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Causes
By Mayo Clinic staffProlonged blood sugar extremes — blood sugar that's either too high or too low for too long — may cause various conditions, all of which can lead to a diabetic coma.
- Diabetic ketoacidosis. If your muscle cells become starved for energy, your body may respond by breaking down fat stores. This process forms toxic acids known as ketones. Left untreated, diabetic ketoacidosis can lead to a diabetic coma. Diabetic ketoacidosis is most common in people who have type 1 diabetes, but it can also affect people who have type 2 diabetes or gestational diabetes.
- Diabetic hyperosmolar syndrome. If your blood sugar level tops 600 milligrams per deciliter (mg/dL), or 33 millimoles per liter (mmol/L), the condition is known as diabetic hyperosmolar syndrome. When your blood sugar gets this high, your blood becomes thick and syrupy. The excess sugar passes from your blood into your urine, which triggers a filtering process that draws tremendous amounts of fluid from your body. Left untreated, diabetic hyperosmolar syndrome can cause life-threatening dehydration and coma. Diabetic hyperosmolar syndrome is most common in middle-aged and older adults who have type 2 diabetes.
- Hypoglycemia. Your brain needs glucose to function. In severe cases, low blood sugar may cause you to pass out. Hypoglycemia can be caused by too much insulin or too little food. Exercising too vigorously or drinking too much alcohol can have the same effect. How quickly your blood sugar drops influences the symptoms of hypoglycemia. If your blood sugar drops quickly, the symptoms will be more pronounced.
References
- Masharani U. Diabetes mellitus and hypoglycemia. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y.: McGraw-Hill Medical; 2010. http://www.accessmedicine.com/content.aspx?aID=15524. Accessed Jan. 26, 2010.
- Masharani U, et al. Pancreatic hormones and diabetes mellitus. In: Gardner DG, et al. Greenspan's Basic and Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aID=2633151. Accessed Jan. 26, 2010.
- Kitabchi AE, et al. Hyperglycemic crises in adult patients with diabetes (consensus statement). Diabetes Care. 2009:32;1335.
- Hypoglycemia. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/. Accessed Jan. 26, 2010.
- Brenner ZR. Management of hyperglycemic emergencies. AACN Clinical Issues. 2006:17;56.
- Standards of medical care in diabetes, 2010. American Diabetes Association. Diabetes Care. 2010;33(suppl):11.
- Kitabchi AE, et al. Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 18, 2010.
- Diabetic ketoacidosis (DKA). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec12/ch158/ch158c.html. Accessed Jan. 26, 2010.
- Hyperglycemia (high blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html. Accessed Feb. 17, 2010.
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