Diabetic coma is a life-threatening diabetes complication. Learn about its causes, treatment and prevention.
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 you lapse into a diabetic coma, you're alive — but you can't awaken or respond purposefully to sights, sounds or other types of stimulation. Left untreated, a diabetic coma can be fatal.
The idea of a diabetic coma is scary, but you can take steps to help prevent it. Start by following your diabetes treatment plan.
Before developing a diabetic coma, you'll usually experience signs and symptoms of high blood sugar or low blood sugar.
If your blood sugar level is too high, you may experience:
Signs and symptoms of a low blood sugar level may include:
Some people, especially those who've had diabetes for a long time, develop a condition known as hypoglycemia unawareness and won't have the warning signs that signal a drop in blood sugar.
If you experience any symptoms of high or low blood sugar, test your blood sugar and follow your diabetes treatment plan based on the test results. If you don't start to feel better quickly, or you start to feel worse, call for emergency help.
A diabetic coma is a medical emergency. If you feel extreme high or low blood sugar signs or symptoms and think you might pass out, call 911 or your local emergency number. If you're with someone with diabetes who has passed out, call for emergency help, and be sure to let the emergency personnel know that the unconscious person has diabetes.
Blood sugar that's either too high or too low for too long may cause various serious conditions, all of which can lead to a diabetic coma.
Diabetic ketoacidosis. If your muscle cells become starved for energy, your body may respond by breaking down fat stores. This process forms toxic acids known as ketones. If you have ketones (measured in blood or urine) and high blood sugar, the condition is called diabetic ketoacidosis. Left untreated, it can lead to a diabetic coma.
Diabetic ketoacidosis is most common in type 1 diabetes but sometimes occurs in type 2 diabetes or gestational diabetes.
Diabetic hyperosmolar syndrome. If your blood sugar level tops 600 milligrams per deciliter (mg/dL), or 33.3 millimoles per liter (mmol/L), the condition is called diabetic hyperosmolar syndrome.
Severely high blood sugar turns your blood thick and syrupy. The excess sugar passes from your blood into your urine, which triggers a filtering process that draws tremendous amounts of fluid from your body. Left untreated, this can lead to life-threatening dehydration and a diabetic coma. About 25 to 50 percent of people with diabetic hyperosmolar syndrome develop a coma.
Anyone who has diabetes is at risk of a diabetic coma, but the following factors can increase the risk:
An illness, trauma or surgery. When you're sick or injured, blood sugar levels tend to rise, sometimes dramatically. This may cause diabetic ketoacidosis if you have type 1 diabetes and don't increase your insulin dosage to compensate.
Medical conditions, such as congestive heart failure or kidney disease, also may increase your risk of diabetic hyperosmolar syndrome.
Left untreated, a diabetic coma can lead to:
Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind:
Consider a continuous glucose monitor (CGM), especially if you have trouble maintaining stable blood sugar levels or you don't feel symptoms of low blood sugar (hypoglycemia unawareness).
CGMs are devices that use a small sensor inserted underneath the skin to track trends in your blood sugar levels and transmit the information to a wireless device.
These devices can alert you when your blood sugar is dangerously low or if it is dropping too fast. However, you still need to test your blood sugar levels using a blood glucose meter even if you're using a CGM. CGMs are more expensive than conventional glucose monitoring methods, but they may help you control your glucose better.
If you experience a diabetic coma, prompt diagnosis is essential. The emergency medical team will do a physical exam and may ask those who are with you about your medical history. If you have diabetes, you may want to wear a medical ID bracelet or necklace.
At the hospital, you may need various lab tests to measure:
Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.
If your blood sugar level is too high, you may need:
If your blood sugar level is too low, you may be given a glucagon injection, which will cause your blood sugar level to quickly rise. Intravenous dextrose also may be given to raise blood glucose levels.
A diabetic coma is a medical emergency that you won't have time to prepare for. If you feel the symptoms of extremely high or low blood sugar, call 911 or your local emergency number to make sure help is on the way before you pass out.
If you're with someone with diabetes who has passed out or is acting strange, possibly as if he or she has had too much alcohol, call for immediate medical help.
If you have no training in diabetes care, wait for the emergency care team to arrive.
If you are familiar with diabetes care, test the unconscious person's blood sugar and follow these steps:
December 22nd, 2020