Diabetes is a disease that seems to be so common to be occurring in our society that when we will at least know a person or two who are diagnosed with the condition. Those with diabetes certainly need diabetes care that helps these people live better. This care is also important to address one of the issues that may occur when people with diabetes are not well taken care of, which is diabetic coma.
Before we learn more about diabetic coma, you may want to know a bit more about diabetes and matters that you may overlook when speaking about diabetes. Statistics show that at least 422 million people worldwide have been diagnosed with diabetes and about 1.5 million deaths have been recorded each year due to diabetes, specifically from heart disease and stroke. 1 in 5 adults in Malaysia are living with diabetes. This means that at least 18.3% of the adult population in Malaysia or 3.9 million are living with diabetes.
Type 2 diabetes is diagnosed through several processes. When a doctor determines that the blood sugar level is high or if a person has classic symptoms of high blood glucose such as increased urination (polyuria), increased thirst (polydipsia) or increased hunger (polyphagia) on top of a positive urine test, doctor may not do any further test. A person is said to have diabetes when their random plasma glucose test shows greater than or equal to 200 mg/dL, fasting blood glucose or fasting plasma glucose (FPG) test shows greater than or equal to 126 mg/dL, oral glucose tolerance test (OGTT) shows greater than or equal to 200 mg/dL and A1C test shows greater than or equal to 6.5%. This means that a blood test is the most common way to know if a person has diabetes, on top of the classic symptoms complained by patients.
Treatment for diabetes in general is started with lifestyle modification. You may think that medication is the first treatment but ideally is an initiative of lifestyle modification. This includes regular physical activity and practising healthy eating habits. Despite this, the idea of medication being the first to be given in patients with diabetes is not entirely wrong because most cases of patients with diabetes are unable to keep their blood sugar level within targeted blood sugar level. Thus, patients are prescribed with antidiabetic medication. Most common antidiabetic medication that is prescribed for the first time is metformin. It is worth noting that patients may receive other antidiabetic medication apart from metformin for the first time after being diagnosed with diabetes. It is no surprise that some patients may be prescribed more than one kind of antidiabetic medication to help achieve the targeted blood sugar level.
Now, what is diabetic coma? Diabetic coma is a complication resulting from either very low or high blood sugar level. In general, there are three types of diabetes-related conditions leading to diabetic coma. This includes diabetic ketoacidosis, hyperosmolar hyperglycaemic state and severe hypoglycaemia. Diabetic ketoacidosis is a condition where the blood sugar level is dangerously high caused by the breakdown of fats into ketones to compensate for the condition. Hyperosmolar hyperglycaemic state is a condition where the body attempts to compensate for severe high blood glucose levels that often leads to great dehydration. Severe hypoglycaemia is considered in patients with blood sugar levels below than 54 mg/dL. All of these causes for diabetic coma can lead to terrible complications when not treated well by health professionals such as permanent brain damage and death. People with diabetic coma recover from the life-threatening condition but usually fully recovery expected when patient are given prompt treatment.
Before diabetic coma occurs, there are symptoms that may be early signs to be watched out for before a person is induced into the coma. This includes increased thirst, frequent urination, very dry mouth, blurred vision, nausea, vomiting, headache, shortness of breath, breath smells like acetone (similar to nail polish remover), muscle cramp or weakness, fatigue or tiredness and drowsiness or confusion. Since these symptoms can be similar to many other diseases or health condition, it is best for patient who already have diabetes to get checked by doctors as this can save them from falling into the comma.
One thing for sure, there are things that can be done by patients or caregivers to prevent diabetic coma from happening. The most important step to take to mitigate risk from diabetic coma or worsening of the already existing diabetes is to always follow doctor’s instructions when taking antidiabetic medication and appointments as planned. Patients are encouraged to have their own blood sugar monitor device to be used at home to test their blood sugar level regularly. Patients are also encouraged to practise a healthy lifestyle of regular exercises, plan for regular balanced meals and to always keep hydrated preferably with plain water. When patients start to have hypoglycemia symptoms such as shaking, sweating, irritability, dizziness, insatiable hunger, nervousness or fast heartbeat, it is best to always keep a fast source of sugar in hands like sweets or candy to be taken immediately.
