Insulin shock is considered a negative consequence of hypoglycemia, in which the level of glucose in the blood decreases and there is an increase in the hormone insulin produced by the pancreas. Once, in severe cases of schizophrenia, they did not know any other method of treatment, except for the patient falling into an insulin coma. So with medical help they tried to save patients from a mental disorder. In official medicine, there is only one way to introduce a patient into this condition, but how can I get it out of it?
What it is?
An insulin coma is a reaction of the body or a condition that occurs as a result of a decrease in blood glucose over a long period of time. In another way, it is called insulin shock.
Types of coma
Experts identify the following varieties:
- Ketoacidotic - appears in people suffering from type 1 diabetes. It is due to the release of a significant number of ketones, which appear in the body due to the processing of fatty acids. Due to the high concentration of these elements, a person is immersed in a ketoacidotic coma.
- Hyperosmolar - develops in people suffering from type 2 diabetes. Due to significant dehydration. The degree of glucose in the blood is capable of reaching a mark of more than 30 mmol / l, there are no ketones.
- Hypoglycemic - appears in those who inject the wrong dose of insulin or do not follow the diet. With a hypoglycemic coma, blood sugar reaches a mark of 2.5 mmol / L and lower.
- Lactic acidotic is a rare variation of diabetic coma. It appears against the background of anaerobic glycolysis, which leads to a change in lactate-pyruvate balance.
Harbingers of the disease
Signs of an insulin coma:
- Decreased glucose in the brain. Neuralgia, a variety of pathologies of behavior, convulsions, fainting appear. As a result, the patient is able to lose consciousness, and a coma ensues.
- The patient's sympathoadrenal system is agitated. There is an increase in fear and anxiety, a reduction in blood vessels, an acceleration of the heartbeat, a malfunction of the nervous system, pilomotor reflexes (muscle contractions that cause the reaction, popularly referred to as “goosebumps”), intense sweating.
Symptomatology
An insulin coma appears suddenly, but it has its own previous symptoms. With a slight decrease in the amount of glucose in the blood, the patient begins pain in the head, lack of appetite, fever.
With sugar crisis, the general weakness of the whole organism is traced. In addition, the heart is pulsating at an accelerated rate, sweating is intensifying, hands and the whole body are shaking.
It is not difficult to cope with this condition, you only need to eat a product with a high level of carbohydrates. Those patients who know about their own disease carry something sweet with them (refined sugar, sweets, much more). With the initial symptoms of insulin shock, it is necessary to use sweetness in order to normalize blood sugar.
With long - term insulin therapy, the degree of blood sugar decreases most strongly in the evening and at night. During this period, hypoglycemic shock is able to manifest itself . If such a condition appears in the patient during sleep, then you may not notice it for a sufficiently long period.
Key features
At the same time, the patient has a bad, shallow and anxious sleep, and often the person suffers from intolerable visions. When the disease is observed in children, they often cry and sob at night, and after waking up, the child does not remember what happened before the seizure, his consciousness is confused.
After sleep, patients have a complication of overall well-being. At this time, the degree of blood sugar increases significantly, this condition is called fast glycemia. During the day after the sugar crisis suffered at night, the patient is irritable, nervous, capricious, a state of apathy is manifested, there is a great weakness in the body.
Clinical symptoms
The patient has the following medical symptoms of an insulin coma of artificial (intentional) or natural nature:
- the skin becomes white and wet;
- heart palpitations;
- muscle activity increases.
At the same time, the eye pressure does not change, the tongue remains wet, breathing is continuous, but if the patient does not receive special help in a timely manner, then over time the breathing becomes shallow.
If the patient is in an insulin shock for a long period, then a state of hypotension is observed, the muscles lose activity, symptoms of bradycardia appear and body temperature decreases. It is getting lower than standard indicators.
In addition, there is a decrease or absolute loss of reflexes.
If the patient is not diagnosed on time and the required therapeutic care is not provided to him, then the situation can instantly change for the worse.
Convulsions may appear, an attack of nausea, vomiting begins, the patient becomes restless, and after some period he loses consciousness. However, these are not the only signs of a diabetic coma.
In a laboratory study of urine, sugar is not detected in it, and the reaction to the solvent, at the same time, can demonstrate both a favorable result and a negative one. It depends on at what level the compensation of carbohydrate metabolism occurs.
Signs of an insulin coma can be monitored in people who have long had diabetes, while the degree of sugar in the blood can be standard or increased. It is advisable to explain the sudden jumps in glycemic data, for example, from 6 mmol / L up to 17 mmol / L or in the reverse order.
Causes
Insulin coma often appears in patients with severe insulin dependence in diabetes mellitus.
The following conditions are capable of becoming a prerequisite for the appearance of such a condition:
- An unacceptable amount of insulin was injected into the patient.
- The hormone was injected not under the skin, but intramuscularly. This can happen if the syringe is with a long needle, or the patient wants to accelerate the effect of the drug.
- The patient experienced increased physical exertion, and then did not eat carbohydrate-rich foods.
- When the patient has not consumed food following the administration of the hormone.
- The patient took alcohol.
- A massage was carried out on the part of the body where the hormone was introduced.
- Pregnancy in the initial 2 months.
- The patient has kidney failure.
- The patient has fatty liver disease.
Sugar crisis and coma are often formed in patients when diabetes is formed with concomitant diseases of the liver, intestinal tract, kidneys, and endocrine system.
Often, an insulin coma occurs after the patient has taken salicylates or with the simultaneous administration of these medicines and sulfonamides.
Therapy
Treatment for insulin coma begins with an intravenous injection of glucose. Use 25-110 ml of a 40% solution. The dose is determined depending on how rapidly the patient's condition improves.
In severe cases, parenteral administration of glucagon or intramuscular injections of glucocorticoids can be used. In addition, subcutaneous injection of 2 ml of 0.1% adrenaline hydrochloride may be used.
If the swallowing reflex is not lost, the patient is allowed to inject glucose, or he should drink sweet tea.
If the patient lost consciousness, while the reaction of the pupils to the stimulation by light is not traced, there is no swallowing ability, the patient must drop glucose under his tongue. And in a period of unconsciousness, it can be absorbed from the oral cavity.
This must be done carefully so that the patient does not choke. Similar substances are produced in the form of a gel. It is allowed to use honey.
It is forbidden to use insulin in a state of insulin coma, since this hormone will only provoke a complication and significantly reduce the likelihood of a cure. The use of this tool in this kind of situation can cause death.
To avoid the untimely introduction of the hormone, manufacturers supply the syringe with a mechanical blocking mode.
First aid
For correct assistance, it is necessary to know the symptomatic manifestations that occur with an insulin coma. When these signs are established, first aid should be given to the patient immediately.
Sequencing:
- ambulance call;
- Before the arrival of doctors it is necessary to put the patient in a comfortable position;
- you need to give him something sweet: caramel, candy, drink or honey, jam or ice cream. If the patient is unconscious, place a piece of sugar on his cheek. When the patient is in a state of diabetic coma, sweets will not hurt.
An urgent visit to the hospital will be required in such situations:
- with a second injection of glucose, the patient does not regain consciousness, the amount of sugar in the blood does not increase in any way, the insulin shock does not stop;
- insulin coma is constantly repeated;
- when it was possible to overcome the insulin shock, but there is a deviation in the work of the heart, blood vessels, and nervous system, cerebral pathologies appeared that did not exist before.
A diabetic coma or hypoglycemic condition is a significant disorder that can lead to death for the patient. Thus, timely assistance and the implementation of a course of effective therapy are especially significant.
Prevention
In order not to bring the body to such difficult conditions as an insulin coma, elementary rules should be observed: constantly adhere to a diet, regularly monitor glucose levels, inject insulin on time.
Important! It is imperative to focus on the shelf life of insulin. Using expired is prohibited!
It is better to beware of stress and strong physical exertion. Various infectious diseases, when diagnosed, are treated immediately after the onset of the first symptoms.
Parents of a child with diabetes mellitus need to pay great attention to dieting. Often the baby secretly from his father and mother violates the diet. It is much better to first clarify all the results of this behavior.
Healthy people should from time to time monitor the degree of sugar in the blood, if you deviate from generally accepted norms, you should definitely contact an endocrinologist.
Risk group
The risk group includes patients with chronic diseases who underwent surgery, pregnant girls.
The risk of hyperglycemic coma is significantly higher in those who do not intend to adhere to the diet prescribed by the doctor or who do not deliberately reduce the dose of insulin administered. Drinking can also provoke a coma.
It was noted that hyperglycemic shock is extremely rare in patients of retirement age, as well as in those prone to overweight. More often this condition is detected in children (usually due to a sharp breakdown in the diet, which often even the father and mother do not know about) or patients at a young age and with a short term of illness. In almost 25% of patients with diabetes mellitus, signs of ancestor are observed.
Psychiatry
The use of insulin coma in psychiatry and the reviews of doctors and patients themselves about this are often positive. Despite the fact that it is a dangerous condition, the cure in this way brings its results. It is used only as a special measure.
Treatment of schizophrenia with an insulin coma is as follows. The patient is injected subcutaneously with the maximum amount of insulin for his body. This causes a condition that helps in the treatment of the disease.
The consequences of insulin coma in psychiatry are very different. As already mentioned, this condition is dangerous and can lead to death. 100 years ago it was. Due to lack of knowledge and equipment, doctors could not always save the patient. Today, everything is different, and for the removal of a patient from an artificially created state, physicians have their own methods and means.
Rehabilitation
In consequence of such serious complications as coma, great attention should be paid to the rehabilitation phase. When the patient leaves the hospital ward, it is necessary to organize all the conditions for his full recovery.
First, carry out all the doctor’s prescriptions. This applies to diet, lifestyle, and the need to refrain from unhealthy habits.
Secondly, to compensate for the deficiency of vitamins, micro and macro elements lost during the illness. Take vitamin complex complexes, show interest not only in quantity, however, and in the quality of food.
And the final one: do not give in, do not give up and strive to enjoy every day. Since diabetes is not a verdict, it is just part of life.