If a friend or loved one has diabetes, making sure the condition is properly managed can sometimes be a matter of life or death.
Imagine this: During an afternoon at home with your parents, your father ‹ who has Type II diabetes ‹ all of a sudden says he is very thirsty.
You leave the room to get him a glass of water. When you return, you find him slumped over and unconscious. He has slipped into a diabetic coma.
Here's what you should know about a diabetic coma regarding risk factors, causes, treatment, and prevention.
Who Is At Risk For A Diabetic Coma?
“The most common diabetic coma we see is in people with Type I diabetes,” says Greta VanDyke, RN, a certified diabetes educator at the Diabetes Resource Center at West Valley Medical Center.
People with Type I diabetes are completely dependent on insulin. However, she adds, “anybody with diabetes is at risk for diabetic coma,” including people with Type II and gestational diabetes.
What Causes A Diabetic Coma?
Greta says there are three main reasons why a person may fall into a diabetic coma.
1. Hypoglycemia
“If you have low blood sugar — hypoglycemia — you might feel shaky or anxious at first,” says Greta. “You may feel hungry. You might have a racing heartbeat.”
If these warning signs go unheeded, symptoms may become more severe, she explains. “Some later symptoms might be things like sweating or not being able to talk very clearly, or not making sense.”
If a loved one has diabetes and starts to show signs of hypoglycemia, make sure she takes steps to raise her blood sugar.
“We encourage people who are taking insulin or are on oral medicines that could potentially make their blood sugars get too low to always have a source of carbohydrate with them,” Greta explains. “It could be a piece of hard candy, crackers, or even a glass of milk. Glucose tablets are another excellent source of carbs you can carry.”
2. Diabetic Ketoacidosis (DKA)
Diabetic ketoacidosis starts with high blood sugar.
“Some significant signs of high blood sugar include feeling thirsty, going to the bathroom a lot, or blurred vision,” says Greta.
As with low blood sugar, getting timely treatment is important.
“DKA occurs when blood sugar is extremely high from the lack of insulin,” Greta explains. “Then, the body starts burning fat instead of glucose.”
Greta warns, “This is a dangerous way of getting fuel. Your body needs fuel so desperately that it burns fat too quickly, which causes a high level of acid in your body. So, if diabetic ketoacidosis is not treated, it can cause a coma (and even death).”
3. Diabetic Hyperosmolar Syndrome
“In a way, diabetic hyperosmolar syndrome is similar to DKA in that people don't have enough insulin available,” says Greta. “They are not able to use the glucose that's in their blood.”
“Then, the body is not only burning fat for fuel, but it's also trying to get rid of the high blood sugar through your kidneys. This is very dehydrating,” she explains.
What Should You Do If Someone Goes Into A Diabetic Coma?
1. Call 911.
“A coma is a medical emergency. Without any treatment, it can be fatal. So, you want to call 911 right away,” says Greta.
What you do next depends on whether you know how the person is managing his diabetes and what you know about caring for diabetes.
“If you don't know anything about diabetes, but you know your loved one has it, you should call 911 and then just wait,” advises Greta.
It's important to give the 911 dispatcher as much information as possible about your friend or loved one's condition. Let the emergency personnel know that he has diabetes. Make note of his appearance, such as if he looks pale and sweaty. If you know how long he has been unconscious, make note of that as well.
“It would be helpful to know his medications. Is he on insulin? What are his oral medicines for diabetes? Those are important things for loved ones and family to know,” says Greta.
2. Test The Person's Blood Sugar.
“If you have an idea of how to care for somebody with diabetes, call 911, and then try to test her blood sugar,” suggests Greta.
“If her blood sugar is low ‹ and we consider anything under 70 low ‹ and if you know how to treat that, one of the things you can potentially do is give her an emergency medication called glucagon.”
“But that involves giving a shot, so you need to know what you're doing if you're planning to give glucagon,” she adds.
If glucagon is unavailable or you don't know how to administer it, there are other ways to try to raise the person's blood sugar.
“You can take a honey or glucose gel and rub that on the inside of the lips,” Greta explains. “Glucose ‹ or sugar ‹ from honey could be absorbed through the mucous membranes of the mouth.”
3. Move The Person To A Safe Position.
If you are physically able to, Greta suggests that you “make sure the person is in a position where he can't hurt himself.” For example, if he is unconscious and slumped over in a chair, try to move him into a lying position on the floor.
“Try to get him into a position where he can breathe okay,” she adds. “Positioning him on his side is a good idea.”
How Can You Prevent A Diabetic Coma?
Making sure your friend or loved one is monitoring her blood sugar is the best way to prevent a diabetic coma.
Knowing the signs of high or low blood sugar helps, too.
“It's always better to recognize the signs earlier rather than later, because then you can treat the symptoms and prevent the emergency,” Greta says.
She warns that high blood sugar and low blood sugar share certain symptoms: Blurred vision, nausea, or a fast heartbeat can be evidence of either condition. This is why it's so important to test blood sugar.
A West Valley Medical Center physician can help you and your loved one come up with strategies to manage diabetes.
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