January 19, 2001
Complications
Question from Encinitas, California, USA:
Recently my middle aged uncle, who has type 1 diabetes, was found at his home unconscious. He was rushed to the hospital a week ago, has been in a diabetic coma ever since, and he also has kidney failure. I have a feeling that the doctors are not doing everything they can for my uncle. How long do diabetic comas usually last? Is there anything that can be done to help the doctors wake him from the coma? Is there anything other than dialysis that can be done for kidneys that have failed? I would greatly appreciate any answers or help you can give me.
Answer:
First, I am sorry to hear about your uncle. The term diabetic coma refers to a loss of consciousness, usually from a low blood sugar. The brain requires a constant source of glucose as its primary energy source. Without it, the brain malfunctions. When the glucose level is restored, consciousness usually resumes. When the blood sugars are low, patients can also have seizures or other neurologic problems or damage.
Diabetic coma can also occur when the blood sugars go very high. The high blood sugars cause the brain to loose its water content and it can also malfunction when this occurs. The problems of very low and very high blood sugars can occur in patients who have type 1 or type 2 diabetes.
I would think that the health care team taking care of your uncle would have been able to normalize the blood sugars within 24 hours. Therefore, I would ask them whether they think something else happened to his brain during the acute period of loss of consciousness that would explain his period of prolonged coma. When kidneys fail, you have to perform dialysis or kidney transplantation. There are really no other forms of treatment for chronic kidney failure.
You sound very interested in your uncle’s care. I would suggest you or the family spokesperson arrange a time to meet with the physicians taking care of him so that all the questions you and your family have can be answered to your satisfaction. This is a common practice for the care of patients and for communication with their families.
JTL
