Diagnosis

If you experience a diabetic coma, prompt diagnosis is essential. The emergency medical team will do a physical exam and may ask those who are with you about your medical history. If you have diabetes, you may want to wear a medical ID bracelet or necklace.

Lab tests

You may need various lab tests to measure:

  • Your blood sugar level
  • Your ketone level
  • The amount of nitrogen or creatinine in your blood
  • The amount of potassium, phosphate and sodium in your blood

Treatment

The type of emergency treatment for a diabetic coma depends on whether your blood sugar level is too high or too low.

High blood sugar

If your blood sugar level is too high, you may need:

  • Intravenous fluids to restore water to your tissues
  • Potassium, sodium or phosphate supplements to help your cells function correctly
  • Insulin to help your tissues absorb the glucose in your blood
  • Treatment for any underlying infections

Low blood sugar

If your blood sugar level is too low, you may be given a glucagon injection, which will cause your blood sugar level to quickly rise. Intravenous dextrose may also be given to raise blood glucose levels.

Consciousness typically returns when blood sugar reaches a normal level.

Preparing for your appointment

A diabetic coma is a medical emergency that you won't have time to prepare for. If you feel the symptoms of extreme high or low blood sugar, call 911 or your local emergency number to make sure help is on the way before you pass out.

If you're with someone with diabetes who has passed out or is acting strange, possibly as if he or she has had too much alcohol, call for immediate medical help.

What you can do in the meantime

If you have no training in diabetes care, wait for the emergency care team to arrive.

If you are familiar with diabetes care, follow these steps:

  1. Test the unconscious person's blood sugar.
  2. If the blood sugar level is lower than 70 mg/dL (3.9 mmol/L), administer an injection of glucagon. If glucagon isn't available, rub glucose gel, honey or non-sugar-free syrup on the inside of the unconscious person's cheek. Do not try to give fluids to drink and do not give insulin to someone with low blood sugar.
  3. If the blood sugar level is above 70 mg/dL, wait for medical help to arrive. Don't give sugar to someone whose blood sugar isn't low.
  4. Let the emergency care team know about the diabetes and what steps you've taken, if any.
May 22, 2015
References
  1. Standards of medical care in diabetes — A position statement of the American Diabetes Association. Diabetes Care. 2015;38(suppl):S1.
  2. Ketoacidosis (DKA) and ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed March 31, 2015.
  3. Hyperglycemia (high blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html. Accessed March 31, 2015.
  4. Hypoglycemia. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/. Accessed March 31, 2015.
  5. Disadvantages of using an insulin pump. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/disadvantages-of-using-an.html. Accessed March 31, 2015.
  6. Hypoglycemia (low blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html. Accessed March 31, 2015.
  7. Continuous glucose monitoring. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/glucosemonitor/. Accessed March 31, 2015.