Diabetes mellitus is a disease caused by insufficient insulin or insulin resistance. There are two main types of diabetes complications. Complications in the short term and long-term complications. Here we will discuss short-term complications of diabetes.
Short-term complications
Hypoglycemia
Nonketotic hyperosmolar coma
Ketoacidosis
Causes of hypoglycemia:
Hypoglycemia is seen when the patient's level of blood glucose drops too low. The causes ofhypoglycemia
1-insufficient food intake, especially after taking hypoglycemic drugs or insulin.
2-excessive dose of insulin or sulfonylureas can cause hypoglycemia as well.
3-Excessive exercise can also lead to hypoglycemia, especially those who are anti-diabetic drugs. In this exercise is glucose in the cells and the level of glucose in the blood decreases.
Symptoms of hypoglycemia:
Whenever there is hypoglycemia, the patient may have symptoms such aspalpitations, feeling tremors, sweating, tingling in the lips, going pale, heart palpitations, rapid heart rate, anxiety, confusion and irritability. These are only warning signs, if not, we will treat the patient's hypoglycemia can lead to coma and even death can occur.
What if hypoglycemia occurs:
If you are in a hospital and the nurse or doctor to find out who is hypoglycemic, it is likely to inject 25% dextrose 5 vials of water, dependingthe level of glucose in the blood. At home, hypoglycemia can be treated simply by taking a sweet juice like orange juice or glucose tablets containing. If the patient enters a coma after undergoing intramuscular injection of glucagon can help. Glucagon is a hormone that increases blood sugar. This requires that you travel or go out, should have a glucagon kit with you. Family and friends should be instructed on how to inject glucagon, a patient is unconscious andI can not do the same. If the patient is unconscious, do not try to put food or drinks in the mouth, which can lead to suffocation. If you are on insulin and drink alcohol, there are opportunities to go to hypoglycemia as a body will not be able to quickly produce glucose. It is suggested that men with insulin should have three units of alcohol and women must take two units. Also, while you drink, you should always eat something.
What is ketoacidosis, ketoacidosis Definition
Ketosis isthe accumulation of ketone bodies (produced by the breakdown of fats) in blood and acidosis increases the acidity of the blood pH, which decreases the blood. This is a serious condition that can lead to coma. Usually seen in patients with type 1 diabetes can also occur in patients with type 2 diabetes, especially the elderly. Diabetic acidosis is often initiated by an infection such as urinary tract infection or chest infection.
Pathophysiology and causes of diabetesKitoacidosis:
CAD usually see when you miss a dose of insulin as a result blood glucose levels increase, and cells of the body begin to burn fat, which leads to the production of ketone bodies and acidosis.At same time, secretion of high levels of glucose in the urine because of dehydration due to loss of water and salts. Ketoacidosis occurs when the body's cells can not meet their metabolic needs, in the absence of sufficient glucose. In contrast, cells begin to receive energy from the decomposition ofFatty acids results in the formation of ketone bodies. PH of the body becomes acidic and the body tries to eliminate acids from the acceleration and the depth of acids.
Signs and symptoms of ketoacidosis:
Fatigue fruity breath as the elimination of nail polish increased thirst, increased urination, urinating more frequently. Weight loss. Muscular oral candidiasis lose. Confusion, irritation, aggression agitation emesis (vomiting), abdominal pain. Loss of appetite. Flu-like symptoms. Lethargy and apathy. Patientsbreathe deeply and rapidly. Unconsciousness (diabetic coma) after prolonged CAD.
Prevention of diabetic ketoacidosis
If you are sick with an infection, always remember that your body will need more insulin in these conditions, so try to increase the dose of insulin during the contagious disease, but before taking insulin should always check the glucose level blood. keep tight control of sugar levels in the blood occurs meter. Whenever you hearwell, just check the level of glucose in the blood. If you ever find that your blood glucose is high, then the test for ketones in your urine. You should always have the urine ketone strips at home so far.
Diabetic acidosis is often seen in infection with gastritis of the stomach, as you might think that less insulin is needed if symptoms of gastritis, such as nausea and vomiting and reduced food intake such insufficient insulin can lead to acidosis.
How do you knowIf you have diabetic ketoacidosis?
Diagnosis is made by: Always measure blood glucose - s is always higher in diabetic ketoacidosis. Analysis of urine for ketones a blood sample taken from an artery -. That is done in the hospital and measure the pH of the doctor will also perform blood tests to rule out any infection.
Regarding the treatment of diabetic ketoacidosis.
This condition usually requires hospitalization. Treatment consists of: intravenous saltmedia, such as NaCl, KCl etc. insulin is given through a drip. potassium supplements added to the infusion if the infection is present, antibiotics are also added.
The prognosis is good stop if diabetic ketoacidosis is diagnosed and treated before the patient recovers in a few days if the acidosis is not treated before it can become deadly.
Nonketotic hyperosmolar coma
Diabetes type 2 diabetic coma hyperosmolar hyperglycemic nonketotic coma is aserious complication in patients with type 2 diabetes with severe infections or stress. Diabetic coma is seen when blood glucose is too high and there is severe dehydration. Unlike ketoacidosis, which is usually seen in type 1 diabetes, when we see no ketones in the body and hyperosmolar urine, and no acidosis. The diabetic hyperosmolar coma is usually seen in diabetic patients over 60 years, as they have altered the sense of thirst, and are more likely toseverely dehydrated. If there is a significant loss of body fluids, can lead to Syncopy shock, coma and death
What are the causes of diabetic coma?
Severe infections of the urinary tract, respiratory tract infections, bacterial meningitis, retropharyngeal abscess, hepatobiliary sepsis. Failure of insulin therapy or diet drugs heart attack kidney failure (diuretics, steroids, phenytoin, beta-blockers, calcium channel), fever disease hyperglycemia blood clot bleeding ulcerCVA traumatic pancreatitis
Hyperosmolar coma symptoms:
The symptoms of hyperosmolar coma have occurred due to hyperglycemia and dehydration. Increased thirst, increased urination, severe weakness, drowsiness, altered mental state of restlessness, headache Paralysis inability to talk if you have any of these signs and symptoms, check your blood sugar and call your doctor if your blood sugar is high. The diabetic hyperosmolar coma is usually seen when blood glucoseincreased to 600 mg / dL or more.
What are the laboratory results of the patient in diabetic coma.
or severe hyperglycemia (> 500mg/dl)
Plasma hyperosmolarity
or urea: creatinine
glucosuria or secondary
The absence or significant metabolic acidosis, ketoacidosis or absent or mild
How is diabetic coma? This is an emergency situation and must be treated immediately. Patient should be hospitalized. The therapeutic goals aretreatment of hyperglycemia with insulin and treat dehydration with intravenous fluids. The infection can be treated with antibiotics.
How to prevent diabetic coma? Control and monitor your blood glucose regularly, as recommended by your doctor check the level of blood glucose every four hours when you are suffering from infections. Pay special attention to themselves when they have serious illnesses.
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