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The state of unconsciousness that is induced by dangerously high or low levels of blood sugar is referred to as diabetic coma. This condition is often observed in diabetics who develop severe hypoglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemic state. Though diabetic coma is a reversible form of coma, note that it is referred to as a medical emergency. It could be fatal if medical assistance is not sought on time.

Causative Factors
While severe hypoglycemia and diabetic ketoacidosis usually affect those who suffer from type 1 diabetes, hyperosmolar hyperglycemic state is more common in people who suffer from type 2 diabetes. The symptoms that the affected individual may experience before he/she passes out would vary, depending on the underlying cause.

Severe Hypoglycemia
Hypoglycemia is a medical condition that occurs when blood sugar levels become less than 70 mg/dL. When the blood sugar levels continue to fall, and become less than 55 mg/dL, the brain doesn't get enough glucose. The insufficient supply of glucose to the brain (neuroglycopenia) impairs brain function. The impairment of the cognitive function causes confusion and slowing of the reflexes. Under such circumstances, the affected individual may not be able to recognize the symptoms of low blood sugar. If he/she fails to take the necessary steps to normalize the blood sugar levels, he/she may lose consciousness.

Those who have low blood sugar are likely to experience symptoms such as:
» Nervousness
» Sweating
» Confusion
» Anxiety
» Fatigue
» Lightheadedness
» Intense hunger
» Palpitations
» Abdominal discomfort

Hyperosmolar Hyperglycemic State
A person is said to suffer from hyperglycemia when the blood sugar levels become higher than 180 mg/dL. The increase in blood glucose levels causes the osmotic pressure of blood to increase. Under such circumstances, water may be drawn out from the tissues. This may cause dehydration and electrolyte imbalance. If a person is experiencing dehydration and has severe hyperglycemia (blood sugar is more than 600 mg/dL), he/she is likely to suffer from diabetic coma. This condition is also called nonketotic hyperosmolar coma.

When high blood sugar levels lead to a hyperglycemic hyperosmolar state, the affected individual is likely to experience symptoms such as:
» Dehydration
» Dry mouth
» Electrolyte imbalance
» Lethargy
» Confusion
» Excessive thirst
» Increased urination
» Weakness on one side of the body

Diabetic Ketoacidosis
This condition occurs due to the body's inability to produce sufficient amounts of insulin. Under such circumstances, the body burns down fat for energy. Ketones are organic compounds that are produced in this process. Ketoacidosis refers to the high levels of ketone bodies in blood and urine. If the patient is experiencing physical fatigue and dehydration along with severe hyperglycemia, it can lead to advanced diabetic ketoacidosis. If left untreated, the patient may become comatose. This condition can be reversed if treatment is administered soon.

When high blood sugar levels lead to diabetic ketoacidosis, the affected individual is likely to experience symptoms such as:
» Increased thirst
» Increased urination
» Nausea
» Vomiting
» Lethargy
» Rapid breathing
» Fruity breath due to ketosis
» Abdominal pain
» Weakness

Treatment Options
It is extremely important to monitor blood sugar levels. If the patient has passed out due to low or high blood sugar, medical help must be sought immediately.

» If the cause of diabetic coma (hypoglycemia or hyperglycemia) is unknown, do not give insulin to the patient.
» If you are confused about the patient's condition, and don't know what to do to keep the patient in a conscious state, please do not give the patient anything except water.

If severe hypoglycemia leads to diabetic coma, the treatment would involve raising blood sugar with the help of glucose. The treatment for advanced diabetic ketoacidosis and nonketotic hyperosmolar coma would involve insulin therapy, and oral or intravenous administration of fluids and electrolytes to compensate for the loss of body fluids. The dosage of insulin may vary, based on the patient's condition and severity of the symptoms.

Tips for Diabetics
Consult your physician regularly, and follow the advice of your doctor regarding medicines and lifestyle-related changes.

» Keep your blood glucose levels under control.
» If your blood sugar levels are low, have a glucose tablet or a fast-acting carbohydrate. This will help in restoring the blood sugar level to normal.
» Follow an exercise regimen, but refrain from performing vigorous exercises if you suffer from hypoglycemia.
» If possible, wear a medical bracelet/necklace or carry a medical card in your wallet that identifies you as a diabetic patient.

Studies reveal an alarming increase in the number of people affected by diabetes throughout the world. Since diabetes puts people at an increased risk of developing serious medical conditions, steps must be taken to keep blood sugar levels under control. While diabetics must comply with the guidelines regarding drugs and lifestyle modifications, their family members must also be educated about the steps that must be taken to avert life-threatening complications associated with diabetes.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.