hypoglycemic coma - a pathological condition of the nervous system caused by the acute shortage of glucose in the blood supply to the brain cells, muscle and other cells of the body.Status hypoglycemic coma developing rapidly, resulting in the inhibition consciousness of all vital functions.In case of late rendering of the first medical.possible state aid that threaten human life: heart failure, failure of the respiratory center in the medulla oblongata.
hypoglycemic coma is the logical culmination of a long hypoglycemia.Therefore, it is important to be able to recognize the state of Harbinger - hypoglycemia.
reasons hypoglycemic coma
Because of the term, it is clear that the cause hypoglycemic coma is prolonged hypoglycemia.Consider the main causes of hypoglycemia.
most often hypoglycemic coma occurs in people with diabetes.This disease is due to inadequate secretion of the hormone insulin by beta cells of the pancreas.Sometimes insulin secretion may remain at the le
Besides insulin-dependent diabetes there are other forms in which the insulin produced is less than required, which leads to the typical symptoms of diabetes, but less pronounced, or appear only after consumption of carbohydrate foods.For this type of diabetes treatment usually involves taking drugs, insulin secretagogues, and a special diet.Hypoglycemic drugs such as glibenclamide, have a number of side effects, and an overdose can provoke a state of hypoglycemic coma.
When using insulin greatest preference is given to doctors appointment or a rapid-acting insulin, or prolonged.Substitution therapy-acting insulin based on the introduction of directly when the body's need is greatest - before eating (since the action occurs over time) and at night.It is because of this particular therapy, there is a fairly high probability of provoking a hypoglycemic coma, for example, if after the introduction of insulin before eating a meal followed.
When using the traditional scheme of insulin (a third rapid-acting insulin, and the rest - long) the most important condition for a person to follow a strict diet.Diet is necessary in order to avoid the development of hyper-and hypoglycemia, and hypoglycemic coma.Power fractional, a six-five, in compliance with all the criteria: the nutritional value of needs, a comparison of the amount of grain to the number of units of insulin.
For some reason it may be a critical mismatch introduced human insulin (the hormone responsible for the processing of glucose) and consumption of carbohydrate foods.Due to the fact that the body sufficient circulating insulin and blood glucose is not added, condition develops hypoglycemia can provoke such a state as hypoglycemic coma.The man, absorbed in their daily worries, time may not notice gradually increasing symptoms of hypoglycemia.
Moreover, even with the diet, the patient may mistakenly or intentionally inject insulin by the rules (not under the skin, and intramuscularly).This leads to more rapid absorption and stronger effect of insulin, which will inevitably lead to a state of hypoglycemia and subsequently cause hypoglycemic coma.
Another version of violations of the rules and insulin - drinking alcoholic beverages the night before.It has long been established that the alcohol inhibits the normal metabolism of carbohydrates (including glucose).By
of hypoglycemic coma can result in unplanned exercise without correction of diet and insulin.In other words, after the introduction of the hormone was followed by a sharp physical activity, for which simply did not have the available amount of energy (which is mostly taken in the processing of glucose).There
unusual situation where the person who has access to insulin, suddenly wanted to commit suicide by means of an overdose of drugs.Such people are unable to save, if they are pre-treated for psychological help, or the day before talking about such a desire to know the people.
For decades hypoglycemic coma is used as a therapeutic shock treatment in the psychiatric practice.Insulin shock therapy, along with electro-convulsive therapy contribute to slowing the development of symptoms in patients with severe, rapidly progressive form of schizophrenia and other mental illnesses.These procedures are carried out only in a hospital after a long preliminary preparation and, of course, they are associated with a certain risk.
Older people with diabetes is very rare, but it can occur acute hypoglycemia or hypoglycemic coma in response to receiving glucose-lowering drugs.Namely, the cases have been reported after administration of high doses of drugs sulfonylureas (gliquidone, glibenclamide, etc.), And malnutrition throughout the day.
Of course, one reason for hypoglycemic coma - mistake of dosage, for example, when dialing insulin syringe of a volume and labeling (using a syringe with a standard dose of 40 and 100 units per milliliter), and as a result, the introduction of a dose exceeding the single in1.5 - 2 times.In some cases, such administration may induce a state of shock and almost immediate development of coma.
direct impact on the situation of hypoglycemia has a tumor of the pancreas cells that produce insulin - insuloma.Tumor cell proliferation of pancreatic islets of Langerhans with current can deliver a lot of trouble to the patient, because it is very difficult to diagnose.Sometimes insulin secretion from the tumor reaches a critical numbers, causing hypoglycemic coma.
The above reasons can lead both to a sudden development of hypoglycemic coma, and the gradual development of hypoglycemia, and after - to coma.
hypoglycemic coma symptoms
hypoglycemic coma clinic, many patients are usually lubricated, for the first time few people pay attention to the symptoms.The initial manifestations lowering blood glucose levels associated with "starvation" of the brain and related chemical processes and synapses in neurocytes (cells of the brain), as the cells begin to synthesize energy from the reserve substances absolutely not intended for that.Against the background of growing weakness headache, which is practically not removed painkillers.There coldness of hands and feet, humidity, palms and feet.There are "tides" heat, and summer and can presyncopal state because of violations of thermoregulation and blood circulation.
becomes noticeable pallor and numbness (tingling), nasolabial triangle, which is always clearly shows the degree of saturation of the brain with oxygen and glucose.In this state, people are usually aggressive, impatient of criticism.With an increase in hypoglycemia enhanced fatigue, significantly decreases working capacity, especially in the intellectual sphere.Shortness of breath when walking and light loads.Perhaps a temporary decrease in visual acuity to restore the required level of glucose.Over time, enhanced trembling fingers, and later the other muscle groups.
In all patients, without exception, there is a strong sense of hunger.Sometimes it is so pronounced that it is described as a feeling bordering on nausea.
At later stages of development of hypoglycemic coma may double vision, difficulty focusing vision, impairment of color perception (colors appear duller and everything in shades of gray).
Disturbances in nerve center of control of movements lead to reduced accuracy of movements, which may lead to accidents in the workplace and at home, behind the wheel and in the performance of habitual actions.
If the condition is caught up with a man during the hospital stay hospital, you must tell the nurse and doctor.They will do the necessary tests (urine for acetone, blood sugar) and proceed to the treatment of hypoglycemic coma.
of the violations in the cardiovascular system, it should be noted the rising tachycardia.This is the kind of quantitative violation heart rate.In some cases, the tachycardia can reach 100-145 or more beats per minute, and is attached to a sense of palpitations anxiety, shortness of breath, hot flushes.Upon receipt of a carbohydrate meal or sugary foods (sweet tea, candy, cube sugar) heart gradually "calms down", the frequency of beats per minute is reduced, and the other symptoms disappear without a trace.
Signs hypoglycemic coma
hypoglycemic coma - one of the few states that has a lightning fast character development.Symptoms specific to hypoglycemic coma, should encourage the correct emergency medical and first aid.Indeed, in a coma the human body is at the features of the life and death, and any mistake in the treatment or emergency care can be fatal.
Predkomatoznoe state has a number of features: abrupt onset of clonic and tonic seizures or epileptiform seizures.It starts with twitching of muscles throughout the body and rapidly intensified to an extreme degree - seizures.This condition is dangerous because there is absolutely unpredictable, and a person can become a victim of a car accident, a fall from a height.
condition hypoglycemic coma caused by a reaction of the medulla oblongata to hypoglycemia: complete loss of consciousness, the pupils are dilated.Upon closer examination: pale skin, cold clammy sweat, breathing slightly weakened, blood pressure is normal or elevated, pulse normal or slightly speeded up, knee and elbow reflexes are strengthened.
consciousness is missing, which is expressed in the lack of response to physical stimuli, such as a pat on the cheeks, shouts, dousing with cold water, and other methods of "awakening."It registered many cases where people after leaving hypoglycemic coma claimed to have seen what is happening around the part.Official science, this information is not confirmed and are considered too realistic illusions influx during unconsciousness.
Breath in the early stages of hypoglycemic coma changed slightly.But the most threatening complication is failure of the respiratory center.This means that the patient's breathing (rhythm, uniformity, depth) must be given due attention during transport or resuscitation.If breathing shallow, that is, for presentation to mirror the patient's mouth is, fogging, you must enter the respiratory stimulants, because, missed the point, you lose a man.
Clinic hypoglycemic coma combines many features of emergency conditions, and only a comparison of all the symptoms in a single picture will help the health worker, a relative, or a passerby to provide proper care.
If a person assisted is true, he regains consciousness for 10-30 minutes (if no complications hypoglycemic coma).
hypoglycemic coma in children
basic principle of the development and course of hypoglycemic coma in children is similar to that in adults.
reason hypoglycemic coma in children can also serve as an improper administration of insulin, prolonged fasting, failure to comply with the diet of rare hereditary diseases (lack of digestive enzymes, glucose intolerance, galactose, or fructose).
Children hypoglycemia difficult to distinguish from a wide variety of conditions, because children, especially preschoolers, often can not describe what exactly they are concerned.
At a headache, the child is likely to be tearful, restless.The syndrome of abdominal pain (stomach pain as a manifestation of reactive hypoglycemia) in children decreased appetite, to eat can and does refuse, even hunger - one of the obvious symptoms of hypoglycemia.
In the next step the flow of hypoglycemia in children, they become lethargic, indifferent to everything, it is non-contact.All this is happening against the background of the previous well-being.Such changes in behavior should alert parents.
As in adults, there is pallor of the skin, severe hand tremors and sweating palms.In addition, the fits of dizziness, especially along with lightheadedness when changing body position (with a sharp rising).
It should be borne in mind that children develop much faster than all the symptoms, though the clinic hypoglycemic coma is not different from that of adults: rapid onset, convulsions, loss of consciousness;typical coma symptoms: slowed breathing, heart rate, lowering blood pressure.Death or irreparable violation of the brain is faster, so the speed and coherence of people, providing assistance, dependent life and health of the child.
Treatment of hypoglycemic coma
therapy to serious condition such as a hypoglycemic coma, to be effective, you must make sure that this state - coma, and after that it is hypoglycemic coma.The correct diagnosis in this case is of great importance.For example, if someone is suspected hyperglycemic early introduction of glucose solution can be fatal.
Much depends on whether there are witnesses who could describe the behavior of loss of consciousness, to describe his complaint, to provide information about the drugs that the patient took recently.If witnesses verified convulsions, loss of consciousness and then, pre-treatment with insulin or prolonged starvation victim, then you can safely begin resuscitation of diagnosis "hypoglycemic coma".And if the person has already been found in an unconscious state, it was not there any traces of the use of medications (insulin or hypoglycemic agents), then to start it must be delivered in a medical facility, which will be carried out rapid tests for glucose, acetone, ketones, andafter - treatment measures.
In the early stages of development of hypoglycemic coma (in a state of hypoglycaemia) as the best preventive method is to receive a coma sweet and carbohydrate foods.This should not eat chocolates because they contain large amounts of various fats, flavorings, fillers taste of dubious origin and little glucose.A person suffering from diabetes, it is best to carry in your pocket a few simple candy, but no chocolate.
doctor must conduct interviews with people with diabetes, especially children and their parents about the importance of diet, taking medication regime, as well as the correct allocation exercise.
Caution should be used long-acting insulin.It is recommended to be administered under the skin of the thighs and the shoulder, as its absorption in these places slower.A very important task is to conduct research glycemic profile during the day.This will facilitate the task of choosing insulin to be administered at night and give the opportunity to prevent hypoglycemia during sleep.
People suffering from diabetes of the first type, you need a diet based on their energy needs.