Difference Between Diabetic Coma and Insulin Shock

Diabetes is a chronic condition that affects millions of people around the world. It is caused by the body's inability to produce or use insulin effectively, which leads to high levels of glucose in the blood. The consequences of this can be severe, and in some cases, even life-threatening. Two of the most serious complications of diabetes are diabetic coma and insulin shock. While these conditions may seem similar at first glance, there are some significant differences between them.

What is Diabetic Coma?

Diabetic coma, also known as hyperosmolar hyperglycemic nonketotic syndrome (HHNS), is a condition that occurs when blood sugar levels become extremely high. This can happen when someone with diabetes does not take their insulin as directed, or when they are under a significant amount of stress. When blood sugar levels get too high, the body responds by trying to flush out the excess glucose through the urine. This process can lead to severe dehydration, which can cause a person to slip into a coma.

The symptoms of diabetic coma are similar to those of other types of comas. A person may become unresponsive, and their breathing may slow or stop altogether. They may also have a rapid heartbeat, low blood pressure, and fever. In severe cases, they may experience seizures or go into a state of shock.

Causes of diabetic coma include diabetic ketoacidosis, diabetic hyperosmolar syndrome, and hypoglycemia.

Diabetic ketoacidosis is a serious condition in people who suffer from diabetes. When the body does not have enough insulin, it breaks down fatty deposits. In this process, fatty acids form ketones, leading to different complications, including diabetic coma.

Diabetic hyperosmolar syndrome occurs when blood sugar levels are above 600 mg/dL. When blood sugar reaches this concentration the blood becomes syrupy and thick. The excess sugar is excreted from the body with the urine, which leads to withdrawal of fluids from the body and causes dehydration and unconsciousness.

In the case of diabetic coma, emergency medical help is needed. The treatment depends on the cause of the diabetic coma. In the case of hyperglycemia, the treatment includes sodium, potassium, and fluids, to treat dehydration, and insulin to reduce the blood sugar levels. In the case of hypoglycemia, the treatment includes dextrose or glucagon injection to increase the blood sugar levels.

In order to prevent diabetic coma, it is necessary to −

• Monitor the blood sugar levels;

• Be aware of the early signs of diabetic coma;

• Take medications as prescribed;

• Always have glucose tablets or candies on hand, for when blood sugar drops;

• Check for ketones when blood sugar is high;

• Minimize alcohol consumption;

• Inform friends and family members how to identify the signs of diabetic coma and how to react;

• Wear a medical ID bracelet.

• Regularly visit a doctor.

What is Insulin Shock?

Insulin shock is the response of the body to a decrease in the blood sugar level (hypoglycemia), caused by too much insulin.

The most common symptoms of insulin shock include −

• Feeling nervous, anxious, shaky, dizzy, irritable, confused;

• Feeling sleepy or clumsy;

• Heart palpitations;

• Weakness;

• Headache;

• Impaired or blurred vision;

• Sweating, chills, and clamminess;

• Numbness or tingling in the cheeks, lips or tongue;

• Nausea, etc.

Symptoms of insulin shock occur when the blood sugar levels are below 70 mg/dL. The low blood sugar level triggers the body to release adrenaline, which causes the early symptoms of insulin shock.

It is necessary to slowly and carefully raise the blood sugar level. The sugar levels can be increased by taking glucose tablets or small amounts of carbohydrates via food and beverages (for example 100 ml of regular, non-diet soda, a cup of milk or a tablespoon of honey or sugar).

Differences: Diabetic Coma and Insulin Shock

One of the key differences between diabetic coma and insulin shock is the cause of the condition. Diabetic coma is caused by high blood sugar levels, while insulin shock is caused by low blood sugar levels. The symptoms of each condition are also slightly different, with diabetic coma often leading to dehydration and insulin shock often causing overstimulation of the sympathetic nervous system.

Treatment for diabetic coma and insulin shock also differs. In both cases, it is essential to seek medical attention immediately. In the case of diabetic coma, treatment typically involves rehydration and the administration of insulin to bring blood sugar levels back down to a safe range. In the case of insulin shock, treatment may involve administering glucose orally or intravenously to raise blood sugar levels quickly.

The following table highlights the major differences between Diabetic Coma and Insulin Shock −

Characteristics	Diabetic Coma	Insulin Shock
Definition	Diabetic coma is a state of unconsciousness resulting from critically high or critically low blood sugar levels in people with diabetes.	Insulin shock is the response of the body to a decrease in the blood sugar level, caused by too much insulin.
Symptoms	When a person is in a diabetic coma he/she does not respond to acoustic, visual, and other types of stimulation of the senses. Prior to a diabetic coma, the patient may experience various symptoms depending on the blood sugar levels. In the case of hypoglycemia, the symptoms include anxiety, fatigue, weakness, hunger, nausea, dizziness, confusion, sweating, etc. In the case of hyperglycemia,the symptoms include frequent urination, increased thirst, dry mouth, shortness of breath, fruity breath odor, nausea, fatigue, rapid heartbeat, etc.	The most common symptoms of insulin shock include feeling nervous, anxious, shaky, dizzy, irritable, confused, sleepy or clumsy; heart palpitations, weakness, headache, impaired or blurred vision, sweating, chills, clamminess, numbness or tingling in the cheeks, lips or tongue, nausea, etc.
Etiology	Causes of diabetic coma include diabetic ketoacidosis, diabetic hyperosmolar syndrome, and hypoglycemia.	Insulin shock occurs when the blood sugar levels are below 70 mg/dL.
Treatment	In diabetic coma, the treatment depends on its cause. In the case of hyperglycemia, the treatment includes sodium, potassium, fluids, and insulin. In the case of hypoglycemia, the treatment includes dextrose or glucagon injection to increase the blood sugar levels.	The insulin shock can be treated by taking glucose tablets or small amounts of carbohydrates via food and beverages (non-diet soda, milk, honey, etc.), injectable glucagon.
Prevention	In order to prevent diabetic coma it is necessary to monitor the blood sugar levels, be aware of the early signs of diabetic coma, take medications as prescribed, always have glucose tablets or candies on hand, check for ketones when blood sugar is high, minimize alcohol consumption, inform friends and family members how to identify the signs of a diabetic coma and how to react, wear a medical ID bracelet, regularly visit a doctor.	In order to prevent insulin shock it is necessary to monitor the blood sugar levels, be aware of the early signs of insulin shock, take medication as prescribed, consume smaller meals throughout the day, always have glucose tablets or candies on hand, inform friends and family members how to identify the signs of insulin shock and how to react, wear a medical ID bracelet, regularly visit a doctor.

Conclusion

In conclusion, diabetic coma and insulin shock are two serious complications of diabetes that can have life-threatening consequences. While they may seem similar at first glance, there are significant differences between the two conditions, including their causes, symptoms, and treatment. It is essential for people with diabetes to monitor their blood sugar levels carefully and seek medical attention if they experience any symptoms of either condition.

With proper care and management, most people with diabetes can lead healthy, active lives and avoid the serious complications associated with the condition.