Can diabetes cause a coma? (Diabetes-Related Coma) Let's talk about this dangerous condition

What do you do if someone with diabetes suddenly loses consciousness and cannot be woken up no matter how much you talk to them? This is really scary. This is a coma, which is one of the most dangerous complications of diabetes. To be precise, it is a state of unconsciousness that makes someone fall into a deep sleep. This is even life-threatening. But if you are properly informed, you can prevent this situation and even save someone's life. So let's talk about this simply today.

What is this diabetic coma?

Simply put, if a person with diabetes has uncontrollable high blood sugar levels (hyperglycemia) or low blood sugar levels (hypoglycemia) , it can directly affect brain function and cause a person to lose consciousness. This is called a diabetic coma. This is a serious condition that requires emergency medical treatment.

This type of coma can be caused by three main conditions related to diabetes.

1. Diabetic Ketoacidosis (DKA): This occurs when ketones, a type of acid, increase in the blood, causing the blood to become acidic.

2. Hyperosmolar Hyperglycemic State (HHS): This is a condition where blood sugar levels become very high and the body becomes severely dehydrated.

3. Severe hypoglycemia: This is when the amount of glucose that provides energy to the brain becomes very low, causing brain function to stop.

Let's look at the three main causes of coma in a little more detail.

It is very important to know a little about these three conditions, because recognizing the symptoms of each condition early can prevent them from progressing to a coma.

1. Diabetic ketoacidosis (DKA)

This condition is most common in people with Type 1 diabetes , but it can sometimes develop in people with Type 2 diabetes.

It simply happens like this: The hormone insulin is essential for our body's cells to take in glucose (sugar) for energy. In DKA, the body doesn't have enough insulin. Then, because the cells can't take in glucose, the body starts burning its own fat for energy. When this fat is burned, a chemical called ketones is released into the blood as a byproduct. These ketones are a type of acid. When they accumulate in large amounts in the blood, the blood becomes acidic. This is called DKA. If this condition is not treated quickly, you can go into a coma.

Typically, DKA is a condition where the blood sugar level is higher than 250 mg/dL . But remember, the main cause of DKA is not just high sugar, but also a lack of insulin and an increase in ketones.

2. Hyperosmolar hyperglycemic state (HHS)

This is most common in people with Type 2 Diabetes . This is when blood sugar levels become uncontrollably high (often above 600 mg/dL ). When this happens, the body tries to get rid of the excess sugar in the urine. At the same time, a large amount of water is lost from the body, causing severe dehydration . This can affect the brain, causing loss of consciousness, and if left untreated, can lead to a coma.

3. Severe hypoglycemia

This is when blood sugar levels drop to very low levels, usually below 40 mg/dL . This is also very dangerous for life.

Glucose is the main source of energy for our bodies, especially the brain. When there is no glucose in the blood, the brain loses its ability to function. Just as a car's engine stops when it runs out of fuel, the brain can "shut down" and go into a coma. This condition is most common in people who take insulin injections or certain types of diabetes medications (e.g., sulfonylureas).

Warning signs before going into a coma

A person does not suddenly go into a coma. Before that, the body shows several warning signs. The most important thing is to recognize these signs early. Let's look at the symptoms related to these three conditions separately.

After these symptoms, if someone goes into a coma, they will show three main symptoms:

• Complete loss of consciousness: Like being in a deep sleep. Cannot be awakened in any way.
• Unresponsive eyes: Eyes remain closed. No response when eyes are opened.
• Body immobility: No conscious movement of arms or legs. However, some reflexes may be present.

Things we should do immediately if someone becomes unconscious (first aid)

Imagine if someone with diabetes in your area fainted like this. There are a few things you can do. This could even save a life.

1. Call 1990 immediately: The first thing to do is call an ambulance. When calling, say, "A diabetic person is unconscious."

2. Do not give anything to eat or drink: If you give food or drink to an unconscious person, it can become lodged in the airway and become even more dangerous.

3. Turn the person to the side: Instead of having them lie down on their side, turn the person to one side (on their side) to prevent vomiting or choking.

4. Wait for the ambulance to arrive: Follow the instructions given by the 1990 operator.

Why does this happen? What are the risk factors?

As mentioned earlier, severe dehydration, which occurs in both DKA and HHS, affects the brain and leads to a coma. Similarly, during hypoglycemia, the brain does not receive the energy (glucose) it needs, causing brain function to stop and leading to a coma.

Anyone with diabetes is at risk, but certain factors can increase this risk.

• Diabetes type: People with type 1 diabetes are more likely to go into a coma due to DKA and severe hypoglycemia. People with type 2 diabetes are more likely to go into a coma due to HHS.
• Other illnesses: During illnesses such as fever and infections, it is difficult to control the body's sugar levels.
• Surgery or accidents: The stress these things put on the body can cause blood sugar levels to rise.
• Problems with insulin use: This condition can be caused by missing insulin injections, taking the wrong dose, or a malfunction in the insulin pump.
• Not managing diabetes properly: not taking medication properly, not checking blood sugar levels regularly.
• Drinking alcohol: Alcohol can cause blood sugar levels to drop dangerously low.
• Hypoglycemia Unawareness: Some people don't notice the early symptoms of low blood sugar, such as shakiness and sweating. They may suddenly lose consciousness.

What do they do at the hospital? (Diagnosis and treatment)

Because this is a medical emergency, all treatment takes place in a hospital. Doctors can quickly diagnose the condition by checking the patient's details and blood sugar levels. They also check the blood for ketones.

Treatment depends on the cause of the coma.

• If due to DKA or HHS:
• IV fluids (saline): Saline is given through a vein to prevent dehydration and balance the body's salts.
• Insulin: Insulin is given intravenously or as an injection to control blood sugar levels.
• Other treatments: If there is an underlying infection that is causing this condition, that will also be treated.

• Severe Hypoglycemia (low blood sugar) is caused by:
• Glucagon Injection: Glucagon is a hormone that helps our liver quickly release glucose stored in it into the bloodstream. It can be given as an injection or as a nasal powder. Even if you give this to someone at home, you should definitely take them to a hospital .

Is it possible to recover completely from this condition?

Yes. If treated promptly and properly, diabetic coma can be completely cured. However, sometimes, if treatment is delayed, it can cause permanent brain damage and, in some cases, even death.

How long someone stays in a coma depends on how quickly they receive treatment. Without treatment, a person will not wake up from this state on their own. Therefore, it is important to get them to the hospital as soon as possible.

How can this dangerous situation be avoided?

This coma is often preventable . The most important thing to do is to be aware of the early warning signs of DKA, HHS, and Hypoglycemia and take action as soon as they appear.

Talk to your doctor about your diabetes management plan. Seek immediate medical attention if you experience any of the following:

It's normal to feel scared when you hear about the complications of diabetes. But being well-informed and prepared is the best way to prevent them. Never hesitate to ask your doctor any questions you have about managing your diabetes.