Diabetic Coma in Type 2 Diabetes Hyperglycaemic hyperosmolar nonketotic coma is a serious complication seen in type 2 diabetes patients with severe infection or stress. Diabetic coma is seen when blood glucose level becomes too high and there is severe dehydration. Unlike ketoacidosis which is usually seen in type 1 diabetes, in hyperosmolar stage we dont see any ketones in body and urine, and there is no acidosis. Diabetic hyperosmolar coma is usually seen in diabetic patients older than 60 years as they have altered sense of being thirsty and are more likely to become severely dehydrated. If there is severe loss of water from body, it can lead to shock, syncopy, coma and death

What are Causes of Diabetic Coma?
Severe Infection UTI, respiratory tract infection, bacterial meningitis,retropharyngeal abscess, hepatobiliary sepsis. Noncompliance with diet or insulin therapy Heart attack Renal failure Drugs (diuretics, steroids, phenytoin, ß -blockers, calcium channel blockers) Fever Illness Bleeding ulcer Blood clot hyperglycaemia Trauma CVA Pancreatitis

Symptoms of Hyperosmolar Coma:
Symptoms of hyperosmolar coma are produced due to hyperglycaemia and dehydration. Increased urination Increased thirst Severe Weakness Drowsiness Altered mental status Headache Restlessness Inability to speak Paralysis If you have any of these signs and symptoms, check your blood glucose and call your doctor if your blood glucose is high. Diabetic hyperosmolar coma typically seen when blood glucose increases to 600 mg/dL or more.

What are laboratory findings of Diabetic Coma patient.
• Severe hyperglycaemia (> 500mg/dl)
• Plasma hyperosmolality
• urea:creatinine ratio increased
• Secondary glycosuria
• Absence of significant ketoacidosis o Metabolic acidosis absent or mild

How Is Diabetic Coma Treated?
It is an emergency situation, and should be treated immediately. Patient should be hospitalised. Treatment goals are to treat hyperglycaemia with insulin and treat dehydration with intravenous fluids. Infection can be treated with antibiotics.

How to prevent diabetic coma?
Monitor and Check your blood glucose regularly, as recommended by your doctor Check your blood glucose every four hours when you are suffering from any infection. Take special care of yourself when you are having severe illness.