Diabetic coma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Diabetic coma
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Unconsciousness, confusion, dehydration, rapid breathing, fruity breath odor
Complications	Brain damage, death
Onset	Sudden
Duration	Variable
Types	Diabetic ketoacidosis, Hyperosmolar hyperglycemic state, Hypoglycemia
Causes	Diabetes mellitus
Risks	Poorly controlled blood sugar, infection, stress, alcohol consumption
Diagnosis	Blood glucose test, urinalysis, arterial blood gas
Differential diagnosis	Stroke, seizure, drug overdose
Prevention	Proper diabetes management, regular blood sugar monitoring
Treatment	Intravenous fluids, insulin therapy, electrolyte replacement
Medication	N/A
Prognosis	Variable, depends on promptness of treatment
Frequency	Common in poorly controlled diabetes
Deaths	N/A

A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. If left untreated, a diabetic coma can be fatal.

Causes

A diabetic coma can occur in people with both type 1 diabetes and type 2 diabetes. The main causes include:

• Severe hypoglycemia: This occurs when blood sugar levels drop too low, often due to excessive insulin administration, insufficient food intake, or excessive physical activity.
• Diabetic ketoacidosis (DKA): This is more common in type 1 diabetes and occurs when the body starts breaking down fats at an excessive rate, leading to the accumulation of ketones in the blood.
• Hyperosmolar hyperglycemic state (HHS): This is more common in type 2 diabetes and is characterized by extremely high blood sugar levels without the presence of ketones.

Symptoms

The symptoms leading up to a diabetic coma vary depending on whether the blood sugar is too high or too low.

Symptoms of Hyperglycemia

• Increased thirst
• Frequent urination
• Fatigue
• Nausea and vomiting
• Shortness of breath
• Stomach pain
• Fruity-scented breath

Symptoms of Hypoglycemia

• Shakiness
• Sweating
• Hunger
• Irritability
• Confusion
• Dizziness
• Weakness

Diagnosis

Diagnosis of a diabetic coma involves:

• Checking blood sugar levels
• Testing for ketones in the blood or urine
• Assessing the patient's medical history and symptoms

Treatment

The treatment for a diabetic coma depends on whether the cause is hyperglycemia or hypoglycemia.

Treatment for Hyperglycemia

• Intravenous fluids to restore hydration
• Insulin therapy to lower blood sugar levels
• Electrolyte replacement

Treatment for Hypoglycemia

• Administration of glucose, either orally or intravenously
• Glucagon injection if the patient is unable to take glucose orally

Prevention

Preventing a diabetic coma involves careful management of diabetes:

• Regular monitoring of blood sugar levels
• Adhering to a diabetes management plan
• Recognizing early symptoms of high or low blood sugar
• Educating family and friends about diabetes emergencies

See also

• Diabetes mellitus
• Type 1 diabetes
• Type 2 diabetes
• Diabetic ketoacidosis
• Hyperosmolar hyperglycemic state