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What Is a Diabetic Coma?

    What Is a Diabetic Coma?

    Diabetes is one of the leading causes of reduced life expectancy in the world. As such, it is one of the largest global public health concerns worldwide. With rising levels of obesity, the incidence of diabetes is also on the rise. Those who suffer from diabetes need to take extra precautions on multiple aspects of their health to prevent complications from occurring. Management of weight, maintenance of blood sugar levels, and monitoring extremities are all important for diabetics to stay healthy. Another complication that may arise from diabetes is a diabetic coma.

    What Is a Diabetic Coma?

    A diabetic coma or diabetic ketoacidosis is a life-threatening complication of diabetes that causes unconsciousness. People who have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia), can go into a diabetic coma.

    In a coma, although the patient is alive, they cannot respond to any stimulation. If left unattended, a diabetic coma can lead to death.

    Diabetic Coma Symptoms

    Prior to going into a diabetic coma, a person will experience symptoms of either high blood sugar or low blood sugar. A hyperglycemic person suffering from high blood sugar may experience:

    • increased thirst
    • frequent urination
    • fatigue
    • nausea
    • vomiting

    In addition, they may also experience:

    • shortness of breath
    • a very dry mouth
    • rapid heartbeat
    • stomach pain

    People dealing with hypoglycemia or low blood sugar may experience fatigue, shakiness or nervousness, weakness, and anxiety. Additional hypoglycemic symptoms may include difficulty speaking, confusion, dizziness or lightheadedness, nausea, and hunger.

    Long-time diabetics may develop a condition known as hypoglycemia unawareness. This condition may not allow them to see the warning signs of a drop in their blood sugar. For this reason, regular testing of blood sugar is important for diabetics to determine a proper treatment plan and avoid going into a coma.

    Treatment for a Diabetic Coma

    A diabetic coma is a serious condition that requires emergency medical treatment. The kind of treatment is based on whether the patient’s blood sugar is too high or too low.

    Before insulin was discovered and successfully prepared commercially, a diabetic coma was viewed as one of the most hopeless catastrophes in medicine. Insulin proved to be a gamechanger in the treatment of this disease.

    If a patient is hyperglycemic, they may need:

    • intravenous fluids to restore water to the tissues
    • potassium, sodium, or phosphate supplements to help cells function properly
    • insulin to help tissues absorb the glucose in the blood

    A study published in 1974 had 38 patients in a diabetic coma from four different centers. These patients were given continuous low-dose insulin at an average dose of 7·2 IU/hr. All patients recovered rapidly except for one who died. Plasma glucose fell 58% four hours after insulin began to be delivered.

    In the case of hypoglycemic patients, a glucagon injection to quickly elevate blood sugar may be given. Doctors may also give dextrose intravenously to raise blood glucose levels.

    Key Takeaways

    The high prevalence of diabetes worldwide makes it paramount to address this disease and its complications. The severe and life-threatening complication of a diabetic coma is a condition that leaves a person with high blood sugar or low blood sugar unconscious and unresponsive.

    There are symptoms of hyperglycemia or hypoglycemia that a diabetic person must be aware of in order to avoid falling into a diabetic coma. An emergency medical treatment will likely be required if a person goes into a coma. Intravenous fluids, supplements, and insulin may have to be administered to wake them from this unfortunate condition.

    For more on Diabetes Complications, click here.

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    Sources

    Diabetic coma: Symptoms and causes, https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475, Accessed January 12, 2022

    Severe Diabetic Ketoacidosis (Diabetic “Coma”): 482 Episodes in 257 Patients; Experience of Three Years,

    https://diabetesjournals.org/diabetes/article/20/7/490/3523/Severe-Diabetic-Ketoacidosis-Diabetic-Coma-482, Accessed January 12, 2022

    Treatment of Diabetic Coma with Continuous Low-dose Infusion of Insulin, https://www.bmj.com/content/2/5921/687.abstract, Accessed January 12, 2022

    A clinical survey of one hundred and eight consecutive cases of diabetic coma, https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/541966, Accessed January 12, 2022

    Hyperosmolar Hyperglycemic State: A Historic Review of the Clinical Presentation, Diagnosis, and Treatment, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207202/, Accessed January 12, 2022

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    Written by Jason Inocencio Updated 4 days ago
    Medically reviewed by Mitchie Gonzales-Montalbo, MD
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