Diabetic coma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of the acute complications of diabetes. Severe diabetic hypoglycemia, diabetic ketoacidosis or Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness, are the complications of diabetes.
In most medical contexts, the term diabetic coma refers to the diagnostic dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. 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.
Classification
Dabetic coma can be classified as coma due to Severe diabetic hypoglycemia, diabetic ketoacidosis or Hyperosmolar nonketotic coma.
Risk Factors
Anyone who has diabetes is at risk of a diabetic coma.
Natural History, Complications and Prognosis
Left untreated, a diabetic coma can be fatal. Prognosis of diabetic coma depends on whether the patient is treated promptly and properly.
Diagnosis
Laboratory Findings
Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause.
Treatment
Medical Therapy
The treatment of diabetic coma consists of insulin and gradual rehydration with intravenous fluids. Treatment of DKA 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.
Primary Prevention
Controlling diabetes and recognizing the early signs of dehydration and infection can help prevent this condition.