Diabetes results when the body cannot use sugar present in blood as energy, either because of having too little insulin or being unable to use insulin. The most common symptoms of diabetes are frequent feeling of thirst, drinking lots of fluids and urination. Coma is a situation wherein a person is in the state of unconsciousness, for an unknown period of time, that may even lead to death. Diabetic coma is a condition that generally occurs in people suffering from type 2 diabetes. This condition is also coined as hyperglycemic hyperosmolar nonketotic syndrome. Excessive dehydration in a person suffering from diabetes leads to grievous loss of body water which may further lead to shock, coma or death. According to a CDC report review, this is generally found in people above the age of 60. There are three basic diabetic coma causes which are explained below in detail... Diabetic Coma: Causes of Diabetic Coma Diabetic coma is caused either due to extreme low blood glucose levels (hypoglycemia) or extreme high blood glucose levels (hyperglycemia). These extreme low or high fluctuations in blood sugar levels, may lead to death. These diabetic coma causes are categorized as given below: Diabetic Coma Causes # 1: Hypoglycemia This is the condition which arises due to insufficient supply of glucose, which is a fuel to the brain. This has its own effects ranging from nausea to seizure. Both, type 1 and type 2 diabetes patients are prone to face this condition. Treatments for this condition consists of two steps, namely short-term steps and long-term steps. Short-term steps help reverse hypoglycemia, and the long-term steps helps the doctors identify and treat the root cause. The symptoms that can be observed in this case are sweating, hunger, anxiety, abnormal behavior, double or blurred vision, tremor, heart palpitations, loss of consciousness or seizures. These symptoms can be the same for many other conditions and are not specific to low blood sugar symptoms. Sometimes people assume that taking medications in higher doses than prescribed, may help them recover faster. But the reality is that, this overdose may lead to insulin shock, a condition wherein the sugar supply to the brain stops and further leads to brain damage or death, which can be within a few minutes after administering it. In case of a situation, wherein the condition of the victim worsens, you should ask another person with you (if any) to call the ambulance while you take measures to increase his sugar level. Diabetic Coma Causes # 2: Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis, most commonly found in type 1 diabetes patients, is a life-threatening complication. This is a result of absolute scarcity of insulin, that leads to alarmingly high blood sugar levels, saturation of organic acid and ketones in the blood. As the muscle, fat and liver cells become inefficient to use the sugar as a fuel; adrenaline, growth hormone and glucagon force fats that are present in the body to break down into glucose and fatty acids, later converting them into ketones. The symptoms of diabetic ketoacidosis (DKA) that are to be examined while confirming the causes of diabetic coma are, abdominal pain while urinating, vomiting, loss of appetite, dry skin or mouth, increased heart rate, shortness of breath, general weakness and confusion. Diabetic Coma Causes # 3: Nonketotic Hyperosmolar Syndrome (NKHS) This syndrome refers to the high concentration of sugar/glucose in the blood and is most common in older adults who suffer from type 2 diabetes. The people who don't monitor their blood sugar or who don't know if they suffering from diabetes, are primary victims of this syndrome. This is caused due to hyperglycemia, shock and dehydration. In this condition, the blood sugar level reaches 600 mg/dL or 33 mmol/L, and the blood turns thick and syrupy. If there is excess sugar in the body, it flows though urine consuming huge amount of fluids of the body during the filtration process. The primary symptom of NKHS is changed consciousness varying from confusion or disorientation to coma, mainly caused due to excessive thirst. The other symptoms being dry and parched mouth, increased urination, warm and dry skin with no sweating, sleepiness, weakness on one side of the body, vision loss. In case this syndrome is left untreated, it can lead to life-threatening dehydration, hence, immediate medical assistance is essential. There are many other causes that lead to extreme fluctuations of blood sugar levels in diabetic coma. They can be some infections like flu or blood clot; or medicines like steroids, heart medications or diuretics; or kidney failure; or heart attack; or ulcers. Diabetic Coma: Precautions In case, any of the above symptoms (warning signs of diabetic coma), such as extreme fatigue, twitching, headaches, slurred speech or paralysis, etc. are noticed, one must immediately consult a doctor for treatment. Because, if ignored, this could even lead to loss of life. People should take utmost care, if they are victims of diabetes and observe any of these symptoms. The first thing is to test the blood sugar level and if above 600mg/dL, call for the doctor immediately. In case early diabetic coma symptoms are observed, such as increased thirst, frequent urination, drowsiness, restlessness, etc. one may require treatment including intravenous fluids as per the doctors prescription, and may even require insulin. In order to be cautious, one must adhere to the check of blood sugar levels regularly as per the doctors recommendations, an hourly check in case of sickness and special care in case of any illness. Diabetic Coma: Lab Tests Here are the tests that would be carried out to check if you are a victim of diabetic coma.

• Test for Blood sugar level
• Test for Ketone level in the urine
• Test for nitrogen and creatinine in the urine
• Test for proportion of red blood cells and fluid in the blood
• Test for amount of potassium in the blood

Diabetic Coma: Treatments and Drugs The treatment for causes of diabetic coma, mainly depends on whether the blood sugar level is too low or too high. In case it's too low, injections of hormone glucagon is administered, which would help raise the glucose level. In case the blood sugar level in diabetic coma is too high, one may be administered intravenous fluids to restore water in the tissues, and when sufficient fluid has been replaced, insulin may be given to absorb the sugar. In such a situation, a person may also be prescribed potassium, sodium or chlorine supplements which helps the cells function properly. Once the glucose level reaches normal blood sugar levels, consciousness is automatically regained. This was a brief insight of diabetic coma causes, symptoms and treatments that need to be taken care of. Adhering to a proper diabetic diet, performing exercise for diabetes and taking adequate precautionary measures will definitely help one to remain untouched by the causes of diabetic coma. Last but not the least, the most important point to be remembered is that you should never overlook any symptom, as it can be a tell-tale sign of an impending life-threatening condition.