A 47-year-old employee of a multinational company in the city suddenly started gasping for breath around 7am before collapsing earlier this month. A diabetic for the last eight years, he was rushed to the closest hospital where doctors found he was suffering from diabetic coma a result of either extremely high (hyperglycemia) or low (hypoglycemia) blood sugar level.
The man’s blood sugar level had reached 600 milligrams per decilitre (mg/dL). A fasting blood sugar level less than 100 mg/dL is normal.
Due to the coma, he was also experiencing an acute respiratory failure, a condition in which fluid leaks into the lungs, making breathing difficult or impossible.
He was minutes away from a complete respiratory arrest, his doctor said, adding that a delay in treatment could have been dangerous and fatal.
According to experts, diabetic coma is usually a result of poorly managed diabetes, especially Type 1 diabetes, and symptoms include fatigue, weakness, shortage of breath, nausea, difficulty speaking and sweating. Lapsing into a diabetic coma means the patient is alive but can’t awaken or respond to stimulation.
“The man had stopped taking his insulin which would have caused the hyperglycemia, ultimately resulting in a coma,” said endocrinologist Dr Abhay Ahluwalia, who treated him at Columbia Asia Hospital in Palam Vihar.
He added that it took restoring the fluids by giving a controlled quantity to treat the patient who got out of the coma in four days.
However, doctors said one may be able to prevent complications like these by watching the amount and types of food one eats, exercising and taking the necessary medications.
According to doctors, elderly people are most likely to develop hyperglycemia. However, it can also happen when a diabetic person is sick.
“When the blood glucose level starts to climb, the body tries to get rid of all the excess glucose through frequent urination. That dehydrates the body. Adequate fluid is required,” said Dr Ahulwalia, adding that keeping your blood sugar level in a healthy range can avoid eye, kidney and nerve diseases.
India recorded 72 million cases of diabetes in 2017, according to the Indian Council of Medical Research (ICMR), which is 49% of the world’s burden.
Currently, one in every four people under 25 has adult-onset diabetes, a condition more usually seen in 40-50 year old, according to the ICMR youth diabetes registry.
Experts said the disease could be managed easily by taking a few steps and precautions. “Good daily control of diabetes can prevent a diabetic coma. Firstly, keep an eye on your blood sugar levels. Take your medications as directed,” said Dr Atul Luthra, endocrinologist, Fortis Hospital.
He added that planning with the doctor about how to manage your blood sugar levels in case of illness is recommended.
Avoiding diabetes in the first places requires cutting down on sugar and refined carbs in the diet of a high-risk person.
Performing physical activity on a regular basis, quitting smoking and increasing Vitamin D intake may help prevent diabetes, said experts.