Insulin shock is considered a negative consequence of hypoglycemia, in which the degree of glucose in the blood decreases and there is an increase in the hormone insulin produced by the pancreas. Once upon a time, in severe cases of schizophrenia, no other method of treatment was known, except for the patient to fall 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 state, but how to get him out of it?
What is this?
Insulin coma is such a reaction of the body or a condition that occurs as a result of a decrease in blood glucose levels over a long period of time. It is also 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 releasea significant number of ketones that appear in the body due to the processing of fatty acids. Due to the high concentration of these elements, a person plunges into a ketoacidotic coma.
- Hyperosmolar - develops in people suffering from type 2 diabetes. Due to significant dehydration of the body. The degree of glucose in the blood is able to reach 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 rules of nutrition. With hypoglycemic coma, blood sugar reaches the mark of 2.5 mmol / l and below.
- Lactate acidosis is a rare variation of diabetic coma. It appears against the background of anaerobic glycolysis, which leads to a change in the lactate-pyruvate balance.
Harbingers of disease
Signs of insulin coma:
- Decrease in the volume of glucose in the brain. Appear neuralgia, various pathologies of behavior, convulsions, fainting. As a result, the patient is able to lose consciousness, and a coma sets in.
- The patient's sympathoadrenal system is excited. There is an increase in fear and anxiety, there is a contraction of blood vessels, an acceleration of the heartbeat, there is a malfunction in the nervous system, pilomotor reflexes (muscle contractions that cause a reaction called “goosebumps” in the people), intense sweating.
Symptomatics
Insulin coma appears suddenly, but it has its own antecedent symptoms. With a slight reductionthe amount of glucose in the patient's blood begins to pain in the head, lack of appetite, fever.
With a sugar crisis, there is a general weakness of the whole organism. In addition, the heart pulsates rapidly, sweating increases, hands and the whole body are shaking.
This condition is easy to deal with, you just 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, and much more). With the initial symptoms of insulin shock, sweets should be consumed in order to normalize blood sugar.
With long-acting insulin therapy, blood sugar decreases the most in the evening and at night. During this period, hypoglycemic shock can occur. If such a condition occurs in a patient during sleep, then it may not be noticed for a sufficiently long period.
Key Features
At the same moment, the patient has a bad, shallow and disturbing sleep, and often the little man suffers from unbearable 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 mind is confused.
After sleep, patients have a complication of general well-being. At this time, the degree of sugar in the blood increases significantly, this condition is called rapid glycemia. During the day after a night-time sugar crisis, the patient is irritable, nervous, capricious,a state of apathy appears, a great weakness in the body is felt.
Clinical symptoms
The patient has the following medical symptoms of an insulin coma of artificial (intentional) or natural occurrence:
- skin becomes white and wet;
- heartbeat quickens;
- increased muscle activity.
At the same time, eye pressure does not change, the tongue remains wet, breathing is continuous, but if the patient is not provided with special assistance in time, then breathing becomes shallow over time.
If the patient is in insulin shock for a long period, then there is a state of hypotension, muscles lose activity, symptoms of bradycardia appear and body temperature decreases. She is falling below the standard.
In addition, there is a decrease or absolute loss of reflexes.
If the patient is not diagnosed in time and he is not provided with the required therapeutic assistance, then the situation can instantly change for the worse.
Convulsions may appear, an attack of nausea begins, vomiting, the patient becomes restless, and after a while 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 whichlevel, carbohydrate metabolism is compensated.
Signs of insulin coma can be observed in those people who have been suffering from diabetes for a long time, while the degree of sugar in the blood can be standard or increased. It is advisable to explain this by sudden jumps in glycemic data, for example, from 6 mmol / l up to 17 mmol / l or vice versa.
Reasons
Insulin coma often occurs in patients with severe insulin dependence in diabetes mellitus.
The following conditions can become a prerequisite for the appearance of such a state:
- The patient was injected with an unacceptable amount of insulin.
- The hormone was injected not under the skin, but intramuscularly. This can happen if the syringe has a long needle, or if the patient wants to speed up the effect of the drug.
- Patient experienced strenuous physical activity and then did not eat carbohydrate rich food.
- When the patient did not eat after hormone administration.
- The patient took alcohol.
- The part of the body where the hormone was injected was massaged.
- 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, endocrine system.
Often, insulin coma occurs after the patient has taken salicylates or whensynchronous intake of these medications 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 predetermined depending on how rapidly the patient's condition improves.
In severe cases, parenteral glucagon or intramuscular injections of glucocorticoids may be used. In addition, subcutaneous injection of 2 ml of 0.1% epinephrine 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 has lost consciousness, with no pupillary reaction to light stimulation, no swallowing ability, the patient needs to drip glucose under the tongue. And during the 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. Honey is also allowed.
It is forbidden to introduce insulin in a state of insulin coma, as this hormone will only provoke a complication and significantly reduce the likelihood of a cure. The use of this remedy in this kind of situation can be fatal.
In order to avoid untimely introduction of the hormone, manufacturers supply the syringe with a mechanical blocking mode.
First aid
For proper assistance, you need to know the symptomatic manifestations that arewith insulin coma. When real signs are established, first aid should be given to the patient immediately.
Sequence of actions:
- call an ambulance;
- before the doctors arrive, 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 behind his cheek. When a patient is in a diabetic coma, sweets can't hurt.
An urgent hospital visit will be required in the following situations:
- with a secondary 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 keeps recurring;
- when it was possible to overcome insulin shock, but there is a deviation in the work of the heart, blood vessels, nervous system, cerebral pathologies appeared that were not there before.
Diabetic coma or hypoglycemic condition is a significant disorder that can be fatal 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 severe conditions as an insulin coma, you should follow the basic rules: constantly adhere to a diet, regularly monitor glucose levels, inject insulin on time.
Important! It is essential to focus onexpiration date of insulin. Expired items are prohibited!
Better to beware of stress and strong physical exertion. Various infectious diseases, when diagnosed, are treated immediately after the first symptoms appear.
Parents of a child diagnosed with diabetes should pay great attention to diet. Often the baby secretly from the father and mother violates the norms of nutrition. It is much better to explain all the results of this behavior beforehand.
He althy people should from time to time control the degree of sugar in the blood, in case of deviations from generally accepted norms, be sure to contact an endocrinologist.
Risk group
The risk group includes patients with chronic diseases, undergoing surgery, pregnant girls.
The risk of developing a hyperglycemic coma is significantly overestimated in those who intend not to adhere to the diet prescribed by the doctor or who do not deliberately reduce the dose of insulin administered. Drinking alcohol can also provoke a coma.
It is noted that hyperglycemic shock is extremely rare in patients of retirement age, as well as in those predisposed to overweight. More often this condition is detected in children (as a rule, 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 duration of illness. Almost 25% of diabetic patients show signs of ancestral coma.
Psychiatry
Use of insulin coma in psychiatry and feedback from doctors and patients about itmore often positive. Despite the fact that it is a dangerous condition, curing in this way brings results. It is used only as a special measure.
Treatment of schizophrenia by insulin coma is carried out 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 be fatal. It was like that 100 years ago. Due to the lack of knowledge and equipment, doctors could not always save the patient. Today, everything is different, and doctors have their own methods and means to remove a patient from an artificially created state.
Rehab
In the aftermath of such serious complications as coma, great attention should be paid to the rehabilitation stage. When the patient leaves the hospital room, it is necessary to organize all the conditions for his full recovery.
First, carry out all the doctor's orders. This applies to diet, lifestyle, and the need to refrain from unhe althy habits.
Secondly, to compensate for the deficiency of vitamins, micro- and macroelements lost during the period of illness. Take complex vitamin complexes, show interest not only in the quantity, but also in the quality of food.
And finally: do not give up, do not give up and strive to enjoy every day. Since diabetes is not a verdict, but simply a part of life.
