Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of three acute complications of diabetes: The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... A medical emergency is an injury or illness that poses an immediate threat to a persons health or life which requires help from a doctor or hospital. ... For the disease characterized by excretion of large amounts of severely diluted urine, see diabetes insipidus. ... This article is in need of attention from an expert on the subject. ...

1. Severe diabetic hypoglycemia
2. Advanced diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion
3. Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness.

In most medical contexts, the term diabetic coma refers to the diagnostic dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. Diabetic hypoglycemia describes low blood glucose (hypoglycemia) occurring in a person with diabetes mellitus. ... Diabetic ketoacidosis (DKA) is one consequence of severe, out-of-control diabetes mellitus (chronic high blood sugar, or hyperglycemia). ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... Dehydration is the removal of water (hydor in ancient Greek) from an object. ... In medicine, shock (hypoperfusion) is a life-threatening medical emergency characterized by inability of the circulatory system to supply enough oxygen to meet tissue requirements. ... Nonketotic hyperosmolar coma is a type of diabetic coma associated with a high mortality seen in diabetes mellitus type 2. ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... Dehydration is the removal of water (hydor in ancient Greek) from an object. ... The emergency department entrance at Mayo Clinics Saint Marys HospitalThe red-and-white emergency sign is very noticeable. ... A medical identification tag is a small tag worn on a bracelet, neck chain, or on the clothing bearing a message that the wearer has an important medical condition that might require immediate attention. ... A paramedic, is a highly trained medical professional who responds to medical and trauma emergencies in the pre-hospital setting (in-field) for the purpose of stabilizing a patients condition before and during transportation to an appropriate medical facility, usually by ambulance. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ...

Severe hypoglycemia

People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Most hypoglycemia severe enough to cause unconsciousness occurs during sleep. Predisposing factors can include eating less than usual, prolonged exercise earlier in the day, and heavy drinking. Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia. See diabetes mellitus for further general information on diabetes. ... The structure of insulin. ... Diabetic hypoglycemia describes low blood glucose (hypoglycemia) occurring in a person with diabetes mellitus. ... Carbohydrates are chemical compounds that contain oxygen, hydrogen, and carbon atoms. ... Glucose (Glc), a monosaccharide, is one of the most important carbohydrates. ... (for options, see option exercise) U.S. marine emerges from the water upon completing the swimming portion of the triathlon. ... In chemistry, an alcohol is any organic compound in which a hydroxyl group (-OH) is bound to a carbon atom, which in turn is bound to other hydrogen and/or carbon atoms. ...

Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms. Twitching or convulsions may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat, all signs of the adrenaline response to hypoglycemia. He is not usually dehydrated and breathing is normal or shallow. A meter or laboratory glucose at the time of discovery is usually low, but not always severely, and in some cases may have already risen from the nadir which triggered the unconsciousness. This article is about the medical condition. ... Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... A glucose meter (or glucometer) is a medical device for determining the approximate amount of glucose in a drop of blood obtained by pricking the skin with a lancet. ...

Unconsciousness due to hypoglycemia is treated by raising the blood glucose with intravenous glucose or injected glucagon. Glucagon ball and stick model Glucagon is a 29-amino acid polypeptide acting as an important hormone in carbohydrate metabolism. ...

Advanced diabetic ketoacidosis

Diabetic ketoacidosis (DKA), if it progresses and worsens without treatment, can eventually cause unconsciousness, from a combination of severe hyperglycemia, dehydration and shock, and exhaustion. Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation. Diabetic ketoacidosis (DKA) is one consequence of severe, out-of-control diabetes mellitus (chronic high blood sugar, or hyperglycemia). ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... Dehydration is the removal of water (hydor in ancient Greek) from an object. ... In medicine, shock (hypoperfusion) is a life-threatening medical emergency characterized by inability of the circulatory system to supply enough oxygen to meet tissue requirements. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ...

In the early to middle stages of ketoacidosis, patients are typically flushed and breathing rapidly and deeply, but visible dehydration, pallor from diminished perfusion, shallower breathing, and rapid heart rate are often present when coma is reached. However these features are variable and not always as described.

If the patient is known to have diabetes, the diagnosis of DKA is usually suspected from the appearance and a history of 1-2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal hyperglycemia and severe metabolic acidosis. In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ...

Treatment of DKA consists of isotonic fluids to rapidly stabilize the circulation, continued intravenous saline with potassium and other electrolytes to replace deficits, insulin to reverse the ketoacidosis, and careful monitoring for complications. In medicine saline is a solution of sodium chloride in sterile water, used commonly for intravenous infusion, cleaning contact lenses, and nasal irrigation or Jala Neti. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance silvery white Atomic mass 39. ...

Nonketotic hyperosmolar coma

Nonketotic hyperosmolar coma usually develops more insidiously than DKA because the principal symptom is lethargy progressing to obtundation, rather than vomiting and an obvious illness. Extreme hyperglycemia is accompanied by dehydration due to inadequate fluid intake. Coma from NKHC occurs most often in patients who develop type 2 or steroid diabetes and have an impaired ability to recognize thirst and drink. It is classically a nursing home condition but can occur in all ages. Nonketotic hyperosmolar coma is a type of diabetic coma associated with a high mortality seen in diabetes mellitus type 2. ... See diabetes mellitus for further general information on diabetes. ... Steroid diabetes is a medical term referring to prolonged hyperglycemia due to glucocorticoid therapy for another medical condition. ... A nursing home or skilled nursing facility (SNF) is a place of residence for people who require constant nursing care and have significant Activity of Daily Living (ADL) deficiencies. ...

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals extreme hyperglycemia (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.

Identifying the cause of diabetic coma

Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers became universally available in hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a meter glucose to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. Also, the astute physician remembers that other conditions can cause unconsciousness in a person with diabetes: stroke, uremic encephalopathy, alcohol, drug overdose, head injury, or seizure.

Fortunately, most episodes of diabetic hypoglycemia, DKA, and extreme hyperosmolarity do not reach unconsciousness before a family member or caretaker seeks medical help.

See also

• Diabetic hypoglycemia
• Diabetic ketoacidosis
• Nonketotic hyperglycemic coma