Diabetic ketoacidosis (DKA), if it progresses and worsens without treatment, can eventually cause unconsciousness, from a combination of severe hyperglycemia, dehydration and shock, and exhaustion. Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation.
Full Answer
What is a diabetic coma?
Print Overview A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma.
Can You recover from a diabetic coma?
Recovery from diabetic coma If a diabetic coma is not treated within a couple of hours of it developing, it can cause irreversible brain damage. If no treatment is received, a diabetic coma will be fatal. In addition, having blood sugar levels that continue to be too low or too high can be bad for long-term health.
What is the rate of incidence for diabetic coma?
An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. Types Severe hypoglycemia People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia.
How long does a coma last?
A coma rarely lasts more than 2 to 4 weeks. They do not respond to A coma does not usually last for more than a few weeks. Most of these come out of the coma as expected, however, the extent of the brain damage is usually not revealed until they do so.
Can someone come out of a diabetic coma?
The only way to come out of a diabetic coma is to return blood glucose levels to a healthy range, which can only be done by a medical professional. Because only a medical professional can safely treat a diabetic coma, there is no concrete answer for how long a diabetic coma can last.
What happens when you go into a diabetic coma?
If you go into a diabetic coma, you're alive — but you can't wake up or respond purposefully to sights, sounds or other types of stimulation. If it's not treated, a diabetic coma can result in death.
At what point is a diabetic coma?
A diabetic coma could happen when your blood sugar gets too high -- 600 milligrams per deciliter (mg/dL) or more -- causing you to become very dehydrated. It usually affects people with type 2 diabetes that isn't well-controlled.
How do you know when a diabetic is dying?
weight loss. fatigue. numbness in fingers/toes. wounds that are slow to heal.
Can a diabetic coma cause brain damage?
A diabetic coma can affect a person with diabetes when they have high or low blood sugar levels or other substances in the body. With prompt treatment, a rapid recovery is possible. However, without early treatment, it can be fatal or result in brain damage. It can happen to a person with type 1 or type 2 diabetes.
Can diabetes cause sudden death?
Impairment of tissue insulin sensitivity in type 2 diabetes is a significant factor for sudden cardiac death. The complex pathophysiology stems from coexisting cardiovascular disease and complications of impaired tissue sensitivity to insulin.
How long does a diabetic patient live?
The combined diabetic life expectancy is 74.64 years—comparable to the life expectancy in the general population.
What is the main treatment for diabetic coma?
High blood sugar Intravenous fluids to restore water to your body. Potassium, sodium or phosphate supplements to help your cells work correctly. Insulin to help your body absorb the glucose in your blood.
What is the difference between diabetic coma and insulin coma?
These changes are normal. But if you have diabetes, it's possible for your sugar levels to go outside their normal range, which can be dangerous. Insulin shock means you have very low blood sugar levels. Diabetic coma is when you pass out due to either high or low blood sugar.
What are the warning signs of diabetic ketoacidosis?
DKA Signs and SymptomsFast, deep breathing.Dry skin and mouth.Flushed face.Fruity-smelling breath.Headache.Muscle stiffness or aches.Being very tired.Nausea and vomiting.More items...•
What happens during diabetic shock?
When a person experiences diabetic shock, or severe hypoglycemia, they may lose consciousness, have trouble speaking, and experience double vision. Early treatment is essential because blood sugar levels that stay low for too long can lead to seizures or diabetic coma.
What is a diabetic coma?
A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma.
What to do if you pass out from a diabetic coma?
When to see a doctor. A diabetic coma is a medical emergency. If you feel extreme high or low blood sugar signs or symptoms and think you might pass out, call 911 or your local emergency number. If you're with someone with diabetes who has passed out, call for emergency help, and be sure to let the emergency personnel know ...
Why does insulin stop?
Insulin delivery can stop if the pump fails or the tubing (catheter) is twisted or falls out of place. A lack of insulin can lead to diabetic ketoacidosis. An illness, trauma or surgery. When you're sick or injured, blood sugar levels tend to rise, sometimes dramatically.
What happens if you don't monitor your blood sugar?
If you don't monitor your blood sugar properly or take your medications as directed, you'll have a higher risk of developing long-term complications and a diabetic coma. Deliberately skipping meals or insulin.
What is a continuous glucose monitor?
Continuous glucose monitor. A continuous glucose monitor (CGM) is a device that measures your blood sugar every few minutes using a sensor inserted under the skin. Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind:
Can diabetes cause a coma?
Anyone who has diabetes is at risk of a diabetic coma, but the following factors can increase the risk: Insulin delivery problems. If you're on an insulin pump, you have to check your blood sugar frequently. Insulin delivery can stop if the pump fails or the tubing (catheter) is twisted or falls out of place.
Can high blood sugar cause a coma?
Severely high blood sugar turns your blood thick and syrupy. The excess sugar passes from your blood into your urine, which triggers a filtering process that draws tremendous amounts of fluid from your body. Left untreated, this can lead to life-threatening dehydration and a diabetic coma. About 25 to 50 percent of people with diabetic hyperosmolar ...
What is a diabetic coma?
What is Diabetic Coma? Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified: Severe diabetic hypoglycemia Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious Patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious Patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. What is diabetes? Diabetic Ketoacidosis (DKA) Hyperosmolar Hypoglycemic Non-Ketotic Coma (HHNKC) Hypoglycemic Coma What happens In Intensive Care? How long will your loved one remain in Intensive Care? Internet Links What is Diabetes? Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.This high blood sugar produces Continue reading >>
How Long Does A Coma Usually Last?
Doctors kept telling me to talk to her but I wonder if they do this to help the relatives. If the person has very severe brain injuries though, they may move from coma into a vegetative or minimally conscious state. If the person Indeed, in recent years, we have learned that dehydration in the last days of life is often less of a problem than is over-hydration. A coma rarely lasts more than 2 to 4 weeks. They do not respond to A coma does not usually last for more than a few weeks. Most of these come out of the coma as expected, however, the extent of the brain damage is usually not revealed until they do so. Some people may never wake up from a coma. Late attention to diabetic coma might take more glucose to be given to the person for better healing. How long will the coma last? What can I do? This feeling of desperation is not one that any person wants to go through. Persistent vegetative state refers to another form of altered consciousness in which the person appears to be awake but does not respond meaningfully to the outside . A massive brain injury or brain tumor can be more difficult to treat, and can lead to a much longer or irreversible coma. 20 Apr 2014 This is another episode of “YOUR QUESTIONS ANSWERED” and in last week's episode I answered another question from one of our readers and the Propofol (Diprovan), which is a short acting sedative drug and is commonly used for an induced coma <7 Continue reading >>
What Is A Coma?
Coma A coma is a deep state of unconsciousness. A person in a coma is alive but can’t wake up. Someone in a coma is not able to respond in an appropriate way to what is around him or her. What is a persistent vegetative state? Sometimes, following a coma, a person may enter what is known as a persistent vegetative state. The patient is able to breathe and may appear awake. People in this state may open their eyes, but not recognize things they see. They may move parts of their body, but with little purpose. People in a coma or vegetative state may do some of these things: Open their eyes Move about in bed Grasp your hand when you hold their hand Laugh, cry, or moan People in this state are not able to speak or respond to commands. What causes a coma? Special parts of the brain control a person’s ability to wake up or respond. A coma may be caused by: Head injury Trauma Brain tumor Drug or alcohol overdose How long does a coma last? It is difficult to predict how long someone will be in a coma. A coma rarely lasts more than 2 to 4 weeks. But a persistent vegetative state may last for years. Some people may never wake up from a coma. A person may wake from a coma with physical, intellectual, or emotional problems. Some never regain more than basic responses. However, many recover full awareness. If the injury is severe, it may affect the person’s recovery. A person does not suddenly wake up from a coma. It is a gradual process. Every person recovers at a different rate. What special care does a patient in a coma need? Once the patient is out of danger, although still in a coma, the doctors and nurses will concentrate on keeping the patient healthy. They will work to prevent illness, such as pneumonia, infection, or bed sores. They will make sure the patient receives Continue reading >>
What Is Diabetic Ketoacidosis?
Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death. What can I expect in the hospital? You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include: Monitoring You will be checked often by the hospital staff. You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home. A heart (cardiac) monitor may Continue reading >>
What is a coma in the brain?
What Is It? Coma is a deep and prolonged state of unconsciousness resulting from disease, injury or poisoning. The word coma usually refers to the state in which a person appears to be asleep but cannot be awakened. Persistent vegetative state refers to another form of altered consciousness in which the person appears to be awake but does not respond meaningfully to the outside world. In this condition, the person's eyes may be open and there may be some yawning, grunting or other vocalizations. In both cases, the patient is alive, but the brain does not function fully. Some causes of coma include: Head trauma, such as may be sustained in a car accident, sports injury or falling injury Complication of an underlying disease, such as seizure disorder, diabetes or liver or kidney failure Poisoning, usually involving an overdose of drugs that depress the nervous system, such as narcotics, tranquilizers or alcohol Stroke Coma rarely lasts more than a month and usually ends sooner. Coma may worsen to become a persistent vegetative state. Symptoms A person in a coma will be unconscious and unable to communicate. He or she will not respond to light, sound or pain. The person may stretch his or her arms and legs in unusual ways, but the person will not display purposeful movement. In a deep coma, the areas of the brain that control breathing may be affected, and the person may need to be kept alive by an artificial respirator (a mechanical breathing machine). A person in a persistent vegetative state will be able to breathe without assistance. He or she will have cycles of being awake and asleep. During the awake cycles, the person may react to physical pain and may move, but the movement will not be purposeful. Diagnosis Coma is usually a straightforward diagnosis because the s Continue reading >>
How long can a diabetic go without food?
A diabetic cannot go without food for long. If a diabetic doesn't eat regularly, her blood glucose level can plummet. Diabetics should eat snacks and meals on a schedule because a delay of as little as half an hour can lower blood sugar, which can have catastrophic results. Diabetics are especially prone to a condition known as hypoglycemia, a reaction caused by too much insulin in the bloodstream. Once a diabetic takes insulin, it is important to eat something within 30 minutes before blood sugar begins dropping. The dose of insulin you take must also match the amount of carbohydrates you consume in order to keep blood sugar levels under control. When a diabetic does not eat enough food, but still administers insulin, blood glucose levels can drop dangerously low, inducing hypoglycemia. Early signs of hypoglycemia include dizziness, weakness, headache, hunger or shakiness. If blood glucose drops too low, a person can become confused or even lose consciousness. In some cases, insulin shock can lead to coma. Although all diabetics suffer hypoglycemia at times, according to the American Diabetes Association, you should talk to your doctor about what your blood glucose levels should be. If your blood sugar falls below what your doctor recommends, you are likely hypoglycemic. When hypoglycemia occurs, you need to get some sugar into your body quickly. Fruit juice, milk, a few pieces of hard candy, or a tablespoon of sugar or honey can help raise glucose levels in the blood temporarily. Diabetics often need to adjust the doses of insulin they take depending on how many grams of carbohydrates they eat for a meal or snack. While this balance can be different for one person than for another, counting the carbohydrates you consume allows you to maintain a healthful blood glucose Continue reading >>
What causes a diabetic to go into a coma?
The three most common causes of coma in people with diabetes are: Severe hypoglycemia and coma Severe hypoglycemia (very low blood glucose levels) can lead to loss of consciousness and coma if not treated. In most cases the body will restore blood sugar levels to normal by releasing glucagon to raise blood sugar levels.
What happens if a diabetic stays in a coma?
The diabetic coma is connected to the metabolic abnormalities which forces the diabetic patient to the coma. If the diabetic patient stays in the coma for longer periods of time or if the patient is unattended for long time, permanant brain damage may take place or in rare instances it may lead to death of the patient.
How to prevent diabetic coma?
Maintaining a regular meal schedule is important to prevent diabetic coma. Eat after regular intervals of time. These intervals can be short. One can prevent the stage of diabetic coma by checking the level of blood sugar regularly. Involve yourself in physical activities to maintain the blood sugar levels.
What is the condition of a person in a coma from hyperglycaemic hyperos?
People who enter coma from hyperglycaemic hyperosmolar state (HHS) are reported to be suffering from dehydration and high sugar level in blood. Insulin is injected to bring the blood sugar level in control. Fluid is given to the patient before 30 to 60 minutes of insulin injection. The infection is treated by antibiotics. In rare cases electrolytes are replaced as per the situation.
What is released in healthy bodies during deficiency of sugar in the blood?
Glucagon is released in healthy bodies during deficiency of sugar in the blood. The same procedure cannot be recorded in diabetic people as it requires administration of exogenous glucagon. Glucose biscuits or sweets are given to the person in such situation. In dire cases, glucose is injected to combat the situation.
How to save yourself from a diabetic coma?
Whenever there is any symptom of diabetic fainting in you, you should immediately check your current glucose level and take immediate action on it. Remember, diabetic coma can only be restricted with immediate medical attention. Train yourself on how to use the glucose measurement devices and practice to use it during emergencies. Thus you can take the responsibility of saving you from diabetic coma.
What is the first step in a diabetic coma?
Therefore, when a diabetic patient is unconscious, the first action taken is blood sugar testing.
Why do diabetics need medical ID?
Carry medical ID to let people know about your diabetic condition in case you are unconscious suddenly.
How Long Does Diabetic Coma Last And How Is It Treated?
When immediately attended and given the right treatment, the diabetic patient can be quickly wakened up from the diabetic coma. Late attention to diabetic coma might take more glucose to be given to the person for better healing. The diabetic coma is connected to the metabolic abnormalities which forces the diabetic patient to the coma. If the diabetic patient stays in the coma for longer periods of time or if the patient is unattended for long time, permanant brain damage may take place or in rare instances it may lead to death of the patient. What is the Prognosis or Outlook for Diabetic Coma? Diabetic coma can be fatal. Late attention may prolong the period of treatment. A person who has been treated for long for diabetic coma is recorded to experience a brain damage. This is a dire situation but can be avoided by taking precautionary measures. Remain alert and aware to save yourself from diabetic coma. Manage your diabetic syndromes effectively to save your life. Even after the sugar level is normalized in a person, he or she will still experience nervous disorders like seizures or talking problems. Problems still persists even after recovering from diabetic coma. The recovery time cannot be predicted and depends on individual case. When immediately attended and given glucose biscuits, a person can be quickly wakened up. Late attention might take more glucose to be given to the person for better healing. Consult your doctor and take necessary guidelines on how to prevent any incident of diabetic coma or any other complexities if you are diabetic. Your doctor may prescribe you tests to determine the exact "dos and don'ts" to you on how to manage diabetes. Diabetic coma is caused by three major reasons: Severe hypolgycemia i.e., low blood sugar level Diabetic ketoacid Continue reading >>
What is a diabetic coma?
What is Diabetic Coma? Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified: Severe diabetic hypoglycemia Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious Patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious Patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. What is diabetes? Diabetic Ketoacidosis (DKA) Hyperosmolar Hypoglycemic Non-Ketotic Coma (HHNKC) Hypoglycemic Coma What happens In Intensive Care? How long will your loved one remain in Intensive Care? Internet Links What is Diabetes? Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.This high blood sugar produces Continue reading >>
How Do People Die From Diabetes?
Well, although the answer to the above question cannot be a straight “Yes”, there is no denying of the fact that diabetes can, in fact, turn out to be a deadly disease. As per a report circulated by Diabetes UK, the life expectancy of a type 1 diabetes patient can be reduced by 20 years, while the same can be reduced by 10 in the case of a type 1 diabetes patient. This, of course, can be controlled by adopting a healthy lifestyle and controlling your blood sugar levels. Some of the ways in which you can die from diabetes include the following: High Blood Glucose Levels : The leading cause of death in diabetic patients is the inability to keep the blood glucose levels under control. Lipid Disorders: With diabetes comes a host of various other complications such as heart diseases, kidney disorders, amongst others. The leading cause of these complications is the disorder of the lipids in a diabetic patient. Diabetes Ketoacidosis: The high sugar level in the blood which is a characteristic of diabetes often leads to the high amount of ketone cells in the body. These ketones could be extremely deadly, causing deaths in patients. Complications: Diabetes is known to cause several complications in patients which adversely affect the functioning of the heart, kidney, eyes, and even nerves of different body parts. Any of these complications can become serious and lead to the death of the patient. Hence, can you die from diabetes? Well, yes you can. However, with proper care, regular exercise, following a proper diet, and taking timely me Continue reading >>
How Often Does A Hypo Actually Kill Someone?
Some research estimates that between four and 13 percent of the deaths of people with type I diabetes are the result of hypoglycemic events. "What's worrisome about these deaths is that they are due to the treatment," says Philip Cryer, MD, FACP president of the American Diabetes Association (ADA). One especially frightening possibility for people on insulin that may be the result of severe hypoglycemia is what the journal Diabetic Medicine referred to in 1991 as "dead in bed syndrome." Victims of the syndrome are found dead in an undisturbed bed, observed to have been in good health the day before and are free from evidence of late diabetes complications. As is the case with accidents, it is very hard to determine if these deaths are the result of hypoglycemia. Researchers in the U.K. note, however, that the timings of the deaths and other circumstantial evidence suggests that hypoglycemia or a hypoglycemic event is responsible. There are major problems with diagnosing hypoglycemia after death (see page 18). Cryer explains that testing the blood sugar of someone found dead after an accident or mysterious death that appears to be the result of hypoglycemia "is of zero value." He explains that the body will continue to process glucose for some time after death. As a result, the BG of a person after death will most likely not be an accurate reflection of their BG prior to death. ... d_syndrome According to IDDT also, apparantly It is also difficul Continue reading >>
What are the symptoms of a diabetic coma?
A diabetic coma can be the result of having a blood glucose level that is too high (hyperglycemia) or a blood glucose level that is too low (hypoglycemia). The diabetic in a diabetic coma is unconscious and can die if the condition is not treated. Symptoms of Diabetic Coma Before you lapse into a diabetic coma, there are usually warning signs of blood sugar levels that are too low or blood sugar levels that are too high. For example, if the blood sugar is too high, the you may experience tiredness, abdominal pain, shortness of breath, increased urination, increased thirst, a rapid heart rate, a dry mouth, and a fruity smell to your breath. If the blood sugar is too low, you may experience signs and symptoms of hypoglycemia, including weakness, tiredness, anxiety, tremulousness, nervousness, nausea, confusion, problems communicating, light-headedness, hunger, or dizziness. If you have had diabetes for many years, you may not have many symptoms of low blood sugar and won’t know you have the condition prior to falling into a coma. If you suspect that you have either high blood sugar or low blood sugar, you need to check your blood glucose levels and do what your doctor has recommended for you to treat the disease. If you don’t feel better after trying home remedies, you need to call 911 and get some kind of emergency care. Causes of Diabetic Coma The main cause of a diabetic coma is an extremely high blood sugar or an extremely low blood sugar. The following medical conditions can cause a diabetic coma: Diabetic hyperosmolar syndrome. This is a condition in which the blood sugar is as high as 600 mg/d: or 33.3 mmol per liter. There are no ketones in the u Continue reading >>
How does a diabetic coma happen?
It can occur in people with type 1 or type 2 diabetes. A diabetic coma occurs when blood sugar levels become either too low or too high. The cells in your body require glucose to function. High blood sugar, or hyperglycemia, can make you feel lightheaded and lose consciousness. Low blood sugar, or hypoglycemia, can cause dehydration to the point where you may lose consciousness. Usually, you can prevent hyperglycemia or hypoglycemia from progressing to a diabetic coma. If a diabetic coma occurs, it’s likely that your doctor can balance your blood glucose levels and restore your consciousness and health quickly if they can respond to your condition in a timely manner. You can also slip into a diabetic coma if you develop diabetic ketoacidosis. Diabetic ketoacidosis (DKA) is a buildup of chemicals called ketones in your blood. Hypoglycemia The symptoms of hypoglycemia may include: headache fatigue dizziness confusion heart palpitations shakiness Hyperglycemia If you have hyperglycemia, you may experience noticeably increased thirst and you may urinate more frequently. A blood test would also reveal higher levels of glucose in your blood stream. A urine test can also show that your glucose levels are too high. DKA causes high levels of blood glucose. The symptoms also include increased thirst and a frequent need to urinate. Other symptoms of elevated ketone levels include: feeling tired having an upset stomach having flushed or dry skin If you have more severe diabetic coma symptoms, call 911. Severe symptoms may include: vomiting difficulty breathing confusion weakness dizziness A diabetic coma is a medical emergency. It can lead to brain damage or death if you don’t get treatment. Treating hyperg Continue reading >>
What is the most difficult problem for diabetics?
Over 80 years ago, famed diabetologist Elliot Joslin said about the treatment of patients with type 1 diabetes: “Ketoacidosis may kill a patient, but frequent hypoglycemic reactions will ruin him.” Unfortunately, hypoglycemia continues to be the most difficult problem facing most patients, families, and caregivers who deal with the management of type 1 diabetes on a daily basis. Frequent hypoglycemia episodes not only can “ruin,” or adversely impact the quality of life for patients, but also, when severe, can cause seizures, coma, and even death. A Tragic Case Recently, our group published a case report in the journal Endocrine Practice describing a tragic death from hypoglycemia that occurred while the patient slept in his own bed. Our patient, a 23-year-old man with type 1 diabetes who had a history of recurrent severe hypoglycemia, was using an older model insulin pump and wearing a separate, non-real-time continuous glucose monitoring (CGM) system. He was given the CGM in 2005 for the purpose of tracking his nocturnal (nighttime) blood glucose values and making further insulin pump adjustments. After he was pronounced dead in the emergency room, our diabetes nurse removed the pump and CGM to help us understand what happened. His insulin pump was found to have been working correctly. What we learned was that after supper, he had a heavy workout at a gym, followed by a late snack. Between 8 pm and midnight, he “stacked” five boluses of insulin, totaling 7.35 units (33% of his basal dose), in an attempt to keep his glucose values in “tight” control. The downloaded sensor demonstrated that his glucose values fell from about 200 mg/dL at midnight to under 50 mg/dL by 2:00 am, and to under 30 mg/dL by 5:00 am – three hours before he was found by his pare Continue reading >>
