Treatment For Diabetic Coma
Treatment options for diabetic coma include:
- ketoacidotic coma intravenous fluids, insulin and administration of potassium
- hyperosmolar coma intravenous fluids, insulin, potassium and sodium given as soon as possible
- hypoglycaemic coma an injection of glucagon to reverse the effects of insulin or administration of intravenous glucose.
A Low Blood Sugar Level Without Diabetes
A low blood sugar level is uncommon in people who do not have diabetes.
Possible causes include:
- a gastric bypass
- other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
- some medicines, including quinine
See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.
What Causes Hyperglycemia In People With Diabetes
- The dose of insulin or oral diabetes medication that you are taking is not the most helpful dose for your needs.
- Your body isnt using your natural insulin effectively .
- The amount of carbohydrates you are eating or drinking is not balanced with the amount of insulin your body is able to make or the amount of insulin you inject.
- You are less active than usual.
- Physical stress is affecting you.
- Emotional stress is affecting you.
- You are taking steroids for another condition.
- The dawn phenomenon is affecting you.
Other possible causes
- Pancreatic diseases such as pancreatitis, pancreatic cancer and cystic fibrosis.
- Certain medications .
- Gestational diabetes, which happens in 4% of pregnancies, and is due to decreased insulin sensitivity.
- Surgery or trauma.
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What Are Signs And Symptoms Of Diabetic Ketoacidosis
A person with diabetes developing diabetic ketoacidosis may have one or more of these symptoms excessive thirst or drinking lots of fluid, frequent urination, general weakness, vomiting, loss of appetite, confusion, abdominal pain, shortness of breath, a generally ill appearance, and dry skin or mouth, increased heart rate, low blood pressure , increased rate of breathing, and a distinctive fruity odor on the breath.
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You should know that insulin can help you manage your diabetes and prevent further damage to your kidneys. If youre suffering from diabetes, its important to consult a doctor to make sure that youre a good candidate for the condition. If youre looking for more information, you can read about the various types of diabetes available, as well as how to get a free online health assessment. In many cases, its possible to avoid a doctors visit by doing simple exercises. If youre not familiar with the signs and symptoms of diabetes, you can read online articles about the condition and learn about its treatment.
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High Blood Sugar Levels
Blood sugar levels that are too high can also cause nausea.
In the case of hypoglycemia, its important to consume food or drink with sugar in it to raise blood sugar levels, which should help to relieve nausea. In the case of hyperglycemia, its crucial to check blood glucose often to ensure they dont raise to dangerously high levels and to be in contact with a healthcare provider.
One of the serious complications of uncontrolled high blood sugar includes diabetic ketoacidosis , which commonly occurs in people with type 1 diabetes, and diabetic hyperglycemic hyperosmolar syndrome in people with type 2 diabetes, of which nausea is a symptom of both.
Other signs and symptoms signs of diabetic ketoacidosis include abdominal or stomach pain, fatigue, frequent urination, excessive thirstiness, fruity odor to the breath, shortness of breath, and sometimes unconsciousness.
Dehydration from nausea and vomiting can further worsen electrolyte imbalances, which is why its essential to seek prompt medical attention for these conditions.
A Side Effect Of Medication
Like other medications, some diabetes drugs can cause nausea as a side effect.
These include the common medication metformin, which people should take with food to avoid or reduce nausea.
A person may experience nausea when they start taking injectable medications, but this symptom often goes away once they become used to the injections. If it does not, it is worth talking to the doctor about possibly adjusting the dosage.
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How Do I Prevent Diabetic Ketoacidosis From Happening Again
Diabetic ketoacidosis is life-threatening, so preventing it is important. The most important step in prevention is ensuring proper insulin dosing. The importance of home-monitoring of blood glucose levels cannot be overemphasized. If you are not yet performing home blood glucose monitoring, your veterinary healthcare team can help get you started. The necessary blood sample is tiny – just a tiny drop of blood – and the tiny needle that is used will not hurt your dog. Most dogs barely notice the pin-prick.
Your veterinarian will guide you on how often to take readings, when to report the results to the practice, and will explain how the values are interpreted in order to make decisions about modifying your dog’s insulin dose.
“The importance of home-monitoring of blood glucose levels cannot be overemphasized.”
If you are already doing home monitoring of your dog’s blood glucose levels, your veterinarian will guide you as to how often to check glucose levels once your dog returns home. The key to preventing a recurrence of diabetic ketoacidosis is to be very aware of your dog’s glucose levels both throughout the day, as well as the pattern of his blood glucose levels over the span of several days to several weeks. As you report the glucose levels, your veterinarian will be able to help you fine- tune your dog’s insulin doses and set the stage to prevent this crisis from recurring.
|Contributors: Krista Williams, BSc, DVM Robin Downing, DVM, DAAPM, DACVSMR, CVPP|
How Does Gastroparesis Affect People With Diabetes
People with diabetes are at increased risk for gastroparesisa digestive disorder that can cause severe symptoms and affect quality of life.
Diabetes is the most common known cause of gastroparesis, a digestive disorder that may lead to poor nutrition, problems managing blood glucose, and a reduced quality of life. Here, Dr. Adil E. Bharuchaone of the authors of the chapter, Gastrointestinal Manifestations of Diabetes, in the NIDDK publication Diabetes in America, 3rd Editiondiscusses how health care professionals can diagnose and treat gastroparesis in patients with diabetes.
Q: What is gastroparesis? How common is gastroparesis in people who have type 1 or type 2 diabetes?
A: Gastroparesis is a condition in which the muscles in the wall of the stomach work poorly or dont work at all, slowing or delaying the rate at which food empties from the stomach to the intestine. This is called delayed gastric emptying. In gastroparesis, gastric emptying is delayed because the muscles don’t work effectively, not because a blockage prevents food from moving from the stomach to the intestine.
In one study, over a period of 10 years, about 5% of people with type 1 diabetes and about 1% of people with type 2 diabetes developed gastroparesis. Less than 1% of people without diabetes developed gastroparesis during the study.
Q: In people with diabetes, what is the relationship between gastroparesis and blood glucose levels?
Q: How is gastroparesis diagnosed?
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Gastroparesis Is A Gastrointestinal Condition Occurring In People With Long
with Mahdusudan Grover, MD, and Michael Camilleri, MD
Gastroparesis gets little attention even though it is a relatively common complication arising in many individuals with diabetesboth type 1 diabetes and type 2 diabetes. Its even more common in individuals with both diabetes and obesity.¹
If you have diabetes, stomach pains, bloating, and nausea may be a sign that you gastroparesis. Photo: 123rf
Common symptoms include feeling full before you can finish your meal and staying full long after the meal is over as well as bloating, nausea, vomiting, abdominal pain, and even nutritional deficiencies.1,2
According to results of one study,3 as many as 29% of patients with these gastric symptoms also have diabetes and may experience nerve problems in their stomach, similar to that of that causes tingling and numbness, even pain, in the extremities. Poor blood sugar control may also be a contributing factor.4
If you have had diabetes for a while, this might explain the abdominal pain and other baffling symptoms youve been experiencing after you eat.
High Or Low Blood Sugar Levels
Hyperglycemia occurs when the body has too little insulin, for example, when a person eats more or exercises less than they had planned. It can also happen in the morning, which is known as the dawn phenomenon. Learn more about high blood sugar in the morning.
Hypoglycemia can occur when a person takes too much insulin or does not eat enough food. It can lead to serious complications, including insulin shock.
Both hyperglycemia and hypoglycemia can make a person feel nauseated.
Other symptoms to look out for include:
Without treatment, people with diabetes will go through repeat events of hypoglycemia and hyperglycemia. Over time, this can result in health complications, such as insulin shock, diabetic ketoacidosis, and diabetic neuropathy.
People can usually prevent these complications by managing their diabetes.
A person can avoid hyperglycemia and hypoglycemia by:
- eating regular meals and snacks
- taking medications according to the prescription
- adjusting food and medication intake when increasing activity levels
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What Tests And Procedures Diagnose Diabetic Ketoacidosis
The diagnosis of diabetic ketoacidosis is typically made after the health care practitioner obtains a history, performs a physical examination, and reviews the laboratory tests. Blood tests will be ordered to document the levels of sugar, potassium, sodium, and other electrolytes. Ketone level and kidney function tests along with a blood gas sample are also commonly performed. Other tests may be used to check for conditions that may have triggered the diabetic ketoacidosis, based on the history and physical examination findings. These may include chest X-ray, electrocardiogram , urine analysis, and possibly a CT scan of the brain.
What Are The Symptoms Of Type 1 Diabetes In A Child
Type 1 diabetes often appears suddenly. In children, type 1 diabetes symptoms may be like flu symptoms. Symptoms can occur a bit differently in each child. They can include:
- High levels of glucose in the blood and urine when tested
- Unusual thirst
- Frequent urination
- Extreme hunger but weight loss
- Loss of appetite in younger children
- Blurred vision
- Serious diaper rash that does get better with treatment
- Fruity breath and fast breathing
- Yeast infection in girls
The symptoms of type 1 diabetes can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
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What Is Type 1 Diabetes In Children
Diabetes is a condition in which the body can’t make enough insulin, or can’t use insulin normally. Type 1 diabetes is an autoimmune disorder. The body’s immune system damages the cells in the pancreas that make insulin. Insulin is a hormone. It helps sugar in the blood get into cells of the body to be used as fuel. When glucose cant enter the cells, it builds up in the blood. This is called high blood sugar . High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. It can also cause symptoms such as tiredness.
Type 1 diabetes mellitus is a long-term condition. It may start at any age. Insulin from the pancreas must be replaced with insulin injections or an insulin pump.
There are two forms of type 1 diabetes:
- Immune-mediated diabetes. This is an autoimmune disorder in which the body’s immune system damages the cells in the pancreas that make insulin. This is the most common kind of type 1 diabetes.
- Idiopathic type 1. This refers to rare forms of the disease with no known cause.
When To Contact Your Doctor
Contact a doctor if youre experiencing frequent diarrhea. Theyll look at your health profile and assess your blood sugar levels. They may also perform a brief physical exam to help rule out any other medical conditions.
Before you start a new medication or another treatment regimen, your doctor will want to be sure youre not experiencing any other gastrointestinal issues.
- taking loperamide before meals to manage symptoms
- taking clonidine to regulate bowel movements and reduce spasms
- taking amitriptyline to reduce cramping and slow digestion
- practicing pelvic floor training, and possibly getting a colostomy, for people with fecal incontinence
Depending on their assessment, your doctor may refer you to a gut specialist called a gastroenterologist for further investigation.
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Is It An Emergency
If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.
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Managing Diabetes Lessen The Risk Of Diabetic Gastroparesis
Many endocrinologists focus patient education to improve diabetic gastroparesis on managing blood sugar levels, says Dr. Camilleri. While there is some evidence that those whose poor glucose management and high hemoglobin A1c levels are more likely to end up in the hospital with gastroparesis, achieving good blood glucose is not a miracle cure he says.
Dr. Grover adds that better management of blood glucose may help some patients feel better. You may want to talk to your endocrinologist about , which will continuously monitor your blood sugar and deliver insulin as needed. By allowing your blood sugar to be automated, you may find that you feel better in many ways, including improvements in the symptoms related to the diabetic gastroparesis.
There are some treatments for diabetes itself that can cause the stomach to empty more slowly, Dr. Camilleri says. These drugs end in -tide, like exenatide a glucagon-like peptide-1 receptor agonist .
There are other good diabetes medications, such as the dipeptidyl peptidase 4 inhibitors, or gliptins, but they dont have as favorable an impact on gastric symptoms. When working with his diabetic patients who have gastroparesis, he makes a specific effort to be sure any medications given for blood sugar management wont cause or worsen stomach problems.
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Diabetic Gastroparesis Causes Serious Abdominal Discomfort
It could be that you are one of the estimated 25-55% individuals with type 1 diabetics or the one-in-three people who have type 2 diabetes and experience symptoms of gastroparesis for which there isnt yet an effective treatment targeted to improve this gastrointestinal condition.3
Lets gain some perspective on the management of this gastrointestinal condition thats further complicated by the presence of diabetes. Patients who sought out Mahdusudan Grover, MD, an assistant professor of medicine and a gastroenterologist at the Mayo Clinic in Rochester, Minnesota, hoping to gain relief from gastroparesis had only one option: metoclopramide , the only drug approved to help patients with the condition but it comes with serious potential side effects and black box warnings.
Dr. Grover explains that the procedure involves removing a part of the stomach called the pylorus to help the stomach empty into the intestines more easily. Unfortunately, he says its too soon to know which patients may benefit the most by having the operation.
However, there is an endoscopic procedure, called EndoFLIP, which can determine if there is problem with the way the pylorus is working, and by gathering this information, it will narrow the possibility to those patients who clearly have poor pyloric function.
Still, Dr. Camilleri says that the surgery looks promising and is largely safe, making it an encouraging option for those whose Endo-FLIP examinations show some pyloric dysfunction.
What Causes A Low Blood Sugar Level
In people with diabetes, the main causes of a low blood sugar level are:
- the effects of medicine especially taking too much insulin, medicines called sulfonylureas , medicines called glinides , or some antiviral medicines to treat hepatitis C
- skipping or delaying a meal
- not eating enough carbohydrate foods in your last meal, such as bread, cereals, pasta, potatoes and fruit
- exercise, especially if it’s intense or unplanned
- drinking alcohol
Sometimes there’s no obvious reason why a low blood sugar level happens.
Very occasionally, it can happen in people who do not have diabetes.
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Its important to maintain a healthy body weight. You should also make sure that you drink plenty of water, and limit your intake of sugary drinks. In addition, make sure that you get regular exercise. You should also avoid alcoholic beverages. Lastly, you should avoid alcohol. These beverages contain high amounts of sugar. If you dont drink enough, youre not doing anything to prevent diabetes. Besides, drinking alcohol can be harmful to your health.
The most important thing to do is to follow the recommended diet. Eat more healthy foods that have low amounts of fat and high amounts of fiber. The best way to lose weight is to lose 7 percent of your body weight. If youre overweight, you should try to lose 14 pounds to reduce your risk of developing type 2 diabetes. However, you should not attempt to lose weight while pregnant. Talk to your doctor about what kind of weight is safe for you.
Besides high blood glucose, diabetes can also affect the nerves and skin. It may affect your sexual response and your nervous system. It can also affect your fertility. Women with diabetes are more likely to miscarry or have a baby with a birth defect. It can cause a person to have difficulty hearing and sleep. If the condition is left untreated, it can lead to type 1 diabetes and can even lead to amputation.