People with diabetes mellitus have abnormal glucose regulation, which leads to elevated blood sugar levels. Medication, restricted intake of dietary carbohydrates and exercise help control blood sugar levels. In certain circumstances, however, the blood glucose concentration rises or falls to an extreme level, causing potentially life-threatening metabolic abnormalities and seizures. Rapid diagnosis of the underlying cause of a diabetic seizure proves critically important, enabling health care personnel to begin the appropriate emergency treatments.
Brain Swelling Associated with Diabetic Ketoacidosis
The body utilizes sugar, or glucose, to generate energy. Glucose from the bloodstream can enter the body cells only if insulin enables its entry. People with type 1 diabetes mellitus have little or no insulin. This causes excessive amounts of glucose to build in the bloodstream while the body cells remain starved for sugar. Without glucose to use for fuel, the body cells resort to burning fats and proteins for energy, explains the medical reference text "Harrison's Principles of Internal Medicine." The breakdown of fats leads to an accumulation of acidic byproducts known as ketones. This constellation of metabolic disturbances--abnormally acidic blood in the presence of elevated blood glucose and ketone levels--is called diabetic ketoacidosis.
Although seizures do not occur in most people with diabetic ketoacidosis, some patients with the condition--especially young children--develop brain swelling, reports Seattle Children's Hospital. Patients with this life-threatening complication of diabetic ketoacidosis often experience seizures. The development of brain swelling and seizures associated with diabetic ketoacidosis is an ominous sign. Emergency treatment of brain swelling proves necessary to save the patient's life.
Nonketotic Hyperosmolar Syndrome
Nonketotic hyperosmolar syndrome is another metabolic complication of diabetes mellitus. Unlike diabetic ketoacidosis--which rarely affects type 2 diabetics--nonketotic hyperosmolar syndrome occurs almost exclusively in patients with type 2 diabetes. A markedly elevated blood sugar and profound dehydration characterize the syndrome. The absence of ketones and acidic blood prove distinguishing features of nonketotic hyperosmolar syndrome, compared to diabetic ketoacidosis.
Patients with nonketotic hyperosmolar syndrome typically experience an altered mental state, which may present as drowsiness, confusion, disorientation or hallucinations. Seizures commonly occur with nonketotic hyperosmolar syndrome. Up to 40 percent of patients with nonketotic hyperosmolar syndrome die of the condition, reports The Merck Manuals Online Medical Library.
Low Blood Sugar
Diabetics taking insulin and certain types of oral diabetes medicines may occasionally develop low blood sugar, or hypoglycemia. Because the brain functions poorly without adequate glucose, nervous system-related symptoms feature prominently in hypoglycemia. Possible symptoms include headache, confusion, irritability, moodiness, poor concentration, slurred speech, dizziness and blurred vision. Seizures frequently develop in patients with a markedly low blood sugar, reports the National Institute of Diabetes and Digestive and Kidney Diseases. Coma and death may follow without emergency treatment.
References
- "Harrison's Principles of Internal Medicine, 16th Edition"; Dr. Dennis L. Kasper et al., Editors; 2004
- Seattle Children's Hospital: Guideline of Care, Diabetes Ketoacidosis
- The Merck ManualsOnline Medical Library: Nonketotic Hyperosmolar Syndrome
- National Institute of Diabetes and Digestive and Kidney Diseases: Hypoglycemia
- Endotext.org: Hyperglycemic Crises in Patients with Diabetes: Diabetic Ketoacidosis (DKA), and Hyperglycemic Hyperosmolar State (HHS)
