Diabetic patient may also suffer from coma when the concentration of blood glucose level drops much below the normal level which is called hypoglycemia. But coma due to hypoglycemia (low blood glucose level) occurs rapid and sudden where as coma due to hyperglycemia (excessive blood glucose level) is a slow process. The symptoms of this condition are excessive thirst; dryness of mouth, patient feels very tired and weak, headache, nausea, vomiting, profuse urination, etc.

FIRST AID FOR COMA PATIENTS-
Like every first aid normally the first aid for coma patient is also called as ABC.
A-AIRWAY- The victim’s airway should be tried to open
B-BREATHING- Care should be taken for the patient so that he gets enough oxygen for breathing.
C-CIRCULATION- Stands for maintaining blood circulation. And if the person gets injury on head the bleeding should be tried to stop.
If the person is showing signs of going into coma then he/she should be made to sleep on any one side. The patient should not be forced to drink water, this may be dangerous.

If their is any head injury then care should be taken to avoid movement of head. If coma occurs because of deficiency of potassium then patient should be given coconut water to drink.

FEW RISK FACTORS- Due to sudden withdrawal of alcohol consumption the withdrawal symptoms seen in persons are also at risk of coma. Sometimes FITS (Hypoxia) which occurs because of alcohol consumption also lead to coma. Because of alcohol drinking their may be deficiency of vitamins mainly thiamine, because of this also coma may occur. Such condition is called venix ecnopati.
Treatment for such patients include administration of thiamine, they will easily walk off from the hospital by walking on their own legs.

In villages and small towns some people who go for swimming or for any other thing in old wells, small ponds may suffer from serious health disorders. This is because in old wells and ponds there may be increase concentration of carbondioxide and other toxic gases. These gases will disturb the inhalation of oxygen and carbondioxide may mix up with oxygen and reaches brain through lungs and may result in coma. Such condition is also seen in cities especially among workers who clean man holes.

GLASGOW COMA SCALE- It is the scale which is used to determine the intensity of coma. If the patient doesn’t show any response to the stimuli of doctor then it is set at 3 which is a complete coma stage, and as the condition or response of the patient gets improving the meter of the scale is increased. For example if movement is seen in eyes then the meter reading is increased. Like wise it is done till the reading is achieved till 15 which occur when the patient comes completely out of unconsciousness.

Following are the conditions in which the patient appears to be in coma but in reality that condition is not called coma.

SECOGENIC COMA- Patient looks like a coma patient but he is not.
AKINATE MUSEUM- This is also a similar condition like coma occurs because of mental disorders.
LOCKED IN STATE- The patient looks like not breathing but he can understand everything and is mentally active but due to paralysis of muscles he cannot move his eyes, hands, he cannot speak or cannot respond to any stimuli. It mainly occurs due to injury to the brainstem.
VEGETATIVE STATE- If you are an Indian and interested in movies then you must have seen “Munna Bhai MBBS”- the patient in the movie is of this state. Patient looks like watching us but our speech of words or communication won’t reach him.

COMA due to DIABETES- Those who suffer from low sugar level are at high risk of come. Normally because of Doctor’s advice diabetic patients take medicines regularly on time but problem arises when those medicines are taken without meals and because of that the sugar level falls below 100-140mg/dl to as low as 30-20 making the patient at high risk of coma. In such conditions the patient should be given chocolates or any other sugar substances to bring the sugar level to normal.
Diabetic coma is of 2 more types which occur sometimes because of improper usage of medicines or because of lack of treatment to diabetes.
HYPEROSMOLAR COMA- If the sugar level rises above 500mg/dl then there is risk of coma.
KETOACIDOTIC COMA- It occurs due to increase in number of waste and toxic products in the human body.
In both these cases insulin should be administered to the affected patient to bring back the effected patient to conscious state.
HYPONITRIC COMA- In our body there are many minerals like sodium, potassium, calcium, magnesium. The normal level of sodium in our body is 140-150 milliEquivalents/lite (mEq/L), and if it goes below 110 then there is risk of coma. Those who are blood pressure patients are at risk of this. Reason to maintain blood pressure Doctor’s advise to decrease the intake of salt consumption and some patients avoid salt intake fully. And these patients sodium level may fall below 110mEq/L and may result in coma.

HYPERNITRIC COMA- It occurs because of increase in the sodium level.

FIBRIAL COMA- Severe fever may result in coma.

CARBONDIOXIDE NARCOSIS- In bronchitis patient’s carbondioxide may get deposit in lungs and this carbondioxide from lungs may reach brain. Such patients are at risk of coma.

COMA DUE TO ALCOHOL- There are many reasons for coma due to alcohol consumption. Too much consumption of alcohol may result in brain damage. Sometimes because of alcohol intake the person may go unconscious and he may fell on his head resulting in head injury which may result in blood clot leading to coma.
Thiamine deficiency may also lead to coma.