Diabetic shock–Causes, symptoms and treatment
This type of shock results from extreme fluctuations of blood sugar and consequently hypoglycaemia (low blood sugar) in diabetic patients. Diabetic shock occurs due to failure of regulation of blood sugars.
Normally, insulin produced by the pancreas helps regulate the blood sugar. If this insulin is inadequate or is not being utilised, insulin or diabetic drugs are required from an external source.
Symptoms and signs of diabetic shock
The symptoms and signs are due to hypoglycaemia.
Weakness, lack of energy, fatigue
Diagnosis of diabetic shock
This is a very serious medical problem and the patient may go into a diabetic comaand fatalities are high so it must be diagnosed and treated immediately.
Treatment of diabetic shock
The patient should be stabilisedand blood sugars should be controlled with insulin in intensive care unit.
This is a broad term and encompasses coma due to malfunctions with important hormones like thyroid and corticosteroids (steroids made in the body by the adrenal glands situated above kidneys). Medical conditions that cause it are hypothyroidism, thyrotoxicosis (both lead to cardiogenic shock) and acute adrenal insufficiency due to sudden withdrawal of steroids without tapering the dose among others.
This is an extreme emotional reaction to an unfavourable event or outcome. It is commonly seen in psychiatric patients with a history of depression, bipolar disorder or schizophrenia.
Symptoms and signs ofpsychogenic coma: The person may show extremes of behaviour, may refuse to eat or communicate with family and friends and may withdraw into a shell.
Diagnosis: The patient’s doctor or healthcare workers or family may notice that something is wrong and seek medical attention. If the person refuses to eat for days, he will have to have a stomach tube or intravenous fluids to get nutrition and energy.
This is due to something outside the heart which puts pressure on the heart for e.g. cardiac tamponade occurs when fluid builds up in the pericardium which does not allowheart to beat properly.
Constrictive pericarditis - Here the lining covering the heart (pericardium) gets inflamed causing perocarditis and this causes the heart to function improperly.
Tension pneumothorax - In this condition, increased pressure inside the chest cavity or thorax blocks the impure blood from reaching the heart.
Aortic stenosis - Narrowing of the aortic valve which opens to allow pure blood to flow from the heart to the different organs causesbackpressure on the heart muscles.
Pulmonary embolism - A clot which finds its way to the blood vessels of the lungs can also cause obstructive shock.
Diagnosis of obstructive shock
Almost all the above conditions are medical emergencies and should be handled by experienced and trained specialists.
Treatment of obstructive shock
The factor causing the obstruction should be treated for e.g if there is fluid outside the heart it should be aspirated by a wide bore needle and tension pneumothorax should be surgically treated.
This concludes our series on different types of shock.
Photograph via sxc.hu
Written by Dr Nisreen Nakhoda, General Physician
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