68 CARE OF PATIENT IN DIAGNOSTIC RADIOGRAPHY

morning's list for examination and the radiographer is responsible for

ensuring that he in fact receives attention quickly. The diet kitchen should
be warned in advance and will provide him with a suitable meal before
he leaves the hospital. Alternatively the patient may if he wishes bring his
own food with him and on completion of the X-ray examination should
for eating his meal, away from other
be allowed appropriate facilities
patients and general departmental traffic.
However, the great majority of sufferers are on insulin treatment. These
should be clearly warned that, as breakfast has to be omitted prior to the
X-ray examination, it is most important that the insulin is not taken either.
These patients too should be placed first on the morning's list for examina
tion. Similar arrangements should be made to provide them with a meal
and they must at the same time receive their normal injection of insulin.
The co-operation of the sister in charge of the out-patient department
will ensure that this is done. In general diabetics are well informed and
thoroughly alive to their dangers: in these circumstances many will be
discovered to have come to the X-ray department already equipped with
their own supplies of insulin for injection and food.

Diabetic and Insulin Coma

Two forms of unconsciousness are associated with diabetes :

Diabetic Coma.
(ii) (i)

Insulin Coma.

The first occurs in in whom the disease untreated or from

is

subject
a

whom the correct dose of insulin has been for some reason withheld.

It
due, as has been explained already, to the accumulation in the blood of
is

aceto-acetic acids through faulty combustion of fats. of slow onset,

It
is

taking as rule matter of days to develop.

a

Insulin coma, on the other hand, may occur in patient who has
a

received too much insulin. This may be because the dose has been wrongly
given, or equally may arise in patient who has taken the correct
it

amount of insulin but has not eaten food, so that he has little sugar on
which the insulin can work. His blood sugar falls to an abnormally low
level (hypoglycaemia) and unconsciousness results. of rapid onset and
It
is

may develop within an hour of the patient's arrival at the hospital.

Should diabetic subject become unconscious while in the X-ray
a

department may be of importance that the radiographer able to

it

is

recognize each type of coma. Rapidity of onset significant point:

is

a
a

diabetic patient, apparently normal on arrival, who subsequently becomes