What is a diabetes-related 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 coma is a prolonged, deep state of unconsciousness. People in comas are unresponsive but still alive.
Three diabetes complications can lead to a coma, including:
- Hyperosmolar hyperglycemic state (HHS).
- Diabetes-related ketoacidosis (DKA).
- Severe low blood sugar (hypoglycemia).
A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number.
Hyperosmolar hyperglycemic state
Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of diabetes — mainly Type 2 diabetes. HHS happens when your blood glucose (sugar) levels are too high for a long period, leading to severe dehydration and confusion. Blood sugar levels are usually over 600 milligrams per deciliter (mg/dL).
If you don’t get treatment for HHS in time, it can lead to a coma.
Diabetes-related ketoacidosis
Diabetes-related ketoacidosis (DKA) is a life-threatening complication that mainly affects people with diagnosed or undiagnosed Type 1 diabetes. But it sometimes affects people with Type 2 diabetes as well.
DKA happens when your body doesn’t have enough insulin (natural or synthetic). Your body needs insulin to make glucose in your blood enter your cells, where it’s used as fuel for energy. If there’s no insulin or not enough insulin, your body starts breaking down body fat for energy instead. As your body breaks down fat, it releases ketones into your bloodstream.
For a person with diabetes, a high amount of ketones causes their blood to become acidic. If you don’t get treatment for DKA in time, it can lead to a coma.
Someone who has DKA usually has blood sugar levels above 250 mg/dL. But the main causes of DKA are a lack of insulin and ketones, not just high blood sugar. People with diabetes can have blood sugar over 250 mg/dL and not have DKA.
Severe low blood sugar (hypoglycemia)
Severe hypoglycemia happens when your blood sugar is below 40 mg/dL. This is life-threatening.
Glucose is the main source of energy for your body and brain. When your blood glucose is low, your body can’t function properly. If your blood sugar drops really low (like below 40 mg/dL), you likely won’t be able to function because of the physical and mental changes that occur. Prolonged severe hypoglycemia that’s not treated in time can lead to a coma.
Most cases of severe hypoglycemia affect people with diabetes who take insulin or certain oral diabetes medications, like sulfonylureas.
