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Prevention
By Mayo Clinic staffGood day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind:
- Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.
- Keep an eye on your blood sugar level. Frequent blood sugar tests can tell you whether you're keeping your blood sugar level in your target range — and alert you to dangerous highs or lows. Check more frequently if you've exercised because exercise can cause blood sugar levels to drop, especially if you don't exercise regularly.
- Take your medication as directed. If you have frequent episodes of high or low blood sugar, let your doctor know. He or she may need to adjust the dose or timing of your medication.
- Have a sick-day plan. Illness can elevate blood sugar unexpectedly. Before you get sick, talk with your doctor about how to best manage this increase in your blood sugar.
- Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 240 mg/dL (13 mmol/L). If you have a large amount of ketones or they persist, call your doctor for advice. Call your doctor immediately if you have any level of ketones and are vomiting.
- Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, make sure you have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels.
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Consider a continuous glucose monitor (CGM), especially if you have trouble maintaining stable blood sugar levels or you don't feel symptoms of low blood sugar (hypoglycemia unawareness).
CGMs are devices that use a small sensor inserted underneath the skin to track trends in your blood sugar levels. These devices can alert you when your blood sugar is dangerously low. However, you still need to test your blood sugar levels using a blood glucose meter even if you're using a CGM, and because these devices are still being studied, not all insurance companies will cover them.
- Drink alcohol with caution. Because alcohol can have an unpredictable effect on your blood sugar, be sure to have a snack when you drink, if you choose to drink at all.
- Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize early signs and symptoms of blood sugar extremes — and how to summon emergency help should you pass out.
- Wear a medical ID bracelet or necklace. If you're unconscious, the ID can provide valuable information to your loved ones, co-workers and others — including emergency personnel.
- 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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