Śpiączka cukrzycowa
Diagnostyka i diagnoza

Śpiączka cukrzycowa stanowi stan zagrożenia życia, wynikający z ciężkich zaburzeń metabolicznych w przebiegu cukrzycy, manifestujących się skrajną hiperglikemią lub hipoglikemią. Diagnostyka opiera się na szybkim pomiarze glikemii (poniżej 70 mg/dl lub powyżej 250 mg/dl), badaniu ketonów, gazometrii oraz ocenie elektrolitów i osmolalności osocza. Wyróżnia się trzy główne typy śpiączki: cukrzycową kwasicę ketonową (DKA) z glikemią >250 mg/dl, ketonemią >5 mEq/l, pH <7,3 i luką anionową >12; hiperglikemiczny stan hiperosmolarny (HHS) z glikemią często >600 mg/dl, osmolalnością >320 mOsm/l i brakiem kwasicy; oraz hipoglikemię z glikemią <70 mg/dl, szczególnie <54 mg/dl, prowadzącą do neuroglukopenii. Diagnostyka różnicowa obejmuje wykluczenie innych przyczyn zaburzeń świadomości, takich jak udar, infekcje OUN czy zatrucia.

Diagnostyka śpiączki cukrzycowej

Śpiączka cukrzycowa to stan zagrażający życiu, wymagający natychmiastowej interwencji medycznej. Jest to poważne powikłanie cukrzycy, które powoduje utratę przytomności w wyniku skrajnie wysokiego (hiperglikemia) lub skrajnie niskiego (hipoglikemia) poziomu glukozy we krwi. Stan ten może dotknąć pacjentów z cukrzycą typu 1, typu 2 lub cukrzycą ciążową, choć najczęściej występuje u osób z cukrzycą typu 1.123

Rozpoznanie śpiączki cukrzycowej musi nastąpić jak najszybciej. W większości przypadków medycznych termin „śpiączka cukrzycowa” odnosi się do dylematu diagnostycznego, gdy lekarz ma do czynienia z nieprzytomnym pacjentem, o którym wiadomo jedynie, że choruje na cukrzycę.4 W nowoczesnej praktyce medycznej dzięki dostępności glukometrów i szybkich analizatorów biochemicznych krwi rzadko potrzeba więcej niż kilku pytań, szybkiego badania i pomiaru poziomu glukozy, aby ustalić przyczynę utraty przytomności u pacjenta z cukrzycą.56

Pierwsza ocena kliniczna

Zespół ratownictwa medycznego w przypadku podejrzenia śpiączki cukrzycowej wykonuje następujące czynności:78

  • Szczegółowe badanie fizykalne
  • Zebranie wywiadu medycznego od osób towarzyszących pacjentowi
  • Sprawdzenie, czy pacjent nosi opaskę lub naszyjnik medyczny identyfikujący cukrzycę9
  • Szybki pomiar poziomu glukozy za pomocą glukometru10

Jeśli pacjent jest nieprzytomny, a osoba świadoma opieki diabetologicznej jest obecna, zaleca się postępowanie według następujących kroków:11

  • Jeśli poziom glukozy we krwi jest niższy niż 70 mg/dl (3,9 mmol/l), należy podać zastrzyk glukagonu
  • Jeśli poziom glukozy we krwi jest wyższy niż 70 mg/dl (3,9 mmol/l), należy poczekać na pomoc medyczną
  • Przekazać zespołowi ratunkowemu informacje o cukrzycy pacjenta i podjętych działaniach

Badania diagnostyczne w szpitalu

Po przetransportowaniu pacjenta do szpitala, konieczne jest wykonanie szeregu badań laboratoryjnych, które pomagają nie tylko w potwierdzeniu diagnozy, ale także w ustaleniu przyczyny śpiączki cukrzycowej oraz określeniu sposobu leczenia.1213

Kluczowe badania diagnostyczne obejmują:1415

  • Pomiar poziomu glukozy we krwi
  • Oznaczenie poziomu ketonów we krwi i/lub moczu
  • Określenie poziomu azotu, kreatyniny, potasu i sodu we krwi
  • Badanie równowagi kwasowo-zasadowej (gazometria)
  • Osmolalność krwi
  • Podstawowy panel metaboliczny (BMP)

Rozpoznanie przyczyn śpiączki cukrzycowej

Istnieją trzy główne przyczyny śpiączki cukrzycowej, a każda z nich wymaga nieco innej diagnostyki i ma charakterystyczne parametry laboratoryjne.1617

Cukrzycowa kwasica ketonowa (DKA)

Cukrzycowa kwasica ketonowa to stan najczęściej występujący u osób z cukrzycą typu 1, chociaż może również wystąpić u pacjentów z cukrzycą typu 2 lub ciążową.18 Diagnoza DKA opiera się na następujących kryteriach:192021

  • Poziom glukozy we krwi powyżej 250 mg/dl (13,9 mmol/l) – choć w około 10% przypadków stężenie glukozy może nie być znacząco podwyższone (tzw. euglikemiczna cukrzycowa kwasica ketonowa)
  • Obecność ketonów we krwi (stężenie ketonów powyżej 5 mEq/l) lub w moczu
  • pH krwi poniżej 7,3 (kwasica metaboliczna)
  • Obecność luki anionowej >12
  • Obniżone stężenie wodorowęglanów (<15 mmol/l)

Amerykańskie Towarzystwo Diabetologiczne klasyfikuje DKA u dorosłych według stopnia ciężkości:22

  • Łagodna: pH krwi nieznacznie obniżone do 7,25-7,30; wodorowęglany obniżone do 15-18 mmol/l; pacjent przytomny
  • Umiarkowana: pH 7,00-7,25; wodorowęglany 10-15 mmol/l; może wystąpić lekka senność
  • Ciężka: pH poniżej 7,00; wodorowęglany poniżej 10 mmol/l; może wystąpić stupor lub śpiączka

Stan hiperglikemiczny hiperosmolarny (HHS)

Stan hiperglikemiczny hiperosmolarny charakteryzuje się skrajnym odwodnieniem, bardzo wysokim poziomem glukozy we krwi oraz wysoką osmolalnością krwi, bez obecności ketonów.23 Diagnoza HHS jest zazwyczaj stawiana na podstawie:242526

  • Ekstremalnie wysokiego poziomu glukozy we krwi (często powyżej 600 mg/dl, a nawet 1800 mg/dl (100 mmol/l))
  • Ciężkiego odwodnienia
  • Osoczowej osmolalności powyżej 320 mOsm/l wody (norma: 290 ± 5)
  • pH krwi powyżej 7,30 (brak kwasicy lub łagodna kwasica)
  • Brak lub minimalna obecność ketonów

W przeciwieństwie do DKA, śpiączka spowodowana HHS rozwija się powoli, na przestrzeni kilku dni lub tygodni.27 Stan ten wiąże się z wyższą śmiertelnością (10-50%) w porównaniu do DKA (1,2-9%).28

Ciężka hipoglikemia

Ciężka hipoglikemia może prowadzić do utraty przytomności i śpiączki, jeśli nie zostanie leczona. Diagnoza opiera się na:2930

  • Poziomie glukozy we krwi poniżej 70 mg/dl (3,9 mmol/l), a w szczególności poniżej 54 mg/dl (3,0 mmol/l)
  • Poziom glukozy w mózgu spadający poniżej 3,5 mmol/l, co stanowi ryzyko utraty przytomności
  • Charakterystycznych objawach neuroglukopenii (zaburzenia świadomości, drgawki)
  • Wywiadzie dotyczącym stosowania insuliny lub leków hipoglikemizujących

Stan ten występuje częściej u osób z cukrzycą typu 1 lub u pacjentów z cukrzycą typu 2 przyjmujących insulinę.31

Badania dodatkowe w diagnostyce śpiączki cukrzycowej

Poza podstawowymi badaniami, w zależności od stanu klinicznego pacjenta i podejrzewanej przyczyny śpiączki, mogą być konieczne dodatkowe badania diagnostyczne.3233

Badania w kierunku identyfikacji czynników wyzwalających

Śpiączka cukrzycowa rzadko występuje spontanicznie – zazwyczaj jest wywołana przez jakiś czynnik wyzwalający, który należy zidentyfikować i leczyć. W tym celu wykonuje się:3435

  • Posiewy krwi i moczu (poszukiwanie infekcji)
  • Badanie ogólne moczu (ocena infekcji układu moczowego)
  • RTG klatki piersiowej (wykluczenie zapalenia płuc)
  • EKG (ocena funkcji serca, wykluczenie zawału mięśnia sercowego)
  • W wybranych przypadkach: tomografia komputerowa lub rezonans magnetyczny mózgu (wykluczenie krwawienia mózgowego lub innych stanów neurologicznych)

Badania laboratoryjne pogłębione

W trakcie diagnostyki i monitorowania leczenia śpiączki cukrzycowej wykonuje się również:3637

  • Seryjne pomiary stężenia glukozy we krwi
  • Regularne oznaczanie ketonów we krwi i/lub moczu
  • Monitorowanie równowagi kwasowo-zasadowej poprzez gazometrię
  • Kontrolę elektrolitów (szczególnie potasu, sodu, fosforanów)
  • Ocenę funkcji nerek (mocznik, kreatynina)
  • Pomiar morfologii krwi
  • Oznaczenie hemoglobiny glikowanej (HbA1c) – daje obraz długoterminowej kontroli glikemii

Szczególne aspekty diagnostyczne w różnych grupach pacjentów

Diagnostyka śpiączki cukrzycowej może wymagać nieco innego podejścia w zależności od grupy pacjentów.38

Pacjenci ze świeżo rozpoznaną cukrzycą

U osób, u których cukrzyca nie była wcześniej zdiagnozowana, śpiączka cukrzycowa może być pierwszym objawem choroby. W takich przypadkach diagnostyka obejmuje:394041

  • Standardowe badania jak wyżej
  • Oznaczenie peptyd C (ocena funkcji komórek beta trzustki)
  • Badania w kierunku przeciwciał (anty-GAD, przeciwko komórkom wyspowym, insulinie, IA-2 i IA-2β) – pomoc w ustaleniu etiologii cukrzycy
  • Po ustabilizowaniu stanu pacjenta – wykonanie doustnego testu tolerancji glukozy (OGTT)

Dzieci i młodzież

U dzieci i młodzieży diagnostyka śpiączki cukrzycowej wymaga szczególnej uwagi ze względu na większe ryzyko rozwoju ostrego obrzęku mózgu jako powikłania DKA.42 W tej grupie pacjentów należy:43

  • Dokładnie monitorować stan neurologiczny
  • Zwracać uwagę na oznaki obrzęku mózgu (ból głowy, wymioty, zmiany w zachowaniu, drgawki)
  • Uważnie kontrolować szybkość obniżania poziomu glukozy we krwi
  • Monitorować osmolalność osocza podczas leczenia

Osoby starsze

U osób starszych diagnoza śpiączki cukrzycowej może być utrudniona z powodu:4445

  • Nietypowych objawów
  • Współistniejących chorób, które mogą maskować objawy
  • Stosowania wielu leków, które mogą wpływać na poziom glukozy
  • Częstszego występowania HHS niż DKA
  • Wyższej śmiertelności – w jednym badaniu śmiertelność w śpiączce ketoacidotycznej wynosiła 14%, a w śpiączce nieketonowej 29%, z wyższymi wskaźnikami u starszych pacjentów

Rola diagnostyki różnicowej w śpiączce cukrzycowej

Śpiączka cukrzycowa musi być różnicowana z innymi stanami, które mogą powodować zaburzenia świadomości. Diagnostyka różnicowa powinna uwzględniać:46

  • Śpiączkę hiperosmolarną niecukrzycową
  • Śpiączkę mocznicową
  • Śpiączkę wątrobową
  • Zatrucia (alkohol, leki, narkotyki)
  • Udar mózgu
  • Krwawienie śródczaszkowe
  • Infekcje ośrodkowego układu nerwowego (zapalenie opon mózgowo-rdzeniowych, zapalenie mózgu)
  • Urazy głowy

Dokładne badania laboratoryjne oraz obrazowe pomagają w różnicowaniu tych stanów i ustaleniu właściwego rozpoznania.47

Znaczenie szybkiej diagnostyki i interwencji

Śpiączka cukrzycowa jest stanem zagrożenia życia, który wymaga natychmiastowej interwencji. Opóźnione rozpoznanie i leczenie mogą prowadzić do poważnych konsekwencji.48

Potencjalne powikłania nieleczonej śpiączki cukrzycowej

Nieleczona śpiączka cukrzycowa może prowadzić do:495051

  • Trwałego uszkodzenia mózgu z powodu braku tlenu lub zaburzeń metabolicznych
  • Niewydolności nerek
  • Zaburzeń rytmu serca
  • Powikłań zakrzepowo-zatorowych
  • Zgonu – ryzyko śmierci wzrasta wraz z czasem oczekiwania na leczenie

Algorytm postępowania diagnostyczno-terapeutycznego

Szybkie rozpoznanie przyczyny śpiączki cukrzycowej warunkuje właściwe leczenie. W zależności od rozpoznania, stosuje się odpowiednie postępowanie:5253

W przypadku wysokiego poziomu cukru we krwi (DKA lub HHS):

  • Intensywne nawadnianie dożylne
  • Uzupełnianie elektrolitów (sód, potas, fosforany)
  • Podawanie insuliny
  • Leczenie infekcji, jeśli występują

W przypadku niskiego poziomu cukru we krwi (hipoglikemia):

  • Podanie glukagonu w zastrzyku
  • Podanie dożylne dekstrozy lub glukozy

W obu przypadkach konieczne jest ścisłe monitorowanie parametrów życiowych i laboratoryjnych oraz leczenie chorób współistniejących.54

Monitorowanie i ocena skuteczności leczenia

Po rozpoczęciu leczenia śpiączki cukrzycowej kluczowe jest odpowiednie monitorowanie pacjenta, aby ocenić skuteczność terapii i zapobiec powikłaniom.5556

Parametry wymagające monitorowania

W trakcie leczenia śpiączki cukrzycowej należy regularnie kontrolować:57

  • Poziom glukozy we krwi – początkowo co godzinę, następnie co 2-4 godziny
  • Równowagę kwasowo-zasadową (pH, wodorowęglany)
  • Poziom elektrolitów, szczególnie potasu
  • Parametry życiowe (ciśnienie tętnicze, tętno, saturacja)
  • Stan świadomości
  • Bilans płynów
  • Funkcję nerek (diureza, kreatynina)

Kryteria poprawy stanu klinicznego

O skuteczności leczenia świadczą:58

  • Normalizacja poziomu glukozy we krwi (poniżej 200 mg/dl w przypadku DKA)
  • Normalizacja pH krwi (powyżej 7,3)
  • Ustąpienie ketonemii i ketonurii
  • Poprawa stanu świadomości
  • Stabilizacja parametrów hemodynamicznych

Przy właściwym leczeniu większość pacjentów ze śpiączką cukrzycową odzyskuje przytomność w ciągu 24 godzin. Pełne leczenie DKA następuje, gdy poziom glukozy we krwi jest niższy niż 200 mg/dl, a pH krwi wyższy niż 7,3.59

Podsumowanie

Śpiączka cukrzycowa to stan zagrożenia życia, który wymaga szybkiej i precyzyjnej diagnostyki oraz natychmiastowego leczenia. Kluczowe aspekty diagnostyki obejmują:6061

  • Szybką identyfikację stanu pacjenta poprzez badanie fizykalne i wywiad
  • Natychmiastowe oznaczenie poziomu glukozy we krwi
  • Badania laboratoryjne identyfikujące typ śpiączki cukrzycowej (DKA, HHS, hipoglikemia)
  • Identyfikację czynników wyzwalających i chorób współistniejących
  • Regularne monitorowanie odpowiedzi na leczenie

Dzięki postępom w diagnostyce i leczeniu cukrzycy, śpiączka cukrzycowa występuje rzadziej niż w przeszłości. Niemniej jednak, zwiększona świadomość tego stanu wśród personelu medycznego oraz szybki dostęp do badań diagnostycznych mają kluczowe znaczenie dla zmniejszenia śmiertelności i poprawy rokowania u pacjentów.626364

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Diabetic coma – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475
    A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] Blood sugar that’s either too high or too low for too long may cause the following serious health problems, all of which can lead to a diabetic coma. […] Diabetic ketoacidosis is most common in people who have type 1 diabetes. But it can also occur in people who have type 2 diabetes or gestational diabetes. […] If it’s not treated, a diabetic coma can lead to permanent brain damage and death. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma.
  • #2 Diabetic coma | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma
    The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] A coma is a medical emergency. A quick diagnosis can save the persons life. The cause of a diabetic coma is diagnosed using a number of tests including: medical history, physical examination the person may be wearing an emergency bracelet identifying their medical condition, blood tests including tests for glucose and ketone levels.
  • #3 Diabetes-Related Coma: What It Is, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma
    A diabetes-related coma is a life-threatening complication that can result from very high blood sugar (hyperglycemia) or very low blood sugar (hypoglycemia). […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] A diabetes-related coma is a medical emergency. Anyone in a coma needs treatment in a hospital. […] Healthcare providers can usually quickly diagnose a diabetes-related coma by knowing your medical history and doing a blood glucose test. […] The treatment for a diabetes-related coma depends on the cause. But all cases need treatment in a hospital. […] Yes, its possible to survive a diabetes-related coma if you get treatment for the underlying cause. But some people have permanent brain damage. If you dont get proper treatment in time, you can die. […] The length of a diabetes-related coma depends largely on how quickly you receive proper treatment.
  • #4 Diabetic coma – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_coma
    Diabetic coma is a life-threatening but reversible form of coma found in people with diabetes mellitus. […] In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. […] The diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 12 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis. […] The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. […] Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers were not available in all hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. […] Treatment depends upon the underlying cause: Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously.
  • #5 Diabetic coma – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_coma
    Diabetic coma is a life-threatening but reversible form of coma found in people with diabetes mellitus. […] In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. […] The diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 12 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis. […] The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. […] Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers were not available in all hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. […] Treatment depends upon the underlying cause: Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously.
  • #6 Diabetic coma laboratory findings – wikidoc
    https://www.wikidoc.org/index.php/Diabetic_coma_laboratory_findings
    Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause. […] 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 glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. […] 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. Test that may be done include: Blood osmolarity (concentration), BUN and creatinine levels, Blood sodium level, Ketone test, Very high blood glucose. […] Evaluation for possible causes may include: Blood cultures, Urinalysis.
  • #7 Diabetic coma – Diagnosis & treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479
    If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] The emergency medical team will do a physical exam and may ask those who are with you about your medical history. […] At the hospital, you may need lab tests to measure: Your blood sugar level, Your ketone level, The amount of nitrogen, creatinine, potassium and sodium in your blood. […] Diabetic coma requires emergency medical treatment. […] If your blood sugar level is too high, you may need: Intravenous fluids to restore water to your body, Potassium, sodium or phosphate supplements to help your cells work correctly, Insulin to help your body absorb the glucose in your blood, Treatment for any infections. […] If your blood sugar level is too low, you may be given a shot of glucagon.
  • #8 Diabetic coma
    https://www.mymlc.com/health-information/diseases-and-conditions/d/diabetic-coma2/
    A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you feel extreme high or low blood sugar signs or symptoms and think you might pass out, call 911 or your local emergency number. […] 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. […] At the hospital, 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. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.
  • #9 Diabetic coma | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma
    The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] A coma is a medical emergency. A quick diagnosis can save the persons life. The cause of a diabetic coma is diagnosed using a number of tests including: medical history, physical examination the person may be wearing an emergency bracelet identifying their medical condition, blood tests including tests for glucose and ketone levels.
  • #10 Diabetic Coma: Symptoms, Causes & Treatment | Wockhardt Hospitals
    https://www.wockhardthospitals.com/articles/diabetes/diabetic-coma/
    A diabetic coma or diabetes-related coma is a medical emergency that requires medical intervention in the hospital. […] Healthcare providers or doctors may be able to diagnose diabetic coma by knowing the patients medical history and performing a blood glucose test that confirms the glucose level in the blood. […] They may also perform other tests to look for the level of ketones in the blood and the patients overall health condition.
  • #11 Diabetic coma – Diagnosis & treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479
    A diabetic coma is a medical emergency that you won’t have time to prepare for. […] If you’re with someone with diabetes who has passed out or is acting strange, possibly as if they have had too much alcohol, call for immediate medical help. […] If you have no training in diabetes care, wait for the emergency care team to arrive. […] If you are familiar with diabetes care, test the unconscious person’s blood sugar and follow these steps: If the blood sugar level is lower than 70 Milligrams per deciliter (mg/dL) (3.9 Millimoles per litre (mmol/L)), give the person an injection of glucagon. […] If the blood sugar level is above 70 mg/dL (3.9 mmol/L) wait for medical help to arrive. […] If you called for medical help, tell the emergency care team about the diabetes and what steps you’ve taken, if any.
  • #12 Diabetic coma – Diagnosis & treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479
    If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] The emergency medical team will do a physical exam and may ask those who are with you about your medical history. […] At the hospital, you may need lab tests to measure: Your blood sugar level, Your ketone level, The amount of nitrogen, creatinine, potassium and sodium in your blood. […] Diabetic coma requires emergency medical treatment. […] If your blood sugar level is too high, you may need: Intravenous fluids to restore water to your body, Potassium, sodium or phosphate supplements to help your cells work correctly, Insulin to help your body absorb the glucose in your blood, Treatment for any infections. […] If your blood sugar level is too low, you may be given a shot of glucagon.
  • #13 Diabetic coma – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
    https://www.augustahealth.com/disease/diabetic-coma/
    A diabetic coma is a life-threatening diabetes complication that causes unconsciousness. […] A diabetic coma is a medical emergency. 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. […] At the hospital, 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.
  • #14 Diabetic coma | Beacon Health System
    https://www.beaconhealthsystem.org/library/diseases-and-conditions/diabetic-coma?content_id=CON-20371458
    A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. The emergency medical team will do a physical exam and may ask those who are with you about your medical history. […] At the hospital, you may need lab tests to measure your blood sugar level, your ketone level, and the amount of nitrogen, creatinine, potassium and sodium in your blood. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.
  • #15 Diabetic coma | Altru Health System
    https://www.altru.org/health-library/conditions/diabetic-coma
    A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. The emergency medical team will do a physical exam and may ask those who are with you about your medical history. […] At the hospital, you may need lab tests to measure: Your blood sugar level, Your ketone level, The amount of nitrogen, creatinine, potassium and sodium in your blood. […] Diabetic coma requires emergency medical treatment. The type of treatment depends on whether your blood sugar level is too high or too low.
  • #16 Diabetic coma | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma
    The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] A coma is a medical emergency. A quick diagnosis can save the persons life. The cause of a diabetic coma is diagnosed using a number of tests including: medical history, physical examination the person may be wearing an emergency bracelet identifying their medical condition, blood tests including tests for glucose and ketone levels.
  • #17 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    Diabetic coma is a dangerous condition that can lead to unconsciousness and even death. Diabetic coma may affect 2% to 15% of all diabetics at least once in their lifetime and the condition that most commonly causes the coma is severe hypoglycaemia or low blood sugar. […] There are three main causes of coma in people with diabetes: diabetic ketoacidosis, severe hypoglycaemia and hyperglycaemic hyperosmolar state. However, despite the increased prevalence of diabetes across the globe, improved diagnosis and early treatment of these causative conditions has lessened the risk of death due to diabetic coma. […] A glucometer, for example, can detect high or low blood sugar in an unconscious diabetic patient within seconds and this can be confirmed in the laboratory within an hour. Furthermore, due to the widespread warnings and knowledge regarding the possibility of the three conditions, most patients are brought to an emergency unit before the onset of coma.
  • #18 Diabetic coma – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475
    A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] Blood sugar that’s either too high or too low for too long may cause the following serious health problems, all of which can lead to a diabetic coma. […] Diabetic ketoacidosis is most common in people who have type 1 diabetes. But it can also occur in people who have type 2 diabetes or gestational diabetes. […] If it’s not treated, a diabetic coma can lead to permanent brain damage and death. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma.
  • #19 Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology
    https://emedicine.medscape.com/article/118361-overview
    Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. […] Laboratory studies for DKA include glucose blood tests, serum electrolyte determinations, blood urea nitrogen (BUN) evaluation, and arterial blood gas (ABG) measurements. […] DKA is defined clinically as an acute state of severe uncontrolled diabetes associated with ketoacidosis that requires emergency treatment with insulin and intravenous fluids. […] Biochemically, DKA is defined as an increase in the serum concentration of ketones greater than 5 mEq/L, a blood sugar level greater than 250 mg/dL (although it is usually much higher), and a blood (usually arterial) pH less than 7.3. […] Mental status changes can be seen with mild-to-moderate DKA; more severe deterioration in mental status is typical with moderate-to-severe DKA.
  • #20 Diabetic ketoacidosis – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_ketoacidosis
    Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. […] In about 10% of cases the blood sugar is not significantly elevated („euglycemic diabetic ketoacidosis”). […] A pH measurement is performed to detect acidosis. Blood from a vein is adequate, as there is little difference between the arterial and the venous pH; arterial samples are only required if there are concerns about oxygen levels. […] Diabetic ketoacidosis is distinguished from other diabetic emergencies by the presence of large amounts of ketones in blood and urine, and marked metabolic acidosis. […] The American Diabetes Association categorizes DKA in adults into one of three stages of severity: Mild: blood pH mildly decreased to between 7.25 and 7.30 (normal 7.35-7.45); serum bicarbonate decreased to 15-18 mmol/L (normal above 20); the person is alert. […] Moderate: pH 7.00-7.25, bicarbonate 10-15, mild drowsiness may be present. […] Severe: pH below 7.00, bicarbonate below 10, stupor or coma may occur.
  • #21 Diabetic Ketoacidosis (DKA): Your Guide to Diabetic Coma
    https://www.trifectanutrition.com/health/diabetic-ketoacidosis-dka-guide-to-diabetic-coma?srsltid=AfmBOooMcFhEVksbftT8AdzTePohcfWcE4UFPBTDQcPJ_JIgNV2XOsnl
    Diabetic coma is the term used to describe a mental state change in people with diabetes from extreme fluctuations in blood sugar levels. […] Making the diagnosis of DKA requires blood tests. Sometimes high levels of ketones in the urine are also used to help make the diagnosis of DKA. […] Diagnosing DKA Requires: 1) Elevated Blood Glucose 250 mg dl 2) Elevated Ketones (betahydroxybutyrate or urine ketones) 3) Acidosis (blood pH 7.3) […] Diabetics with positive ketones should always be evaluated by a doctor to ensure they are not in diabetic ketoacidosis.
  • #22 Diabetic ketoacidosis – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_ketoacidosis
    Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. […] In about 10% of cases the blood sugar is not significantly elevated („euglycemic diabetic ketoacidosis”). […] A pH measurement is performed to detect acidosis. Blood from a vein is adequate, as there is little difference between the arterial and the venous pH; arterial samples are only required if there are concerns about oxygen levels. […] Diabetic ketoacidosis is distinguished from other diabetic emergencies by the presence of large amounts of ketones in blood and urine, and marked metabolic acidosis. […] The American Diabetes Association categorizes DKA in adults into one of three stages of severity: Mild: blood pH mildly decreased to between 7.25 and 7.30 (normal 7.35-7.45); serum bicarbonate decreased to 15-18 mmol/L (normal above 20); the person is alert. […] Moderate: pH 7.00-7.25, bicarbonate 10-15, mild drowsiness may be present. […] Severe: pH below 7.00, bicarbonate below 10, stupor or coma may occur.
  • #23 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    If an individuals sugar level in the blood and the brain drops to below 3.5 mmol/l, they are at risk of losing consciousness and falling into a diabetic coma. […] This condition is more common among people with type 1 diabetes or those with type 2 diabetes who are taking insulin. […] The condition may occur due to a missed or inadequate insulin dose, acute infection, major injury or surgery. […] This condition is characterized by severe dehydration, high blood glucose and high blood osmolarity. Common causes of HHS are a missed insulin dose, acute infection or injury, and a heavy food or sugar intake. Unlike with DKA, a coma caused by HHS develops slowly, over several days or weeks.
  • #24 Diabetic coma – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_coma
    Diabetic coma is a life-threatening but reversible form of coma found in people with diabetes mellitus. […] In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. […] The diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 12 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis. […] The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. […] Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers were not available in all hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. […] Treatment depends upon the underlying cause: Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously.
  • #25 Diabetic coma laboratory findings – wikidoc
    https://www.wikidoc.org/index.php/Diabetic_coma_laboratory_findings
    Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause. […] 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 glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. […] 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. Test that may be done include: Blood osmolarity (concentration), BUN and creatinine levels, Blood sodium level, Ketone test, Very high blood glucose. […] Evaluation for possible causes may include: Blood cultures, Urinalysis.
  • #26 Hyperosmolar Hyperglycemic State | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1201/p729.html
    Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. […] Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma. […] Identification and treatment of underlying and precipitating causes are necessary. […] The mortality rate from HHS ranges from 10% to 50%, which is considerably higher than that of DKA (1.2% to 9%). […] Initial laboratory findings in patients with HHS include marked elevations in blood glucose levels (greater than 600 mg per dL [33.3 mmol per L]) and in serum osmolarity (greater than 320 mOsm per L of water [normal = 290 5]), with a pH level greater than 7.30 and mild or absent ketosis. […] Treatment of HHS requires a four-pronged approach: (1) vigorous intravenous rehydration, (2) electrolyte management, (3) intravenous insulin, and (4) diagnosis and management of precipitating and coexisting problems. […] Routine antibiotics are not recommended for all patients with suspected infection. However, they are warranted while awaiting culture results in older patients or in those with hypotension.
  • #27 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    If an individuals sugar level in the blood and the brain drops to below 3.5 mmol/l, they are at risk of losing consciousness and falling into a diabetic coma. […] This condition is more common among people with type 1 diabetes or those with type 2 diabetes who are taking insulin. […] The condition may occur due to a missed or inadequate insulin dose, acute infection, major injury or surgery. […] This condition is characterized by severe dehydration, high blood glucose and high blood osmolarity. Common causes of HHS are a missed insulin dose, acute infection or injury, and a heavy food or sugar intake. Unlike with DKA, a coma caused by HHS develops slowly, over several days or weeks.
  • #28 Hyperosmolar Hyperglycemic State | AAFP
    https://www.aafp.org/pubs/afp/issues/2017/1201/p729.html
    Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. […] Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma. […] Identification and treatment of underlying and precipitating causes are necessary. […] The mortality rate from HHS ranges from 10% to 50%, which is considerably higher than that of DKA (1.2% to 9%). […] Initial laboratory findings in patients with HHS include marked elevations in blood glucose levels (greater than 600 mg per dL [33.3 mmol per L]) and in serum osmolarity (greater than 320 mOsm per L of water [normal = 290 5]), with a pH level greater than 7.30 and mild or absent ketosis. […] Treatment of HHS requires a four-pronged approach: (1) vigorous intravenous rehydration, (2) electrolyte management, (3) intravenous insulin, and (4) diagnosis and management of precipitating and coexisting problems. […] Routine antibiotics are not recommended for all patients with suspected infection. However, they are warranted while awaiting culture results in older patients or in those with hypotension.
  • #29 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    If an individuals sugar level in the blood and the brain drops to below 3.5 mmol/l, they are at risk of losing consciousness and falling into a diabetic coma. […] This condition is more common among people with type 1 diabetes or those with type 2 diabetes who are taking insulin. […] The condition may occur due to a missed or inadequate insulin dose, acute infection, major injury or surgery. […] This condition is characterized by severe dehydration, high blood glucose and high blood osmolarity. Common causes of HHS are a missed insulin dose, acute infection or injury, and a heavy food or sugar intake. Unlike with DKA, a coma caused by HHS develops slowly, over several days or weeks.
  • #30 Hypoglycemic Coma: Causes, Symptoms, Diagnosis, and Management | PPT
    https://www.slideshare.net/slideshow/hypoglycemic-coma-causes-symptoms-diagnosis-and-management/270339011
    Hypoglycemic coma is a life-threatening condition resulting from severe low blood sugar levels. It can occur in patients with diabetes, particularly those on insulin or sulfonylureas. […] Early recognition and treatment are crucial to prevent irreversible brain damage and death. […] Hypoglycemia: Blood glucose level 70 mg/dL (3.9 mmol/L). Normal fasting blood glucose: 70-99 mg/dL (3.9-5.5 mmol/L). […] Causes of Hypoglycemia include excessive insulin or oral hypoglycemic agents, prolonged fasting or missed meals, intense physical activity without adequate carbohydrate intake, and alcohol consumption. […] Clinical Presentation Symptoms of Mild to Moderate Hypoglycemia include sweating, tremors, palpitations, hunger, and anxiety. Signs and Symptoms of Severe Hypoglycemia Leading to Coma include confusion, irritability, seizures, loss of consciousness, and coma.
  • #31 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    If an individuals sugar level in the blood and the brain drops to below 3.5 mmol/l, they are at risk of losing consciousness and falling into a diabetic coma. […] This condition is more common among people with type 1 diabetes or those with type 2 diabetes who are taking insulin. […] The condition may occur due to a missed or inadequate insulin dose, acute infection, major injury or surgery. […] This condition is characterized by severe dehydration, high blood glucose and high blood osmolarity. Common causes of HHS are a missed insulin dose, acute infection or injury, and a heavy food or sugar intake. Unlike with DKA, a coma caused by HHS develops slowly, over several days or weeks.
  • #32 Diabetic Ketoacidosis (DKA): Causes, Symptoms, Treatments
    https://www.webmd.com/diabetes/ketoacidosis
    Testing your pee (urinalysis). Looking at a sample of pee helps your doctor measure your ketones, sugar, and other nutrients. They might also measure how much pee you make (to make sure that you arent getting dehydrated) and test for infections. […] Other diagnostic testing for DKA includes: Ketone test, Arterial blood gas, Blood pressure, Osmolality. […] Your doctor might give you a chest X-ray, CAT scan, or MRI to rule out other problems or get more information about how DKA is impacting you. They may also recommend tests for your heart (electrocardiogram, or ECG) to check how it’s working.
  • #33 Diabetic coma laboratory findings – wikidoc
    https://www.wikidoc.org/index.php/Diabetic_coma_laboratory_findings
    Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause. […] 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 glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. […] 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. Test that may be done include: Blood osmolarity (concentration), BUN and creatinine levels, Blood sodium level, Ketone test, Very high blood glucose. […] Evaluation for possible causes may include: Blood cultures, Urinalysis.
  • #34 Diabetic coma laboratory findings – wikidoc
    https://www.wikidoc.org/index.php/Diabetic_coma_laboratory_findings
    Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause. […] 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 glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. […] 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. Test that may be done include: Blood osmolarity (concentration), BUN and creatinine levels, Blood sodium level, Ketone test, Very high blood glucose. […] Evaluation for possible causes may include: Blood cultures, Urinalysis.
  • #35 Diabetes Canada | Clinical Practice Guidelines
    https://guidelines.diabetes.ca/cpg/chapter15
    Diabetic ketoacidosis and hyperosmolar hyperglycemic state should be suspected in people who have diabetes and are ill. If either diabetic ketoacidosis or hyperosmolar hyperglycemic state is diagnosed, precipitating factors must be sought and treated. […] Diabetic ketoacidosis requires intravenous insulin administration (0.1 units/kg/h) for resolution. Bicarbonate therapy may be considered only for extreme acidosis (pH 7.0). […] DKA or HHS should be suspected whenever people have significant hyperglycemia, especially if they are ill or highly symptomatic. […] To make the diagnosis and determine the severity of DKA or HHS, the following should be assessed: plasma levels of electrolytes (and anion gap), plasma glucose (PG), creatinine, osmolality and beta-hydroxybutyric acid (beta-OHB) (if available), blood gases, serum and urine ketones, fluid balance, level of consciousness, precipitating factors and complications.
  • #36 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka
    Diabetes-related ketoacidosis (DKA) is a life-threatening complication that affects people with diabetes or undiagnosed diabetes. It requires immediate medical attention. […] Healthcare providers diagnose diabetes-related ketoacidosis if you have the following four conditions: Your blood glucose (sugar) level is above 250 mg/dL. Its possible to have DKA if your blood sugar is lower than 250 mg/dL. This is euglycemic diabetes-related ketoacidosis (euDKA). Its not as common. […] In the hospital, healthcare providers may use the following tests to diagnose DKA: Blood glucose test. Ketone testing (through a urine or blood test). Arterial blood gas (ABG). Basic metabolic panel (BMP). Blood pressure measurement. Osmolality blood test. […] If you have diabetes and identify DKA early enough, you may be able to treat it from home with specific instructions from your healthcare provider.
  • #37 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether
    https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/
    DKA requires prompt treatment and close monitoring as deterioration can lead to coma and death. […] The following blood results will diagnose DKA: Blood sugar levels of more than 250 mg/dL, Arterial pH below 7.3, Serum bicarbonate level below 15 mEq/L, Presence of ketonemia (ketones in the blood), Anion gap more than 10 in mild DKA and greater than 12 in moderate or severe DKA. […] The body cannot utilize glucose to produce the necessary energy without insulin. This results in hormones breaking down fat for the body to use as fuel which generates acids known as ketones. […] DKA is a medical emergency that requires intervention to prevent deterioration. […] Administer insulin. IV insulin is the standard treatment for DKA as the patient needs insulin rapidly to decrease glucose and ketone levels.
  • #38 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    Diabetic coma is a dangerous condition that can lead to unconsciousness and even death. Diabetic coma may affect 2% to 15% of all diabetics at least once in their lifetime and the condition that most commonly causes the coma is severe hypoglycaemia or low blood sugar. […] There are three main causes of coma in people with diabetes: diabetic ketoacidosis, severe hypoglycaemia and hyperglycaemic hyperosmolar state. However, despite the increased prevalence of diabetes across the globe, improved diagnosis and early treatment of these causative conditions has lessened the risk of death due to diabetic coma. […] A glucometer, for example, can detect high or low blood sugar in an unconscious diabetic patient within seconds and this can be confirmed in the laboratory within an hour. Furthermore, due to the widespread warnings and knowledge regarding the possibility of the three conditions, most patients are brought to an emergency unit before the onset of coma.
  • #39 Diabetic Coma
    https://www.diabetes.co.uk/diabetes-complications/diabetic-coma.html
    If the symptoms of type 1 diabetes are not spotted soon enough, ketoacidosis can develop leading to coma before a diagnosis is made. […] Approximately 1 in 4 patients diagnosed with type 1 diabetes are recorded as demonstrating signs of ketoacidosis. […] If someone with diabetes has the above symptoms call for medical help as losing consciousness and coma (hyperglycaemic hyperosmolar non-ketotic coma) can follow.
  • #40 Diabetes Mellitus: Diagnosis and Screening | AAFP
    https://www.aafp.org/pubs/afp/issues/2010/0401/p863.html
    Based on etiology, diabetes is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, latent autoimmune diabetes, maturity-onset diabetes of youth, and miscellaneous causes. The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral glucose tolerance testing. […] A1C value of greater than 6.5 percent on two separate occasions is diagnostic for diabetes. […] The diagnosis of diabetes is based on one of three methods of blood glucose measurement. Diabetes can be diagnosed if the patient has a fasting blood glucose level of 126 mg per dL (7.0 mmol per L) or greater on two separate occasions. […] Diabetes can also be diagnosed with a random blood glucose level of 200 mg per dL (11.1 mmol per L) or greater if classic symptoms of diabetes (e.g., polyuria, polydipsia, weight loss, blurred vision, fatigue) are present.
  • #41 Diabetic Coma: Recovery, Prevention, and More
    https://www.healthline.com/health/diabetic-coma-recovery
    A diabetic coma occurs when a person with diabetes loses consciousness. It can occur in people with type 1 or type 2 diabetes. […] A diabetic coma occurs when blood sugar levels become either too low or too high. […] Usually, you can prevent hyperglycemia or hypoglycemia from progressing to a diabetic coma. […] A diabetic coma is a medical emergency. It can lead to brain damage or death if you dont get treatment. […] Treating hyperglycemia requires intravenous fluids to improve fluid levels throughout your body. […] A glucagon injection will help increase your blood sugar levels if youre experiencing hypoglycemia. […] Once your blood glucose levels are in a healthy range, you should start to feel better almost immediately. […] If you experience a diabetic coma without knowing you have diabetes, your doctor will work with you to develop a diabetes treatment plan. […] The key to preventing a diabetic coma is proper blood glucose management. […] A diabetic coma is an unusual event, but its common enough that you should be aware that the risk exists. […] Call 911 if you see someone losing consciousness for any reason.
  • #42 Diabetic Ketoacidosis (DKA) – Endocrine and Metabolic Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetic-ketoacidosis-dka
    Diabetic ketoacidosis (DKA) is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. […] DKA is diagnosed by an arterial pH 7.30 with an anion gap 12 and serum ketones. […] A presumptive diagnosis may be made when urine glucose and ketones are positive on urinalysis. […] Symptoms and signs of diabetic ketoacidosis include symptoms of hyperglycemia with the addition of nausea, vomiting, and particularly in children abdominal pain. […] In the absence of timely treatment, DKA progresses to coma and death. […] Acute cerebral edema, a complication in about 1% of DKA patients, occurs primarily in children and less often in adolescents and young adults. […] Diagnosis of DKA includes arterial pH, serum ketones, and calculation of anion gap.
  • #43
    https://link.springer.com/article/10.1007/BF02998928
    1. In a group of 218 children (first and second decade) there were fifty instances of coma. […] The differential diagnosis and methods of treatment are discussed. […] The diagnosis of diabetic coma.
  • #44
    https://consensus.app/questions/diabetic-coma-how-long-before-death/
    A diabetic coma is a life-threatening complication of diabetes that causes unconsciousness. If left untreated, it can lead to death. Understanding the duration and factors influencing the time before death in diabetic coma is crucial for improving patient outcomes. […] The duration of diabetes significantly impacts the prognosis of patients experiencing a diabetic coma. Studies indicate that patients who have had diabetes for a longer period are more likely to succumb to complications, including coma. […] Early mortality rates in diabetic coma vary based on the type of coma and patient demographics. In a study of 86 episodes of diabetic coma, early mortality was 14% for ketoacidotic coma and 29% for non-ketotic coma, with higher mortality rates observed in older patients. […] Anuria, or the absence of urine production, often precedes death in diabetic coma cases. This condition typically develops six to twelve hours before death and is associated with chronic nephritis in older patients or renal block due to acidosis and blood pressure drops in younger patients.
  • #45
    https://consensus.app/questions/diabetic-coma-how-long-before-death/
    Hypoglycemia and ketoacidosis are common causes of death in diabetic coma. In a population study, 1.73% of deaths were primarily due to coma, with hypoglycemia and ketoacidosis being significant contributors. […] Acute complications such as bacterial pneumonia, aspiration pneumonia, mesenteric and iliac thromboses, myocardial infarction, and cerebral hemorrhage are major causes of death in diabetic coma patients. […] The duration before death in diabetic coma varies based on several factors, including the duration of diabetes, patient age, and the presence of acute complications. Early intervention and proper management of diabetes can significantly improve survival rates. Understanding these factors is essential for healthcare providers to develop effective treatment strategies and improve patient outcomes.
  • #46 Coma: Causes, diagnosis, treatment, and outlook
    https://www.medicalnewstoday.com/articles/173655
    A coma can result from complications of conditions such as diabetes or an infection, or from a traumatic incident involving a blow to the head or a lack of oxygen. […] The causes of a coma vary, but they all involve some level of injury to the brain or central nervous system (CNS). […] Diabetes: The blood sugar levels of a person with diabetes can sometimes rise too much or fall too low, known as hyperglycemia and hypoglycemia, respectively. If either of these states continues for too long, a coma can result. […] A medical history alongside various tests can help determine the cause of a coma, which informs the treatment decisions. […] Doctors will likely use blood tests to check glucose levels. […] A coma is usually a serious medical emergency. Healthcare professionals will start by ensuring the immediate survival of the individual. They will secure their breathing and circulation to maximize the amount of oxygen that reaches the brain. […] As a 2021 review explains, further treatment will then depend on the underlying cause of the coma. […] The treatment options may include administering glucose, even before the results of blood tests are available, in case the person is in diabetic shock or has a brain infection.
  • #47 Diabetic coma – Wikipedia
    https://en.wikipedia.org/wiki/Diabetic_coma
    Diabetic coma is a life-threatening but reversible form of coma found in people with diabetes mellitus. […] In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. […] The diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 12 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis. […] The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals an extremely high blood sugar level (often above 1800 mg/dl (100 mM)) and dehydration. […] Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers were not available in all hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. […] Treatment depends upon the underlying cause: Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously.
  • #48 Understanding and Preventing Diabetic Coma
    https://www.healthline.com/health/understanding-and-preventing-diabetic-coma
    Diabetic coma is a serious, potentially life-threatening complication associated with diabetes. A diabetic coma causes unconsciousness that you cannot awaken from without medical care. Most cases of diabetic coma occur in people with type 1 diabetes. But people with other types of diabetes are also at risk. […] Diabetic comas are considered emergencies that require prompt medical attention and are treated in a hospital setting. […] Diabetic coma is a serious complication that can be fatal. And the odds of death increase the longer you wait for treatment. Waiting too long for treatment can also lead to brain damage. This diabetic complication is rare. But its so serious that all patients must take precautions. […] Diabetic coma is a serious, potentially life-threatening complication associated with diabetes. The power to protect from diabetic coma is in your hands. Know the signs and symptoms that may lead up to a coma, and be prepared to spot problems before they turn into emergencies. Prepare both yourselves and others about what to do if you become comatose. Make sure to manage your diabetes to reduce your risk.
  • #49 Diabetic coma – Symptoms & causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475
    A diabetic coma is a life-threatening disorder that causes unconsciousness. If you have diabetes, dangerously high blood sugar (hyperglycemia) or dangerously low blood sugar (hypoglycemia) can lead to a diabetic coma. […] A diabetic coma is a medical emergency. If you have symptoms of high or low blood sugar and you think you might pass out, call 911 or your local emergency number. […] Blood sugar that’s either too high or too low for too long may cause the following serious health problems, all of which can lead to a diabetic coma. […] Diabetic ketoacidosis is most common in people who have type 1 diabetes. But it can also occur in people who have type 2 diabetes or gestational diabetes. […] If it’s not treated, a diabetic coma can lead to permanent brain damage and death. […] Good day-to-day control of your diabetes can help you prevent a diabetic coma.
  • #50 First Aid for Diabetic Coma – DoveMed
    https://www.dovemed.com/healthy-living/first-aid/first-aid-diabetic-coma
    All incidents of Diabetic Coma should be evaluated by a trained medical professional, as soon as possible! DO NOT wait! Failure to obtain evaluation as soon as possible may result in serious injury or death. Call 911 (or your local emergency number) immediately, if you undergo a Diabetic Coma. […] The condition is a medical emergency and prompt treatment is important. […] The first responders (healthcare personnel) may administer 1 mg of glucagon, in case of hypoglycemia (or low blood sugar levels). […] The prognosis of Diabetic Coma is dependent on the following factors: How high the blood sugar level was, How long the condition persisted, And, the timely manner in which treatment was administered. […] In case of delayed treatment, there is a risk for permanent brain injury due to loss of oxygen supply to the brain.
  • #51 Diabetic Coma: Recovery, Prevention, and More
    https://www.healthline.com/health/diabetic-coma-recovery
    A diabetic coma occurs when a person with diabetes loses consciousness. It can occur in people with type 1 or type 2 diabetes. […] A diabetic coma occurs when blood sugar levels become either too low or too high. […] Usually, you can prevent hyperglycemia or hypoglycemia from progressing to a diabetic coma. […] A diabetic coma is a medical emergency. It can lead to brain damage or death if you dont get treatment. […] Treating hyperglycemia requires intravenous fluids to improve fluid levels throughout your body. […] A glucagon injection will help increase your blood sugar levels if youre experiencing hypoglycemia. […] Once your blood glucose levels are in a healthy range, you should start to feel better almost immediately. […] If you experience a diabetic coma without knowing you have diabetes, your doctor will work with you to develop a diabetes treatment plan. […] The key to preventing a diabetic coma is proper blood glucose management. […] A diabetic coma is an unusual event, but its common enough that you should be aware that the risk exists. […] Call 911 if you see someone losing consciousness for any reason.
  • #52 Diabetic coma – Diagnosis & treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/diabetic-coma/diagnosis-treatment/drc-20371479
    If you experience a diabetic coma, it is very important that it’s diagnosed as soon as possible. […] The emergency medical team will do a physical exam and may ask those who are with you about your medical history. […] At the hospital, you may need lab tests to measure: Your blood sugar level, Your ketone level, The amount of nitrogen, creatinine, potassium and sodium in your blood. […] Diabetic coma requires emergency medical treatment. […] If your blood sugar level is too high, you may need: Intravenous fluids to restore water to your body, Potassium, sodium or phosphate supplements to help your cells work correctly, Insulin to help your body absorb the glucose in your blood, Treatment for any infections. […] If your blood sugar level is too low, you may be given a shot of glucagon.
  • #53 What Causes a Diabetic Coma?
    https://www.verywellhealth.com/diabetic-coma-5115963
    Depending on the cause of your diabetic coma, your labwork will look different. […] A diabetic coma can develop due to severe diabetic ketoacidosis. In addition to high blood sugar, people with diabetic ketoacidosis have high levels of ketones (chemicals produced when your liver breaks down fats) and a high level of acid in their blood. […] If the hypoglycemia isn’t treated for a long time, it can become severe. At that point, severe mental and physical symptoms will prevent normal functioning. […] Treatments for people with diabetes who have high blood sugar include: Replacing your body’s electrolytes, including sodium, potassium, and phosphate; Intensive hydration, including intravenous fluids to restore water to the tissues; Insulin. […] If an individual experiences hypoglycemia, treatments include: Intravenous dextrose or glucose to raise blood glucose levels; Glucagon injection, which causes the blood sugar level to rise quickly.
  • #54 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka
    Hospital treatment of DKA includes: IV fluids: IV fluids help to correct dehydration, clear ketones through your pee and correct electrolyte imbalances. Insulin: Your healthcare team may give you insulin through an IV or as a needle injection (subcutaneous shot). Other treatments: Depending on the severity of DKA, your healthcare team may give you other treatments to help you recover. […] With prompt treatment, recovery from DKA typically happens within 24 hours. Full treatment of DKA happens when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3. […] With prompt treatment, most people recover from diabetes-related ketoacidosis within a day. Sometimes, it takes longer.
  • #55 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether
    https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/
    DKA requires prompt treatment and close monitoring as deterioration can lead to coma and death. […] The following blood results will diagnose DKA: Blood sugar levels of more than 250 mg/dL, Arterial pH below 7.3, Serum bicarbonate level below 15 mEq/L, Presence of ketonemia (ketones in the blood), Anion gap more than 10 in mild DKA and greater than 12 in moderate or severe DKA. […] The body cannot utilize glucose to produce the necessary energy without insulin. This results in hormones breaking down fat for the body to use as fuel which generates acids known as ketones. […] DKA is a medical emergency that requires intervention to prevent deterioration. […] Administer insulin. IV insulin is the standard treatment for DKA as the patient needs insulin rapidly to decrease glucose and ketone levels.
  • #56 Diabetic Ketoacidosis (DKA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether
    https://www.nursetogether.com/diabetic-ketoacidosis-dka-nursing-diagnosis-care-plan/
    Administer IV fluid as ordered. Fluid resuscitation is crucial in the management of patients with DKA. […] Monitor vital signs. Elevated WBC count plus abnormal vital signs such as fever, tachycardia, and tachypnea are manifestations of sepsis. […] Administer isotonic solutions initially. Fluid replacement alone will begin to lower blood glucose. Initial isotonic therapy of 0.9% saline is recommended. […] Administer medications as ordered. Infections are a common cause of DKA. Broad-spectrum antibiotics aid in controlling the source of infection until the pathogen is identified to prevent worsening perfusion.
  • #57 Diabetes With Coma in Dogs – Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost
    https://wagwalking.com/condition/diabetes-with-coma
    Diabetes with coma results due to many factors that can have a crucial effect on your dogs well-being. […] Diagnosis of Diabetes With Coma in Dogs If you are at home and discover your dog is unresponsive, try to remain calm. […] The veterinarian will order a complete blood count, biochemical profile, and urinalysis. […] Your veterinarian will explain the process to you; glucose levels should be checked every hour to every two hours, as recovery progresses. […] Once your pet is stabilised, your veterinarian will further her investigation into why the coma accompanying the diabetes is occurring.
  • #58 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka
    Hospital treatment of DKA includes: IV fluids: IV fluids help to correct dehydration, clear ketones through your pee and correct electrolyte imbalances. Insulin: Your healthcare team may give you insulin through an IV or as a needle injection (subcutaneous shot). Other treatments: Depending on the severity of DKA, your healthcare team may give you other treatments to help you recover. […] With prompt treatment, recovery from DKA typically happens within 24 hours. Full treatment of DKA happens when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3. […] With prompt treatment, most people recover from diabetes-related ketoacidosis within a day. Sometimes, it takes longer.
  • #59 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka
    Hospital treatment of DKA includes: IV fluids: IV fluids help to correct dehydration, clear ketones through your pee and correct electrolyte imbalances. Insulin: Your healthcare team may give you insulin through an IV or as a needle injection (subcutaneous shot). Other treatments: Depending on the severity of DKA, your healthcare team may give you other treatments to help you recover. […] With prompt treatment, recovery from DKA typically happens within 24 hours. Full treatment of DKA happens when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3. […] With prompt treatment, most people recover from diabetes-related ketoacidosis within a day. Sometimes, it takes longer.
  • #60 Diabetic Coma: Symptoms, Treatment, and Prevention
    https://polarbearmeds.com/diabetic-coma/
    A diabetic coma is a severe complication of diabetes that requires immediate medical attention. […] Recognizing the signs and understanding the risk factors associated with this condition is crucial for diabetic patients and their caregivers. […] Immediate medical intervention is necessary to stabilize blood sugar and prevent complications. […] Diabetic comas can be caused by diabetic ketoacidosis, hyperosmolar coma, or hypoglycemic coma. […] Prompt recognition, intervention, and monitoring are crucial for preventing diabetic coma and its complications. […] Diabetic coma is a life-threatening condition characterized by unconsciousness resulting from high or low blood sugar levels in individuals with diabetes. […] Diabetic coma is a critical condition that requires immediate medical intervention to stabilize blood sugar levels and prevent further complications.
  • #61 Diabetic Coma: Symptoms, Treatment, and Prevention
    https://polarbearmeds.com/diabetic-coma/
    It is crucial for individuals with diabetes to closely monitor their blood sugar levels and seek prompt medical attention if symptoms of high or low blood sugar arise to avoid the potentially life-threatening consequences of diabetic coma. […] Early recognition of these symptoms is important as they indicate a medical emergency that requires immediate intervention. […] Severe low blood sugar, diabetic ketoacidosis (DKA), and nonketotic hyperosmolar syndrome (NKHS) are the primary causes of diabetic coma. […] Checking for ketone bodies is crucial when blood glucose levels exceed 240 mg/dL to prevent diabetic coma in cases of DKA. […] Risk factors for diabetic coma include hypoglycemia unawareness, insulin usage, and complications such as NKHS and DKA in different types of diabetes. […] Quick and accurate diagnosis is crucial for prompt and effective treatment of diabetic coma.
  • #62 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Cause-of-Diabetic-Coma.aspx
    Diabetic coma is a dangerous condition that can lead to unconsciousness and even death. Diabetic coma may affect 2% to 15% of all diabetics at least once in their lifetime and the condition that most commonly causes the coma is severe hypoglycaemia or low blood sugar. […] There are three main causes of coma in people with diabetes: diabetic ketoacidosis, severe hypoglycaemia and hyperglycaemic hyperosmolar state. However, despite the increased prevalence of diabetes across the globe, improved diagnosis and early treatment of these causative conditions has lessened the risk of death due to diabetic coma. […] A glucometer, for example, can detect high or low blood sugar in an unconscious diabetic patient within seconds and this can be confirmed in the laboratory within an hour. Furthermore, due to the widespread warnings and knowledge regarding the possibility of the three conditions, most patients are brought to an emergency unit before the onset of coma.
  • #63 Diabetic Coma: Symptoms, Treatment, and Prevention
    https://polarbearmeds.com/diabetic-coma/
    Prompt and appropriate medical intervention is essential in the treatment of diabetic coma to restore healthy blood glucose and insulin levels and prevent further complications. […] The primary goal of treatment is to restore healthy blood glucose and insulin levels, which can help prevent complications. […] Immediate medical attention is crucial in diabetic coma cases, and emergency medical services should be contacted promptly. […] Regular monitoring of blood sugar levels and carrying glucose sources like tablets or gel are essential for managing and preventing hypoglycemia in diabetic comas. […] Prompt medical attention is crucial in treating diabetic coma, as it can be life-threatening. […] By implementing these prevention strategies, individuals with diabetes can significantly lower their risk of diabetic coma and maintain better overall health.
  • #64 Diabetic Coma: Symptoms, Treatment, and Prevention
    https://polarbearmeds.com/diabetic-coma/
    The main treatment for a diabetic coma involves addressing the underlying cause, such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), or severe low blood sugar. […] Prompt medical intervention to stabilize blood glucose levels is crucial for recovery. […] Blood sugar levels above 600 mg/dl or over 240 mg/dl may indicate a risk of coma. […] To manage a hypoglycemic coma, prompt medical attention is crucial.