Islets of Hope  complications of diabetes

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Article disclaimer

By Lahle Wolfe

Sources

Diabetic Coma; Mayo Clinic

Epilepsy Foundation

Nocturnal convulsions and insulin-induced hypoglycaemia in diabetic patients.
Postgrad Med J 1987 Aug;63(742):673-6 (ISSN: 0032-5473)
Fisher BM; Frier BM

Seizures as a manifestation of systemic disease.
Neurol Clin 1986 Aug;4(3):563-84 (ISSN: 0733-8619)
Messing RO; Simon RP


Cognitive functioning not impaired in diabetic children with severe hypoglycemia - NEW YORK (Reuters Health) - Episodes of hypoglycemic seizure or coma at a young age in children with type 1 diabetes (T1DM) do not result in broad cognitive or behavioral impairment, according to results of a study published in the November issue of the Journal of Pediatrics.  11/2005


Diabetes &
Seizure Links

Epilepsy Foundation article about non-epileptic seizures

Epilepsy.com article about non-epileptic seizures

Is it hypoglycemia or seizures?


 

islets of hope diabetes medical library                       back to main "Complications" page
Diabetes Complications

Diabetic Coma, Seizures & Convulsions
from Hyperglycemia & Hypoglycemia Associated with Diabetes

Parent's Recount Experiences of Hypoglycemia Seizure Activity in Children With Type 1 Diabetes


Mini Site Index
What is diabetic coma?
What causes diabetic coma?
-- Coma from Insulin Shock (severe hypoglycemia)
--
Coma from Hyperglycemia
What is a diabetic seizure?
-- Grand mal (tonic) seizure
-- Complex partial seizure
What is a convulsion?
Convulsions and Seizures from Nighttime Hyperglycemia
Why it is important to wear medical information

Ultimate Guide to Carb Counting

Don't just count carbs, understand how they are counted.

The Ultimate Guide to Accurate Carb Counting: Featuring the Tools and Techniques Used by the Experts (Marlowe Diabetes Library) by Gary Scheiner, author of: Insulin Pumping Demystified; Think Like a Pancreas; and more.


What is a diabetic coma?

A coma is a state of unconsciousness.  When a person enters into a diabetic coma it is the result of either severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose).  Any person that is comatose is in immediate danger of dying.  Call 911!


What causes diabetic coma?

Blood glucose levels that are too low (hypoglycemia) or too high (hyperglycemia) can both result in diabetic coma. Causes of diabetic coma are:

Coma from Insulin Shock (severe hypoglycemia)

When coma is induced from low blood glucose levels, it may also be referred to as "insulin shock."   Insulin shock, an extreme episode of hypoglycemia (low blood glucose) is caused by too much insulin in the body.  Untreated, insulin shock can lead to coma, seizures, and death.

Severe hypoglycemia can occur rapidly, even over minutes, and should always be treated immediately.  Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms. Twitching or convulsions may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat, all signs of the adrenaline response to hypoglycemia.

Important IOH Health Tips:   Most hypoglycemia severe enough to cause unconsciousness occurs during sleep.  It is important to know the signs of nighttime hypoglycemia (i.e., waking with high fasting glucose levels, headache, or being drenched in sweat), and to check your blood glucose levels around 3 a.m. at least once a week.  College students should show roommates how to inject glucagon and what to do if the roommate detects a nighttime seizure.  ALWAYS carry glucagon and medical identification and emergency contact information.

Know your bedtime target range and read our tips for preventing nighttime hypoglycemia.

Coma from Hyperglycemia

Hyperglycemia can lead to complications that can result in coma include diabetic ketoacidosis, nonketotic hyperosmolar coma, lactic acidosis., and/or metabolic acidosis.

Chronic, or severe hyperglycemia can lead to coma and death but is more likely to takes hours or days of being in a state of DKA (see above) before coma results.  Those that have been newly diagnosed, young children, the elderly, and those on insulin pump therapy may experience DKA at sooner, and at lower blood glucose levels than other persons with diabetes.


What is a diabetic seizure?

A seizure occurs as a result of a burst of simultaneous, contradictory signals from brain cells.  There are many causes of seizures including head trauma, fever, illness.  Hyperglycemia (high blood glucose) and hypoglycemia (low blood glucose) both can cause seizure, convulsion, coma, and even death.

During a seizure a person is unaware of their surroundings even if they may seem alert on some level.  If the seizure is a result of low blood glucose (hypoglycemia) do not attempt to feed the person who can easily choke on food and drink.  Instead, give a shot of glucagon and call 911 if necessary.

Generalized seizures can have any of the following characteristics:

  • Can, but do not always causes violent convulsions
  • Muscles may twitch, jerk, or slowly become rigid (clonic seizures)
  • Loss of muscle tone (tonic seizures)
  • Can affect involuntary body movement and function (clonic seizures)
  • Alter sensation, awareness or behavior
  • May involve numbness in part(s) of the body
  • Result in brief loss of memory
  • Manifest as detecting a strange odor (when there is none), seeing flashes of light, or sometimes feel like a panic attack
  • Can last a few seconds or result in a continuous seizure that does not stop without medical intervention

There are more than 20 types of seizures classified into groups including motor, sensory, autonomic, emotional or cognitive seizures.  Many seizures have unknown causes and not all seizures result in actual convulsions.

Grand mal seizure (or, tonic seizure)

A person having a grand mal seizure may cry out, lose consciousness and fall to the ground, and convulse.  Grand mal seizures are what most people are familiar with as they tend to occur with violent convulsions during some epileptic seizures.

Complex partial seizure

A person having a complex partial seizure may appear confused or dazed and will not be able to respond to questions or direction. Some people have seizures that are not noticeable to others and the only clue that a person is having an absence (petit mal) seizure is rapid blinking or a few seconds of staring into space.


What is a convulsion?

A convulsion is an abnormal violent and involuntary contraction or series of contractions of the muscles.  Seizures resulting in convulsion can be violent enough to cause injury to the body including head trauma, bone fractures, or broken teeth. Recorded seizures have been violently enough that people have bitten off part of their tongue, and in some cases, died from head trauma.  If a person is having a convulsion form low blood glucose immediately give glucagon and call 911.


Convulsions and Seizures from Nighttime Hypoglycemia

Hypoglycemia can occur at anytime during the night, most typically around 3 a.m.  Undetected nighttime hypoglycemia can lead to seizures and convulsions but it is important to remember that not all seizures result in convulsions.  Two indications that a person has had a severe nighttime episode of hypoglycemia (whether or not seizures were involved) include waking with a high fasting blood glucose level (Somogyi, or Rebound Effect) and morning headache, and being drenched in sweat.

See our section on preventing hypoglycemia for more information about nighttime hypoglycemia causes, how to recognize it, identify the cause, and what to do about it.  


Why it is important to wear medical identification

Unfortunately, there are more than a few headlines about diabetics that have gone into a state of diabetic coma and were mistaken for being drunk.  In some cases, police brutality resulted when the person did not respond, and in others, failure to identify that the person was in a diabetic coma resulted in improper care, and death.  (Read some of these stories in our Human Interest section of Islets of News Headlines.)

Wearing medical identification is one way to help others understand that your being unconscious is a medical emergency, not being drunk or asleep.  If you are admitted to an emergency room while unconscious having medical information on your person that doctors can access may save your life.


Important Medical Disclaimer

All material found on this site is intended for general informational purposes only.  This site should not be used for self-diagnosis or as a substitute for professional medical care.  IOH recommends that you seek the advice of a competent health  professional for diagnosis and treatment options, or before making any changes to your current diabetes care plan.

   

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Page Updated 10/12/2006