Patients with diabetes know the importance of following the diet and treatment prescribed by their doctor. Otherwise jumps blood sugar can lead to serious complications, one of which is hyperglycemic coma.

Hyperglycemic coma is called critical condition a diabetic patient with complete loss of consciousness.

The development of this condition directly depends on the course of the disease. The development of hyperglycemic coma is preceded by a prolonged concentration of glucose in the blood and a rapid increase in insulin deficiency. As a result, there is serious violation metabolism, resulting in loss of reason and coma.

Hypoglycemic coma is a condition caused by an excess of insulin in the body of a diabetic patient.

Development

Coma develops gradually. From the first symptoms of malaise to the patient's coma, it can take from several hours to several weeks. It depends on how high the concentration of sugar in the blood is and how long the sugar stays at a high level.

The first symptoms signaling the gradual development of coma are:

aching headache, increasing with time;
symptoms of poisoning;
nervous breakdown - a feeling of anxiety or apathy;
prostration;
increasing thirst.

As a result of coma, a strong and rapid intoxication of the entire nervous system occurs, therefore this condition is often characterized by nervous disorders to the point of losing your mind.

If nothing is done, after the first symptoms are detected, the patient's condition will worsen. Immediately before falling into a coma, the patient's breath acquires a distinct smell of acetone, each breath is given with effort.

Reasons for the development of the disease

Hyperglycemic coma develops for the following reasons:

detecting diabetes when the disease is already severe;
violation of the diet;
incorrect dosage and untimely injections;
nervous disorders;
transferred severe infectious diseases.

This condition is characteristic of type 1 diabetes, in which acute insulin deficiency is observed. In patients with type 2 diabetes, such a coma is very rare, with a very high concentration of sugar in the blood.

How to recognize who?

Hyperglycemic coma can lead to lethal outcome Therefore, it is very important to recognize the symptoms in time. Timely identification of the problem and contacting a doctor can save the patient's life. To do this, you need to know what a glycemic coma is and what symptoms are characteristic of this disease.

In addition to the symptoms listed above, which appear gradually on initial stage disease, the patient may notice redness of the skin of the face. Patients often complain of dry eyes and oral mucosa.

Another characteristic symptom– the skin of the face becomes excessively soft, the skin loses its elasticity, and the face is puffy. If you study the language of the patient, you can notice a brownish coating.

Before the coma, there is a rapid pulse, low blood pressure and low temperature body.

Distinctive features

The hypoglycemic state develops very rapidly. From the appearance of the first symptoms to loss of consciousness, a few minutes pass. This condition is characterized by the following symptoms:

cardiopalmus;
increased sweating;
strong feeling of hunger;
migraine;
convulsions and trembling in the limbs;
intermittent breathing.

Hypoglycemic coma can be caused excessive load on the body as a result of sports, deliberate reduction of carbohydrate intake or a large dose of insulin.

Hypo and hyperglycemic diabetic coma, if left untreated, is fatal.

First aid

If suddenly developed hyperglycemic coma urgent Care can save a patient's life. As a rule, patients with diabetes themselves know the symptoms of an impending coma and are able to warn others or call a doctor.

However, if a hyperglycemic coma suddenly began, it should be remembered that emergency care can save a person’s life, the following algorithm of actions will help with this:

help the patient inject insulin;
if the patient has lost consciousness, he should be placed on his side;
it is necessary to call a doctor;
monitor how the patient breathes;
control the heartbeat.

Nothing more can be done at home if the patient has already lost consciousness. It remains only to ensure that the patient does not accidentally suffocate due to a sunken tongue and wait for the arrival of the emergency team.

It should be remembered that one of the symptoms of diabetic coma is impaired brain function. This may be accompanied by incoherent speech of the patient before he loses consciousness. It often happens that the patient, for some reason, does not want to call the doctor and tries to assure others that he knows what to do. In this case, it is necessary to call the hospital, contrary to all the assurances of the patient.

First aid in the case of a hypoglycemic state is almost identical to that in a hyperglycemic coma. The only thing to remember is that in case of hypoglycemia, insulin should not be administered until the doctor arrives.

If there is a diabetic in the family, it is important to remember the ambulance algorithm and always keep the phone number of the attending physician at hand.

Treatment in the hospital

No emergency care at home for hyperglycemic coma can replace qualified treatment in the hospital. After the patient has become ill, the first thing to do is to call a doctor.

The patient will be admitted to the clinic for some time necessary to monitor his condition. Treatment of diabetic hyperglycemic coma is primarily aimed at lowering blood sugar levels. With timely treatment to the clinic, treatment will consist of the following activities:

the use of drugs to reduce sugar levels;
the use of "short" injections of the hormone insulin;
elimination of the cause of the development of the condition;
replenishment of body fluid loss.

Such measures will help to stop the pre-coma state and avoid negative consequences.

If the visit to the doctor happened later, then, when the person has already fallen into a coma, treatment may take for a long time and no one can guarantee a successful outcome. If the patient is unconscious, treatment includes mechanical ventilation and gastric probing. Sugar level control is carried out hourly, together with insulin injections.

How to avoid danger?

To avoid the development of diabetic coma, strict adherence to the recommendations of the attending physician will help.

Do not allow a lack or excess of insulin in the body.
Stick to the recommended dietary guidelines.
Don't overstress exercise stress should be gentle.
Avoid high blood sugar levels.

If any symptoms appear, you should immediately consult a doctor, without delay and without trying to stop this condition on your own. Timely qualified treatment will help to avoid the main complication of hyperglycemia - dementia, which occurs due to damage to the nervous system of the body.

Diabetes leaves a certain imprint on a person's habits. If you come to terms with this condition and do not ignore the doctor's recommendations, diabetes will not be a sentence, but a feature of your lifestyle. You can live with diabetes, the main thing is to carefully treat your own health.

Coma is an extreme manifestation of any disease, which is associated with loss of consciousness and a serious condition of the patient. Finding a person between life and death is caused by deep inhibitions of processes in the cerebral cortex. Occurs with head injuries, malaria, meningitis, poisoning, hepatitis, diabetes and a number of other diseases in severe forms. Such conditions are especially dangerous for children.

Types of coma in diabetes mellitus

After some time has passed since the onset of the disease, the human body adapts to some fluctuations in blood sugar levels. However, a very rapid decrease or increase in this indicator leads to irreversible processes in the body. Coma states- This acute complications with illness. Depending on the initial development of the clinic sugar lump subdivided into the following types:

Hyperglycemic- is characterized by a strong increase in blood glucose levels. It occurs more often in patients with type 2 diabetes.
Hypoglycemic. The main reason is a sharp drop in glucose levels.
Ketoacidotic. Due to the lack of insulin, the body receives a lack of energy through the process of splitting fats. As a result, an excess amount of ketone bodies (acetone and acids) is formed, which affect nervous system. As a result, he develops a state of coma.
Hyperlactacidemic. Lactic acid accumulates in tissues and blood in violation of metabolic processes and the liver does not have time to remove such volumes from the body. In connection with this, a coma develops, which is the rarer of all types, but causes the most severe conditions patients.
Hypermolar. This type of coma is more common in older people. Occurs due to disturbed metabolic processes against the background of very high level blood glucose. It rarely develops in children.

Hyperglycemic coma can develop both in adults and in children with diabetes mellitus and who have not received proportionate therapy. The reason may be a missed next insulin injection, causing shortage this protein hormone. In this case, the metabolic processes in the body are disturbed. Coma can develop regardless of the type of diabetes, even if the disease has not even been diagnosed. The consequences can be severe.

Causes

Diagnosis of diabetes mellitus serious illness and must be treated with full responsibility. Indeed, to maintain a normal lifestyle, it is required to monitor the level of glucose in the blood and follow all the doctor's instructions. Failure to comply with these requirements may result in unwanted results. So, both mistake and forgetfulness can lead to the development of hyperglycemic coma. Here are the reasons why such an unforeseen situation may occur:

an untimely diagnosis
delayed administration of the next dose of insulin,
consequences of not taking an insulin injection,
incorrectly selected dosage of insulin when prescribed,
changing types of insulin
gross disregard for the principles of the diet in diabetes,
related severe illness or surgical intervention in the presence of diabetes,
stress.

signs

The development of hyperglycemic coma occurs gradually - it can be several hours or days. In children, it develops during the day. The following symptoms precede it:

constant headache,
intense thirst,
weakness and drowsiness
a sharp decrease in body weight,
lack of appetite,
redness of the face,
an increase in the daily amount of urine,
rapid breathing,
nausea and vomiting, pain in a stomach.

12–24 hours after the first signs appear, the condition worsens, apathy for everything appears, urine completely ceases to be excreted, the smell of acetone from the mouth and shortness of breath appear. The person's breathing becomes frequent with deep and noisy sighs. After some time, there is a violation of consciousness, followed by falling into a coma.

In children, it is not difficult to determine who. It is difficult to prevent it. To do this, parents must constant surveillance for the child. Signs and consequences of hyperglycemic coma in children are almost the same as in adults. If an adult himself can assess his condition, then such an action instead of a child should be performed by parents.

Symptoms

In addition to partial or complete violation consciousness and the smell of acetone, there are a number of symptoms by which these conditions are diagnosed:

drooping eyelids,
eyeballs soft,
smell of acetone
breathing is heavy, noisy,
abdominal tension,
muscle tension leading to cramps,
low blood pressure,
the pulse becomes thready and frequent,
skin become cool and dry
coated tongue dark brown, dry,
almost completely absent reflexes,
in some cases, shock and fever are noted.

Urgent Care

Insulin-dependent patients are aware of the possibility of deterioration. When a hyperglycemic coma develops, emergency care should be provided immediately. If the patient is conscious, it is required to find out if he has insulin with him and provide all possible assistance in performing the injection. If the drug was not with you, then first aid will be provided by the arriving brigade.

If there is a loss of consciousness, help with hyperglycemic coma is to lay the patient in comfortable posture, and turn your head to one side to prevent choking with vomit, as well as to avoid falling of the tongue. Call an ambulance.

Treatment is carried out in a hospital. First aid is the provision of oxygen therapy. Then the treatment is carried out by simultaneous replenishment of fluid and the introduction of insulin according to special schemes, the development of which used a certain algorithm.

Hypoglycemic coma

This type of coma develops very quickly, so its appearance in children is especially dangerous. As a result, it is necessary to act quickly after the diagnosis is made. Some diabetics who are short-term sick have individual sensitivity to insulin. She can be very tall. Their treatment requires individual approach, and this must be taken into account with a sharp drop in blood sugar when first aid is provided.

Coma with hypoglycemia can be caused by the following reasons:

no one taught the diabetic how to prevent a coma when the primary symptoms appeared,
excessive drinking,
ignorance of one's correct dose insulin or its administration was not accompanied by the intake of carbohydrates,
an overdose of pills that cause the body to produce internal insulin.

Symptoms of hypoglycemia

The primary symptoms of hypoglycemic coma are as follows:

pale skin,
increased sweating,
in the hands and feet a feeling of trembling,
increased heartbeat,
unable to concentrate
really want to eat
anxiety,
nausea.

With these symptoms, you need to eat several glucose tablets. The first manifestations of hypoglycemic coma in children are similar, they need to drink sweet tea, treat them with candy or give a piece of sugar.

Secondary symptoms indicating an approaching state of hypoglycemic coma:

severe headache and dizziness,
feeling of weakness
feeling of fear, reaching panic,
a person starts talking, there are violations of visual perception of images,
trembling in the limbs, convulsions.

These signs in children without adequate assistance lead to convulsions chewing muscles And quick loss consciousness. Especially dangerous is the state of hypoglycemic coma in adults that occurs after taking a large number alcohol. In this case, all the symptoms confirm that the person is just drunk. At this time, alcohol blocks the work of the liver for the synthesis of glucose. There is a decrease in blood sugar levels.

Diabetes patients are usually treated by administering insulin before meals. However, there are reasons when it is not possible to eat.

In this case, you need to eat a piece of sugar or candy to avoid hypoglycemia.

When treating patients, it is necessary to learn to distinguish signs of hypoglycemia from hyperglycemia. This is necessary in order not to inject glucose instead of insulin, or vice versa.

Emergency treatment in the hospital begins with intravenous administration glucose, and then it is injected with a dropper. In order to prevent cerebral edema, injections of diuretics are made. They also perform oxygen therapy.

Hyperglycemic coma is a complication of the "sweet illness" of an acute nature, accompanied by high blood sugar levels against the background of absolute (with type 1 disease) or relative (with type 2) insulin deficiency. The condition is considered critical and requires immediate hospitalization and intervention of specialists. The emergency care algorithm for hyperglycemic coma should be known to everyone who suffers from diabetes or has sick friends and relatives.

Coma differentiation

Since there are three different types hyperglycemic coma, then the assistance provided to medical stage, for each of them is different:

ketoacidotic coma;
hyperosmolar coma;
lactic acidosis.

Ketoacidosis is characterized by the formation of ketone bodies (acetone) and develops against the background of insulin-dependent diabetes mellitus. The hyperosmolar state occurs in type 2 disease, ketone bodies are absent, but patients suffer from high performance sugar and significant dehydration.

Lactic acidosis is characterized by moderate glycemia in comparison with the first two pathologies, develops with non-insulin dependent diabetes and is characterized by the accumulation of a significant amount of lactic acid in the blood.

Clinic

Symptoms of ketoacidosis and hyperosmolar coma are similar. Clinical picture increases gradually. There is excessive thirst copious excretion urine, bouts of nausea and vomiting, convulsions.

The difference that allows differentiating these two conditions is the presence of a specific smell of acetone coming from the mouth in ketoacidosis and its absence in the hyperosmolar state.

In addition, at home, you can clarify the level of sugar (with hyperosmolar coma, it can reach 40 mmol / l and above, with ketoacidosis - 15-20 mmol / l) and determine the presence of acetone bodies in the urine using test express strips.

Determination of the level of acetone in the urine is one of the criteria for differentiating the types of hyperglycemic coma

Excessive thirst and polyuria are not typical for lactic acidosis, there are no ketone bodies in the urine. At home, it is almost impossible to diagnose.

First aid

For any type of hyperglycemic coma, you should immediately call an ambulance and, before their arrival, perform a series of sequential measures. First aid is as follows:

Lay the patient in a horizontal position.
Ensure receipt fresh air, unbutton or remove outer clothing. If necessary, remove the tie, belt.
Turn the patient's head to one side so that in the event of an attack of vomiting, the person does not choke on vomit.
Control the position of the tongue. It is important that there is no sinking.
Find out if the patient is on insulin therapy. If yes, create the necessary conditions so that he makes an injection on his own or help him introduce the hormone in the required dosage.
Control blood pressure and pulse. If possible, record the indicators in order to report them to the ambulance specialists.
If the patient is "cowardly", warm him up by covering him with a blanket or providing a warm heating pad.
Drink enough.
In case of cardiac or respiratory arrest, it is necessary to carry out resuscitation.

Features of resuscitation

Resuscitation should be started in adults and children, without waiting for the arrival of ambulance specialists, if symptoms appear: no pulse on carotid arteries, lack of breathing, the skin acquires a gray-bluish tint, the pupils are dilated and do not react to light.

Lay the patient on the floor or other hard, flat surface.
Tear or cut outer clothing to provide access to the chest.
Tilt the patient's head as far back as possible, put one hand on the forehead, and push the other lower jaw patient forward. This approach provides permeability respiratory tract.
Make sure there is no foreign bodies in the mouth and throat, if necessary, remove mucus with a quick movement.

Compliance with the rules of resuscitation is a step towards its successful completion

Breathing "mouth to mouth". A napkin, gauze cut or handkerchief is placed on the patient's lips. Is being done deep breath, lips are pressed tightly to the patient's mouth. Then a strong exhalation is carried out (for 2-3 seconds), while closing the nose of a person. Efficiency artificial ventilation can be seen by lifting the chest. The frequency of breaths is 16-18 times per minute.

Indirect cardiac massage. Both hands are placed on lower third sternum (approximately in the center of the chest), becoming on the left side of the person. Conduct vigorous pushes towards the spine, shifting the surface of the chest by 3-5 cm in adults, 1.5-2 cm in children. The frequency of pressing is 50-60 times per minute.

When combining mouth-to-mouth breathing and heart massage, as well as carrying out activities by one person, it is necessary to alternate 1 breath with 4-5 presses on chest. Resuscitation is carried out until the arrival of ambulance specialists or until signs of life appear in a person.

Important! If the patient has regained consciousness, in no case leave him alone.

Medical stage

After the arrival of specialists, the patient's condition is stabilized, he is subject to hospitalization in the department intensive care. Emergency care for hyperglycemic coma at the medical stage depends on the type of condition that has developed in a patient with diabetes mellitus.

Hospitalization of the patient required condition, even in the case of normalization of the condition at home

Ketoacidotic coma

A prerequisite is the introduction of insulin. First, it is administered in a stream, then intravenously drip on 5% glucose to prevent the appearance of a hypoglycemic state. The patient is given a gastric lavage and the intestines are cleansed with a 4% bicarbonate solution. Intravenous administration of saline, Ringer's solution to restore fluid levels in the body, and sodium bicarbonate is indicated to restore lost electrolytes.

Important! Blood pressure and blood glucose levels are constantly monitored. The level of glycemia is reduced gradually so that it is not critical for the patient.

To support the work of the heart and blood vessels, glycosides, Cocarboxylase are used, oxygen therapy is carried out (saturation of the body with oxygen).

Hyperosmolar state

Emergency care for this coma has certain differences:

used significant amount infusion preparations (up to 20 liters per day) to restore the level of fluid in the body (saline solution, Ringer's solution);
insulin is added to the physiology and administered by drip so that the sugar level decreases slowly;
when glucose levels reach 14 mmol / l, insulin is administered already at 5% glucose;
bicarbonates are not used because there is no acidosis.

Infusion therapy - milestone emergency medical care

lactic acidosis

Features of relief of lactic acid coma are as follows:

drip into a vein is injected with methylene blue, which allows you to bind hydrogen ions;
the introduction of Trisamine;
performing peritoneal dialysis or hemodialysis to purify the blood;
intravenously drip sodium bicarbonate;
small doses of insulin infusion on 5% glucose as preventive measure sharp decline quantitative indicators of glucose in the blood.

Knowing how to properly provide first aid for a hyperglycemic condition, as well as having the skills to conduct resuscitation, can save someone's life. Such knowledge is valuable not only for patients with diabetes, but also for their relatives and friends.

Occurs in patients with diabetes mellitus in people with non-compliance therapeutic treatment And the wrong way life.

What it is?

Diabetes mellitus is a disease in which the main hormone of the pancreas, insulin, is not produced. It is he who is involved in the conversion of incoming sugar into glucose. When sugar accumulates in the human body, it is excreted through the urine. To prevent this from happening, patients with diabetes have to inject insulin intramuscularly.

In case of non-compliance with the dosage or malnutrition blood sugar levels may rise. And when the concentration reaches the limit, hyperglycemic coma occurs. an algorithm of actions in which a person can be saved must be provided immediately. But in medicine, hyperglycemic coma is distinguished in people who do not have diabetes. They can be attributed to the risk zone for this disease. After all, an increase in blood sugar is the first sign of incorrect operation pancreas.

These include patients with cirrhosis of the liver, tumors endocrine system, poor digestion of carbohydrate foods.

Causes

After diagnosing diabetes in a person, an injection schedule is drawn up. The dosage is selected, as a rule, permanently, under the supervision of doctors. The patient must strictly observe the dosage and adhere to the established schedule. Skipping the introduction of insulin threatens to raise blood sugar, as a result of which emergency care will be needed for hyperglycemic coma.

It is important to follow a diet in nutrition, do not eat fatty, fried, smoked, salty, do not drink alcohol. Replace sugar-containing products with special diabetic products, where fructose is used. Deviation from the diet can cause sudden jump blood sugar.

After the injection, the patient must necessarily eat. Diabetics prescribed fractional nutrition. If you do not adhere to this rule, then again, an increase in glucose is possible.

Signs of a coma

Emergency care for hyperglycemic coma is extremely important. But first, let's look at its main features.

In medicine, a pre-coma state of a patient with diabetes mellitus is distinguished, which can last one to two days. Main features:

general weakness;
strong feeling of thirst;
the smell of acetone from the mouth;
dry skin;
frequent urination;
pain in the eyeballs;
loss of consciousness.

If you do not pay attention to these signs in time and do not take appropriate measures, then this condition threatens with loss of consciousness, which in some cases leads to death. An increase in blood sugar levels is accompanied by itching and flaking of the skin, in contrast to reduced level. If the patient pays attention to the above signs in time and begins to systematically inject insulin, he will save his life.

First aid

Proper emergency care for hyperglycemic coma can save a person's life. I would like to note right away that only medical workers. But, if it so happened that a person lost consciousness, he began to have convulsions, immediately call an ambulance.

Before the arrival of the medical team, lay the patient on his side and fix the tongue with a spoon or other long object. This is a necessary step in order to avoid tongue sinking and, as a result, suffocation.

If a person has convulsive twitches or convulsions, make sure that he does not hit. To do this, hold the patient's limbs in a position on their side.

This is what emergency care for hyperglycemic coma is. The algorithm of therapeutic care and treatment in a hospital will be considered further.

Clinical Treatment

After the arrival of the medical team, urgent hospitalization to the intensive care unit. If the patient has a glucometer, the blood sugar level is measured and the following actions are taken on the spot. Insulin is injected subcutaneously, its dosage is calculated based on the readings of the glucometer, and the patient is hospitalized.

A correctly diagnosed hyperglycemic coma is very important, the symptoms, emergency care, in which they are radically different from hypoglycemic. With an erroneous diagnosis, you may not have time to save a person.

Already directly in the intensive care unit, a solution of sodium chloride and glucose is injected intravenously. If the patient's condition is moderate, then the dose of insulin is one hundred units, if severe - about one hundred and fifty, and in extremely severe - about two hundred. The insulin that is injected must be short action for rapid absorption into the blood.

Also after diagnosing the respiratory tract and measuring blood pressure treatment is chosen. In severe cases, the patient is connected to the apparatus artificial respiration. At low pressure, appropriate drugs are administered intravenously.

Special attention to your illness

After receiving the diagnosis of "diabetes mellitus" the patient must treat himself with maximum responsibility. The local endocrinologist explains the principles of self-care. These are timely insulin injections, fractional meals, dieting, blood tests.

It is important to control the level of glucose in the blood, for this diabetics use a glucometer. Ideally, take measurements twice a day, in accordance with which to change the dosage of insulin.

Always carry a diabetic card with you, which should be in your pocket. This will help in case you need emergency care for hyperglycemic coma. For occasions (low blood sugar), have something sweet on hand. It can be honey in a stick or jam.

In no case do not skip insulin intake, and if this happens, then control the sugar level until stabilization.

Important information for family and friends

People who are close to people with diabetes should know general information about the disease, so that emergency care is provided in time for hyperglycemic coma or hypoglycemic.

If the patient has lost consciousness before your eyes, immediately call an ambulance. And before their arrival, make sure that the tongue does not sunk - in which way, we have already told. It would be useful to measure sugar with a glucometer before the doctors arrive, so as not to waste time and provide assistance faster.

In a state of coma, without assistance, a person can live a maximum of a day. Therefore, pay more attention to loved ones with this disease. Emergency care for hyperglycemic coma in children is no different from that of an adult. Differences are only in the dosage of drugs and the duration of inpatient treatment.