Hypoglycemic Coma
Definition
A state of unconsciousness due a severe drop of blood glucose levels
Etiology and Incidence
Skipping food after taking Insulin
Overdose of Insulin
Predisposing factors : eating less than usual or prolonged exercise.
Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia.
Type I diabetics taking full replacement dose are most vulnerable
Blood sugar levels fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed.
Hypoglycemia can be severe enough to cause unconsciousness during sleep.
can occur within 20 minutes to an hour after early symptoms
Symptoms and Signs
Twitching or convulsions may occur.
Pale
Rapid heart beat
Soaked in sweat:
Not usually dehydrated
Breathing is normal or shallow.
Comatose - Not responding to painful stimuli
Blood sugar level : usually low but not always severely, and in some cases may have already risen from the nadir that triggered the unconsciousness.
Treatment
2 ampoules of 25% Dextrose bolus dose
Followed by 5% Destrose maintenance drip
Nursing Management
Monitor blood glucose levels hourly and titrate the dose of glucose
Educate the patient and family about not skipping diet after taking insulin dose
Dietary advice
To prevent hypoglycemia; to carry glucose supplements always and take a mouthful when the early symptoms of hypoglcemia appear
To carry diabetic tag on their body always.
