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