Acute Complications of diabetes mellitus

By | 14th May 2012

 

 

They are life threatening complications required prompt treatment because they are causing rapid mental and physical deterioration.

 

Diabetic ketoacidosis

 

It usually occurs in insulin dependent diabetes mellitus

 

Predisposing factors

  • Acute infection
  • Injuries
  • Emotional stress

 

Clinical features

 

  • Kussmaul’s breathing
  • Acetone smell
  • Marked dehydration
  • Orthostatic hypotension
  • Clouding of consciousness which can lead to coma.

 

Investigations

 

Increased ketone bodies in blood and urine

 

Treatment

Fluid and electrolyte replacement

Insulin replacement

 

Hyperosmolar non ketonic coma.

 

Occurrence in non insulin dependent diabetes mellitus.

 

Predisposing factors are same as ketoacidotic coma.

 

Clinical features

  • Marked dehydration – hyperglycemia – seizures-stupor-coma.

 

Treatment same as ketoacedotic coma.

 

Hypoglycemic coma.

 

Usually present with insulin treated patients.

 

Predisposing factors include insulin dose, delayed ingestion of meal and increased physical activity.

 

Clinical features

 

  • Increased sympathetic activity that include sweating, tachycardia, palpitation.
  • Headache, seizures.

 

Treatment

  • 50 % glucose I.V
  • Glucagon IM