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ACUTE DIABETIC COMPLICATIONS  

These complications of diabetes are medical emergencies because they are immediately life threatening

NONKETOTIC HYPERGLYCEMIC-HYPERSMOLAR COMA

Extremely high blood glucose levels (hyperglycemia) may lead to a coma Nonketotic hyperglycemic-hyperosmolar coma This type of coma occurs in Type 11diabetics. More than 50% of persons who go into this type of coma die. It occurs when there is hyperglycemia with inadequate fluid intake and resulting (dehydration). This condition can occur along with an acute infection. Causes of this condition are infections such as acute pneumonia untreated Type 11 diabetes, and initiation of corticosteroid or diuretic treatment. The blood glucose level is usually >55mmol/l. This condition can cause circulatory collapse and death.

DIABETIC KETOACIDOSIS

Another type of diabetic coma can occur. Diabetic ketoacidosis occurs in Type 1 diabetics. This happens when there is an acute shortage of insulin availability (usually caused by a lapse in treatment, or severe infection).
There is a resultant hyperglycemia with osmotic diuresis causing severe dehydration and can lead to coma and death if not adequately identified and rapidly treated. Signs of developing ketoacidosis are polyuria, nausea, vomiting, occasionally abdominal pain, lethargy and sleepiness.

ACUTE HYPOGLYCEMIA

This occurs when there is too little glucose in the blood for normal body functioning to occur. If the blood glucose levels drop below 3.5-4mmol/l (50mg/dl) the body starts reacting. The symptoms are associated with the brain and the sympathetic nervous system.

The symptoms are associated with the brain because the brain requires sufficient blood glucose for it to function normally. Very low blood glucose levels cause brain blood glucose insufficiency (neuroglycopenia].

Symptoms of hypoglycemia include:

Associated with the brain
Confusion
Bad temper
Irritability
Temporary paralysis, usually one-sided (hemiplegia)
Hallucinations
Coma
Associated with the sympathetic nervous system
Sudden, sometimes profuse sweating
Feeling of being too hot
Palpitations
Anxiety
Agitation
Shakiness
Tremor of the hands
Avoiding Diabetic Complications Hunger
If hypoglycemia persists and is not rectified, it can lead to coma and death.
The symptoms are easily relieved by administration of glucose orally or intravenously. In diabetics the most common cause of hypoglycemia is inadequate caloric intake for the amount of medication, either oral or insulin injection. This may follow skipping a meal, not adhering to the correct prescribed dosages or after strenuous exercise without adequate adjustment to diet.
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