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Diabetic coma

Note: Wikipedia does not provide medical advice. If you have a medical problem, you should seek expert help.

Diabetic coma is a medical emergency in which a person with diabetes is unconscious because the blood glucose level is too low or too high. If the glucose level is too low, the person has hypoglycemia and if the level is too high, the person has hyperglycemia and may develop ketoacidosis. Patients with diabetes mellitus type 1 are especially prone to this condition.

Causes for this condition vary; in the case of a hyperglycemia, it could be due to too much food too quickly or forgetting to inject oneself with insulin, while in the case of a hypoglycemia it could be due to a lack of food, too much exercise for current conditions, or to an insulin overdose. While no particular amount of sugar in the blood is generally recognized as the starting point to an attack of this kind (people vary), usually the person who has a hyperglycemia has a blood glucose reading of 500 mg/dL (28 mmol/L) or more is at risk of hyperglycemic diabetic coma, while a patient whose blood glucose level is 50 mg/dL (3 mmol/L) or less is at risk of a hypoglycemic diabetic coma.

Without performing a blood glucose test, it is difficult to tell with certainty whether the coma is caused by hypoglycemia or hyperglycemia as symptoms are very similar.

In both cases, the coma is caused by brain cell malfunction. In the case of hypoglycemia, there simply isn't enough glucose in the blood, leaving brain cells without enough glucose to satisfy their metabolic needs. In the case of hyperglycemia, while glucose is plentiful, indeed too plentiful, the consequences of so much blood glucose produce chemistry abnormalities which cause brain cells to malfunction. These include cell dehydration due to osmotic pressure, electrolyte balance problems both inside brain cells and in the blood, and in some cases acidosis.

First aid for diabetic coma includes the following:

Other first aid measures include:

First aid providers are encouraged to test blood glucose if possible. If not, give sugar in some form. _Never_ give insulin without compelling evidence that the problem is hyperglycemia. Giving too much sugar is far less dangerous to the hyperglycemic patient than giving insulin to the hypoglycemic patient.

Paramedics are familiar with the treatment of diabetic coma and will treat it with administration of sugars, blood test for glucose, administration of insulin and rapid transport to a hospital if necessary.

Doctors recommend that:

If a diabetes patient has young children living with him/her, it is also very important to teach them the appropriate local emergency telephone number.