Consequences of diabetic coma
The severe fluid deficiency can lead to low blood pressure and a volume deficiency shock. This lack of volume shock can affect kidney function: The volume of urine drops significantly or urine production stops completely as a result of acute kidney failure. Electrolyte disorders are to be expected due to the shifts in the body’s water balance.
For example, if the potassium level is not in the right range, cardiac arrhythmia is the result. The ketoacidotic coma, which is more likely to occur in young patients, can often be confused with appendicitis when abdominal pain (pseudoperitionitis diabetica, see above) occurs at the same time. The consequence is an operation on the appendix, which would actually not have been necessary and which causes all the typical complications of an operation (scarring, infection, etc.).
The treatment of diabetic coma can also cause consequential damage: If during the treatment of diabetic coma the blood sugar level is lowered too quickly by infusions (i.e. dilution by too much intravenous fluid), there is a risk of brain edema. The excess fluid is deposited in the brain substance, which leads to headaches, dizziness, nausea and vomiting. Vision and consciousness disorders are also possible. In the worst case, brain edema can lead to constriction of the brain stem and brain death. About one third of patients with brain edema suffer permanent neurological damage.
Probability of survival of diabetic coma
The mortality rate in diabetic coma is high. In a ketoacidotic coma, the mortality rate is between one and ten percent, i.e. the survival rate is over 90 percent. In hyperosmolar comas, the mortality rate is significantly higher at 40 to 60 percent, as these patients are usually older and therefore have a worse prognosis. The prognosis of diabetic coma also depends on how long the patient was in this state and how severe the metabolic derailment was.
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