How is DKA coma treated?

How is DKA coma treated?

Diabetic coma requires emergency medical treatment….High blood sugar

  1. Intravenous fluids to restore water to your tissues.
  2. Potassium, sodium or phosphate supplements to help your cells function correctly.
  3. Insulin to help your tissues absorb the glucose in your blood.
  4. Treatment for any underlying infections.

How does ketoacidosis cause a coma?

Diabetic ketoacidosis coma This type of coma is triggered by the build-up of chemicals called ketones. Ketones are strongly acidic and cause the blood to become too acidic. When there is not enough insulin circulating, the body cannot use glucose for energy.

Can you go into a coma with DKA?

If you have ketones (measured in blood or urine) and high blood sugar, the condition is called diabetic ketoacidosis. Left untreated, it can lead to a diabetic coma. Diabetic ketoacidosis is most common in type 1 diabetes but sometimes occurs in type 2 diabetes or gestational diabetes.

What fluid do you give a patient with hyperglycemic coma?

According to American Diabetes Association guidelines, fluid resuscitation with 0.9% saline at the rate of 15-20 mL/kg/h or greater is indicated to expand the extracellular volume quickly in the first hour. This amounts to about 1-1.5 L in an average-sized person.

How do you manage a hypoglycemic coma?

Treatment of the comatose patient consists of glucose gel smeared inside the mouth, intramuscular glucagon (1 mg) or intravenous glucose. It is important to avoid giving excess intravenous glucose, particularly in young children in whom the osmotic effects of resultant hyperglycemia can result in cerebral damage.

What level of blood sugar will put you in a coma?

A diabetic coma could happen when your blood sugar gets too high — 600 milligrams per deciliter (mg/dL) or more — causing you to become very dehydrated. It usually affects people with type 2 diabetes that isn’t well-controlled.

At what blood sugar level do you go into a coma?

A diabetic coma could happen when your blood sugar gets too high — 600 milligrams per deciliter (mg/dL) or more — causing you to become very dehydrated. It usually affects people with type 2 diabetes that isn’t well-controlled. It’s common among those who are elderly, chronically ill, and disabled.

What happens when someone goes into a diabetic coma?

In a diabetic coma, you are unconscious and unable to respond to your environment. You are either suffering from high blood glucose (hyperglycemia) or low blood glucose (hypoglycemia). You need immediate medical attention if you go into a diabetic coma.

How long does a diabetic coma last?

Diabetic ketoacidosis, if it progresses and worsens without treatment, can eventually cause unconsciousness, from a combination of a very high blood sugar level, dehydration and shock, and exhaustion. Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation.

What IV solution is given for DKA?

Recent research suggests the fluid type used may be important in treating DKA. Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.

At what rate should IV saline be administered to a patient with diabetic ketoacidosis?

Most protocols call for an initial bolus of isotonic crystalloid solution (0.9% saline) at a starting rate of 15–20 mL/kg/h (1–1.5 L/h) for the first hour. Following the initial hydration, fluids can be administered at a decreased rate of 4–14 mL/kg/h.

What kind of treatment do you get for ketoacidosis?

Treatment usually involves: Fluid replacement. You’ll receive fluids — either by mouth or through a vein (intravenously) — until you’re rehydrated. Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. Insulin therapy.

Which is worse diabetic coma or ketoacidosis?

The two causes of diabetic coma, hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA), differ in whether or not there is ketoacidosis. Although both have severe hyperglycemia, that of HHS is more severe. The results of metabolic changes in both lead to abnormalities in electrolyte concentrations, which can be life-threatening.

Which is the best treatment for diabetic coma?

Treatment for diabetic coma 1 ketoacidotic coma – intravenous fluids, insulin and administration of potassium 2 hyperosmolar coma – intravenous fluids, insulin, potassium and sodium given as soon as possible 3 hypoglycaemic coma – an injection of glucagon (if available) to reverse the effects of insulin or administration of intravenous glucose.

When to stop insulin therapy for diabetic ketoacidosis?

Insulin reverses the processes that cause diabetic ketoacidosis. In addition to fluids and electrolytes, you’ll receive insulin therapy — usually through a vein. When your blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and your blood is no longer acidic, you may be able to stop intravenous insulin therapy…

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