Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered.

An estimated 2 to 15 percent of people with diabetes will have at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia low blood glucose levels.

This can occur if a person takes too much insulin or diabetic medication, does strenuous exercise without eating additional food, misses meals, consumes too much alcohol, or consumes alcohol without food.

Hypoglycemia can be severe enough to cause unconsciousness during sleep. Predisposing factors can include eating less than usual or prolonged exercise earlier in the day. Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia.

Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms.

Twitching or convulsions may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat: all signs of the adrenaline response to hypoglycemia. The individual is not usually dehydrated and breathing is normal or shallow. Their blood sugar level, measured by a glucose meter or laboratory measurement at the time of discovery, is usually low but not always severely, and in some cases may have already risen from the nadir that triggered the unconsciousness.

Unconsciousness due to hypoglycemia is treated by raising the blood glucose with intravenous glucose or injected glucagon. Diabetic ketoacidosis DKA , most typically seen in those with type 1 diabetes, is triggered by the build-up of chemicals called ketones.

These are strongly acidic and a build-up can cause the blood to become acidic. If it progresses and worsens without treatment it can eventually cause unconsciousness, from a combination of a very high blood sugar level, dehydration and shock , and exhaustion.

Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation. In the early to middle stages of ketoacidosis, patients are typically flushed and breathing rapidly and deeply, but visible dehydration, pale appearance from diminished perfusion, shallower breathing, and a fast heart rate are often present when coma is reached.

However these features are variable and not always as described. If the patient is known to have diabetes, the diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 1—2 days of vomiting.

The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis. Treatment of diabetic ketoacidosis consists of isotonic fluids to rapidly stabilize the circulation, continued intravenous saline with potassium and other electrolytes to replace deficits, insulin to reverse the ketoacidosis, and careful monitoring for complications.

Nonketotic hyperosmolar coma usually develops more insidiously than diabetic ketoacidosis because the principal symptom is lethargy progressing to obtundation , rather than vomiting and an obvious illness.

Extremely high blood sugar levels are accompanied by dehydration due to inadequate fluid intake. Those at most risk of this type of coma are people with type 2 diabetes, who have an infection or acute illness and have reduced their intake of fluids.

The kidneys respond to high levels of blood glucose by doing their best to remove it, along with a great deal of water.

They will become dehydrated and urgently need intravenous fluids. Without this kind of treatment, they may lapse into hyperosmolar coma.

Hyperosmolar coma develops slowly over several days or weeks, so if the high blood glucose levels or dehydration are detected and treated early, coma can be prevented. Hypoglycaemia , or low blood glucose levels below 3.

If the blood glucose falls to very low levels, the person may become unconscious hypoglycaemic coma and seizures may occur. First aid for someone who has lapsed into a diabetic coma includes:.

A coma is a medical emergency. The cause of a diabetic coma is diagnosed using a number of tests including:. This page has been produced in consultation with and approved by:. Content on this website is provided for information purposes only.

Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.

The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website.

All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.

The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Diabetes. Diabetic coma. Actions for this page Listen Print. Summary Read the full fact sheet.

On this page. If you have hyperglycemia, you may experience noticeably increased thirst and you may urinate more frequently. A blood test would also reveal higher levels of glucose in your bloodstream.

A urine test can also show that your glucose levels are too high. DKA causes high levels of blood glucose. The symptoms also include increased thirst and a frequent need to urinate. Other symptoms of elevated ketone levels include:. A diabetic coma is a medical emergency.

Treating hyperglycemia requires intravenous fluids to improve fluid levels throughout your body. You may also receive insulin to help your cells absorb the extra circulating glucose.

If your sodium, potassium, or phosphate levels are low, you may get supplements to help bring them up to healthy levels. The treatment will be similar for DKA. Once your blood glucose levels are in a healthy range, you should start to feel better almost immediately.

If the symptoms occurred for a while before treatment or if you were in a diabetic coma for several hours or longer, you could experience some brain damage.

An untreated diabetic coma may also result in death. People who receive emergency treatment for a diabetic coma usually recover fully. Your doctor may recommend that you wear a medical identification bracelet that explains the nature of your diabetes and other health concerns.

This may help ensure you get the proper treatment for future problems quickly. If you experience a diabetic coma without knowing you have diabetes, your doctor will work with you to develop a diabetes treatment plan.

This will include medications, as well as recommendations for diet and exercise. The key to preventing a diabetic coma is proper blood glucose management. This means taking your insulin and testing your blood glucose and ketones as your doctor recommends.

You should also pay close attention to your carbohydrate intake. This is true for people who have type 1 or type 2 diabetes. They can help you create a diabetes meal plan. You should know what to do if you miss a dose of insulin or other diabetes medication.

Ask your doctor about that, as well as what to do if you start to feel symptoms of hyperglycemia or hypoglycemia.

Diabetes can affect other parts of your health. Uncontrolled diabetes can harm your cardiovascular health in particular. Be prepared to change medication doses or adjust your diet along the way.

Take steps to manage your diabetes properly and ask your doctor any questions you have about how to prevent a diabetic coma. Call if you see someone losing consciousness for any reason. It may be a temporary fainting spell due to a sudden drop in blood pressure or an anxiety attack.

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Measure content performance. Understand audiences through statistics or combinations of data from different sources. Develop and improve services. Use limited data to select content. List of Partners vendors. Type 2 Diabetes. By Yvelette Stines. Medically reviewed by Do-Eun Lee, MD. Table of Contents View All.

Table of Contents. Risk Factors. When to Call a Healthcare Provider. Importance of Checking Your Blood Sugar As a patient with diabetes, it is always important to check your blood sugar. Guidelines for Blood Glucose Monitoring. When to Seek Medical Care If a person is showing any symptoms of a diabetic coma, it is important to call immediately so they can get the proper care that is needed as soon as possible.

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What is your feedback? Related Articles. American Diabetes Association. Glycemic targets: Standards of Medical Care in Diabetes — Diabetes Care. Cryer PE. Hypoglycemia in adults with diabetes mellitus. Accessed July 11, Tips for emergency preparedness.

Low blood glucose hypoglycemia. National Institute of Diabetes and Digestive and Kidney Diseases. Insulin pumps: Relief and choice. Continuous glucose monitoring. Managing diabetes. Hirsch IB. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis.

Inzucchi SE, et al. Clinical presentation, diagnosis and initial evaluation of diabetes mellitus in adults. Castro MR expert opinion. Mayo Clinic, Rochester, Minn.

July 24, Hyperglycemia high blood glucose. Associated Procedures. A Book: Guide to the Comatose Patient. A Book: The Essential Diabetes Book. Show the heart some love!

Give Today. Help us advance cardiovascular medicine. Find a doctor. In the event of a severe hypoglycemic episode, a car accident or other emergency, the medical ID can provide critical information about the person's health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc.

Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can't speak for themselves. Medical IDs are usually worn as a bracelet or a necklace. Traditional IDs are etched with basic, key health information about the person, and some IDs now include compact USB drives that can carry a person's full medical record for use in an emergency.

As unpleasant as they may be, the symptoms of low blood glucose are useful. These symptoms tell you that you your blood glucose is low and you need to take action to bring it back into a safe range.

But, many people have blood glucose readings below this level and feel no symptoms. This is called hypoglycemia unawareness.

Hypoglycemia unawareness puts the person at increased risk for severe low blood glucose reactions when they need someone to help them recover.

People with hypoglycemia unawareness are also less likely to be awakened from sleep when hypoglycemia occurs at night. People with hypoglycemia unawareness need to take extra care to check blood glucose frequently.

This is especially important prior to and during critical tasks such as driving. A continuous glucose monitor CGM can sound an alarm when blood glucose levels are low or start to fall. This can be a big help for people with hypoglycemia unawareness.

If you think you have hypoglycemia unawareness, speak with your health care provider. This helps your body re-learn how to react to low blood glucose levels. This may mean increasing your target blood glucose level a new target that needs to be worked out with your diabetes care team.

It may even result in a higher A1C level, but regaining the ability to feel symptoms of lows is worth the temporary rise in blood glucose levels. This can happen when your blood glucose levels are very high and start to go down quickly. If this is happening, discuss treatment with your diabetes care team.

Your best bet is to practice good diabetes management and learn to detect hypoglycemia so you can treat it early—before it gets worse. Monitoring blood glucose, with either a meter or a CGM, is the tried and true method for preventing hypoglycemia.

Studies consistently show that the more a person checks blood glucose, the lower his or her risk of hypoglycemia. This is because you can see when blood glucose levels are dropping and can treat it before it gets too low.

Together, you can review all your data to figure out the cause of the lows. The more information you can give your health care provider, the better they can work with you to understand what's causing the lows. Your provider may be able to help prevent low blood glucose by adjusting the timing of insulin dosing, exercise, and meals or snacks.

Changing insulin doses or the types of food you eat may also do the trick. Breadcrumb Home Life with Diabetes Get the Right Care for You Hypoglycemia Low Blood Glucose. Low blood glucose may also be referred to as an insulin reaction, or insulin shock.

Signs and symptoms of low blood glucose happen quickly Each person's reaction to low blood glucose is different. Treatment—The " Rule" The rule—have 15 grams of carbohydrate to raise your blood glucose and check it after 15 minutes.

Note: Young children usually need less than 15 grams of carbs to fix a low blood glucose level: Infants may need 6 grams, toddlers may need 8 grams, and small children may need 10 grams.

Signs of a diabetic coma include an altered mental state, inability to speak, visual problems, drowsiness, weakness, headache, and restlessness. In general, it is important for people with diabetes to check their blood sugar regularly and take their medication as prescribed by their healthcare provider.

If you are in the presence of a person with diabetes who needs attention due to a diabetic coma, you should call immediately. A diabetic coma can be caused by either high or low blood sugar. Symptoms of hyperglycemia include:. Different types of hyperglycemia include:.

As a patient with diabetes, it is always important to check your blood sugar. If you have any questions or concerns, contact your healthcare professional. They can help you understand and manage your numbers and condition. This can lead to symptoms such as:. If a person has diabetes, hypoglycemia can, at times, be a side effect of diabetes medication.

Glucose is an important factor for the body. The liver releases glucose, as needed, when the blood sugar levels start to fall. It is always important to check with your healthcare professional if you have questions or concerns.

It is helpful to know the signs and symptoms of both a hypoglycemic coma and a hyperglycemic coma, as they differ.

If a person is lapsing into a hypoglycemic coma, it feels similar to fainting, including:. These symptoms occur before consciousness is lost. If not treated quickly, brain damage is possible. When a hyperglycemic coma occurs, it is known to have a slow onset with drowsiness that deepens over time.

Other symptoms include:. When a hyperglycemic coma occurs, a person will typically receive treatment including insulin; supplements of phosphate, sodium, and potassium; and intravenous fluids. If a person is showing any symptoms of a diabetic coma, it is important to call immediately so they can get the proper care that is needed as soon as possible.

If an individual has diabetes, they are at risk for a diabetic coma. The type of diabetes is an indicator of the type of coma they may experience.

Other risk factors include:. Blood sugar levels that occur during a diabetic coma include:. If an individual has symptoms of a diabetic coma, call for emergency medical attention and inform responders that the person has diabetes.

It is also recommended that the individual with diabetes wear a medical identification necklace or bracelet. If the blood glucose falls to very low levels, the person may become unconscious hypoglycaemic coma and seizures may occur. First aid for someone who has lapsed into a diabetic coma includes:.

A coma is a medical emergency. The cause of a diabetic coma is diagnosed using a number of tests including:. This page has been produced in consultation with and approved by:. Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.

The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website.

All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances.

The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Skip to main content. Home Diabetes. Diabetic coma. Actions for this page Listen Print. Summary Read the full fact sheet.

On this page. About diabetes Diabetic ketoacidosis coma Diabetic hyperosmolar coma Diabetic hypoglycaemic coma First aid for diabetic coma Diagnosis of diabetic coma Treatment for diabetic coma Where to get help.

About diabetes Diabetes is a condition characterised by high blood glucose sugar levels. Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. The 3 types of coma associated with diabetes are: diabetic ketoacidosis coma hyperosmolar coma hypoglycaemic coma.

Diabetic ketoacidosis coma Diabetic ketoacidosis typically occurs in people with type 1 diabetes, which was previously known as juvenile diabetes or insulin dependent diabetes mellitus IDDM , though it can occasionally occur in type 2 diabetes.

Symptoms of ketoacidosis Symptoms of ketoacidosis are: extreme thirst lethargy frequent urination due to high blood glucose levels nausea vomiting abdominal pain progressive drowsiness deep, rapid breathing a fruity or acetone smell on the breath.

People with diabetes should monitor their blood sugar daily, especially if they are on medications that increase insulin levels in the body. Doing so will help you spot problems before they turn into emergencies.

If you have problems with monitoring your blood sugar, consider wearing a continuous glucose monitor CGM device. These are especially useful if you have hypoglycemia unawareness. Diabetic coma is a serious complication that can be fatal.

And the odds of death increase the longer you wait for treatment. Waiting too long for treatment can also lead to brain damage. This diabetic complication is rare.

The power to protect from diabetic coma is in your hands. Know the signs and symptoms that may lead up to a coma, and be prepared to spot problems before they turn into emergencies. Prepare both yourselves and others about what to do if you become comatose.

Make sure to manage your diabetes to reduce your risk. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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Causes Symptoms Emergency care Prevention Outlook Takeaway If you are a person with diabetes, knowing the symptoms of a diabetic coma can save your life. How diabetes can lead to coma. Signs and symptoms.