Diabetic Coma – Symptoms and Causes

ByJanis Updated

Overview

A diabetic coma is a serious medical emergency. It happens when a person with diabetes becomes unconscious and cannot be awakened or respond to their environment.

This dangerous condition can be caused by extremely high blood sugar levels (hyperglycemia) or severely low blood sugar levels (hypoglycemia). Without proper and prompt medical treatment, a diabetic coma can be fatal.

Signs of Blood Sugar Problems

High Blood Sugar Signs

When your blood sugar gets too high, you may notice several warning signs. These include:

  • Feeling very thirsty
  • Needing to urinate often
  • Blurry eyesight
  • Feeling tired or weak
  • Headaches
  • Feeling sick to your stomach
  • Trouble breathing
  • Stomach pain
  • Breath that smells fruity
  • Very dry mouth

These signs can happen slowly over time as blood sugar levels rise above normal.

Low Blood Sugar Signs

When blood sugar drops too low, the body reacts with these warning signs:

  • Shaking or trembling
  • Feeling nervous
  • Unusual tiredness
  • Muscle weakness
  • Sweating more than normal
  • Strong hunger
  • Tingling feelings on skin
  • Feeling dizzy
  • Headache pain
  • Trouble talking clearly
  • Vision problems
  • Feeling confused
  • Passing out

Some people who have had diabetes for many years may not feel these warning signs. This is called hypoglycemia unawareness, which can be dangerous.

When to See a Doctor

Contact emergency services (call 911) right away if you have diabetes and feel symptoms of very high or low blood sugar that might lead to unconsciousness. This is a serious medical emergency requiring immediate help.

If you find someone with diabetes who has lost consciousness, call for emergency help immediately. Be sure to tell the emergency responders that the person has diabetes so they can provide appropriate treatment.

Don’t wait or try to handle a potential diabetic coma on your own – prompt medical attention can save a life.

Causes

Blood sugar levels that remain too high or too low for extended periods can trigger several serious health issues that might lead to a diabetic coma.

Diabetic ketoacidosis (DKA) happens when the body cannot use glucose for energy. Instead, it starts breaking down fat, which creates toxic acids called ketones.

This condition combines high blood sugar with ketones in the blood or urine. People with type 1 diabetes face the highest risk of DKA, though it can also affect those with type 2 or gestational diabetes.

Diabetic hyperosmolar syndrome occurs when blood sugar rises above 600 mg/dL (33.3 mmol/L). At these extreme levels, excess sugar spills into the urine, pulling large amounts of fluid from the body.

This process can cause severe dehydration if not treated promptly, potentially resulting in a diabetic coma.

Severe hypoglycemia (very low blood sugar) can also lead to unconsciousness. The brain depends on glucose to work properly. When blood sugar drops too low, brain function becomes impaired. Several factors can trigger hypoglycemia:

  • Taking too much insulin
  • Not eating enough food
  • Exercising too vigorously
  • Drinking excessive alcohol

Risk Factors

Several factors can increase the chance of experiencing a diabetic coma:

Medical Device Issues

  • Problems with insulin pumps, such as failure or twisted tubing, can stop insulin delivery and lead to diabetic ketoacidosis
  • Regular blood sugar checks are essential for those using insulin pumps

Health Challenges

  • Illnesses, injuries, surgeries, or trauma can cause significant blood sugar fluctuations
  • These changes increase the risk of diabetic ketoacidosis and hyperosmolar syndrome

Diabetes Management Problems

  • Poor blood sugar monitoring increases coma risk
  • Not taking medications as prescribed by healthcare providers raises the danger of complications

Intentional Medication Skipping

  • Some people with eating disorders might skip insulin doses to lose weight
  • This dangerous behavior significantly increases coma risk

Alcohol Consumption

  • Alcohol affects blood sugar in unpredictable ways
  • It can mask low blood sugar symptoms, making hypoglycemia-related comas more likely

Substance Use

  • Using illegal drugs, particularly cocaine, can cause severe blood sugar spikes
  • These substances increase the risk of conditions associated with diabetic coma

Complications

Without proper treatment, a diabetic coma can cause lasting brain damage or even death. The brain needs a steady supply of glucose to function correctly.

When blood sugar levels stay too high or too low for too long, brain cells can be damaged or die.

Ways to Avoid Diabetes Crisis

Managing diabetes daily helps prevent serious problems. Here are key steps to keep your blood sugar levels stable:

  • Follow your eating plan. Regular meals and snacks help control blood sugar. Stick to your plan to avoid dangerous ups and downs.
  • Check blood sugar often. Regular testing shows if your levels stay in your target range. This helps you catch problems before they become serious. Test more after exercise since physical activity can lower blood sugar for several hours.
  • Take medications correctly. Use diabetes medicines exactly as prescribed. Tell your doctor if you notice frequent high or low blood sugar episodes. Your medication dose or timing might need adjustment.
  • Prepare for sick days. If you can’t eat when sick, your levels might drop. Talk with your doctor about a sick-day plan before you need it. Keep at least a week’s worth of diabetes supplies ready.
  • Test for ketones when needed. Check your urine for ketones when blood sugar stays above 250 mg/dL (14 mmol/L) on multiple tests, especially during illness. Call your healthcare provider immediately if:
    • You find high ketone levels
    • You have any ketones and are vomiting
  • Keep emergency supplies handy. Always have:
    • Fast-acting sugar sources (glucose tablets, juice)
    • An up-to-date glucagon kit if you use insulin
    • Extra testing supplies
  • Be careful with alcohol. Drinking can affect blood sugar unpredictably. If you choose to drink:
    • Always eat something while drinking
    • Monitor your blood sugar more closely
  • Teach others how to help. Make sure family, friends, and coworkers know:
    • How to recognize low or high blood sugar symptoms
    • When and how to call for emergency help
    • How to give emergency injections if needed
  • Wear medical ID. A medical bracelet or necklace tells emergency workers about your diabetes if you can’t communicate.

Continuous Glucose Monitors and Insulin Pumps

Modern technology offers better ways to manage diabetes. Continuous glucose monitors (CGMs) track your blood sugar levels throughout the day and night. These helpful devices:

  • Place a tiny sensor under your skin
  • Check glucose levels every few minutes
  • Send readings to your smartphone or other device
  • Alert you when levels are dropping too fast or getting too low
  • Help if you have trouble feeling low blood sugar symptoms

CGMs are more expensive than standard testing, but they give you much better information about your blood sugar patterns.

Insulin pumps work alongside monitors to deliver insulin more precisely. These devices:

  • Attach outside your body
  • Connect to a small catheter placed under your skin
  • Deliver steady, programmed amounts of insulin
  • Provide extra insulin doses when you eat
  • Help maintain more stable blood sugar levels

Using both technologies together creates a system that can dramatically improve blood sugar control. Your doctor can help determine if these devices are right for you based on your diabetes management needs.

Even with these advanced tools, you’ll still need to be actively involved in your diabetes care and respond to alerts and readings appropriately.


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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.