Diabetes patients, if they uncontrolled their diabetes, the Diabetes may lead to Coma or unconsciousness. Diabetes is a condition characterized by high blood glucose (sugar) levels.

The three types of Coma associated with Diabetes include ketoacidotic Coma, hyperosmolar Coma and hypoglycaemic Coma.

Ketoacidotic Coma

Ketoacidotic Coma is more common in Diabetes patients who are in Type 1 diabetes, which is also known as juvenile Diabetes or insulin dependent Diabetes mellitus (IDDM). This type of Coma is triggered by the build-up of chemicals called ketones. Ketones are strongly acid and cause the blood to become too acidic. Ketones are by-products of fat breakdown; they can build up excessively when there is insufficient insulin in the body. When there is not enough insulin circulating, the body cannot use glucose for energy. Instead, fat is broken down, which is then converted to ketones in the liver. Common causes of ketoacidosis include a missed dose of insulin or an acute infection.

Symptoms of Ketoacidosis

• Extreme thirst
• Lethargy
• Frequent urination (due to high blood glucose levels)
• Nausea
• Vomiting
• Abdominal pain
• Progressive drowsiness
• Deep, rapid breathing
• A fruity or acetone smell on the breath may also be present.

Hyperosmolar Coma

A hyperosmolar Coma of Diabetes patients is caused by severe dehydration and very high blood glucose levels (hyperglycaemia). Events that may lead to high blood glucose levels include:

• Forgotten Diabetes medications or insulin.
• An infection or illness, such as the flu or pneumonia
• Increased intake of sugary foods or fluids.

Those at most risk of this type of Coma are patients with Type 2 diabetes, who have an infection or acute illness and have reduced their intake of fluids or are taking diuretic medication or steroids.

The kidneys respond to high levels of blood glucose by doing their best to excrete it, along with a great deal of water. The patients experiencing diabetic hyperosmolarity will be very thirsty but they can’t drink enough water to replace the lost fluids. They will become dehydrated and urgently need intravenous fluids. Without this kind of Treatment, they may lapse into hyperosmolar Coma. Hyperosmolar Coma develops slowly over several days, so if the high blood glucose levels are detected and treated early, Coma can be prevented.

Hypoglycaemic Coma

Hypoglycaemia, or low blood glucose levels, may occur if patients on Diabetes medication or insulin:

• Takes an extra or an increased dose
• Exercises strenuously without eating extra food or reducing their insulin intake
• Misses a meal or snack
• Drinks too much alcohol or drinks alcohol without eating food.

If the blood glucose level falls very low, the person may become unconscious (hypoglycaemic Coma) and seizures may occur.

Symptoms of Hypoglycaemia Include:

• Trembling
• Palpitations
• Weakness
• Sweating
• Intense hunger
• Confusion, altered behavior, drowsiness or Coma may occur if the blood glucose becomes very low.

Prolonged or frequent Coma should be avoided and hypoglycemia treated quickly.

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