Hyper- and Hypoglycemic Coma among Diabetic Patients in Arar, Northern Saudi Arabia

Abstract

Background: Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified; Severe low blood sugar in a diabetic person, diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock and exhaustion, hyperosmolar non ketotic coma (usually type 2) in which an extremely high blood sugar level and dehydration alone are sufficient to cause unconsciousness. The aim of this study was to determine the prevalence of diabetic coma among the studied diabetic patients and to illustrate the relationship between type of diabetic coma and type of DM, period of diabetes and place of management of coma. Methods: A cross-sectional study was carried out on 113 diabetic patients (both type I and II DM) in Arar city, Northern Saudi Arabia, KSA, during the period from 1 December to 30 June 2017. Data collected by a pre-designed online self-administered questionnaire. Results: The mean age of participants was 35.62 (±21.62) years and 67.3% were females. The prevalence of diabetic coma among the studied diabetic patients was 57.5% and the type of coma was hypoglycemic in 70.7% and hyperglycemic in 29.3%. 42.1% of hyperglycemic coma patients had type I diabetes and 57.9% had type II. While, 50% of hypoglycemic coma patients had type I diabetes. On the hand, 21.1% of hyperglycemic coma patients treated in the emergency department, 10.5% admitted to the hospital and 68.4% treated at home. While 34.8% of hypoglycemic coma patients treated in the emergency department, 6.5% admitted to the hospital and 58.7% treated at home. There was no significant relation between type of DM and type of diabetic coma (P= 0.562) or between period of diabetes and type of diabetic coma (P= 0.060). Conclusion: The prevalence of diabetic coma among the studied diabetic patients was 57.5% and the type of coma was hypoglycemic in 70.7% and hyperglycemic in 29.3%. We recommend to spread awareness of the diabetic patients about causes and manifestations of diabetic coma to guard against it. Also we recommend a large scale and more detailed researches.