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Risk factors
By Mayo Clinic staffAnyone who has diabetes is at risk of a diabetic coma.
If you have type 1 diabetes you're more at risk of a diabetic coma caused by:
- Low blood sugar (hypoglycemia)
- Diabetic ketoacidosis
If you have type 2 diabetes, you're generally more at risk of a diabetic coma caused by:
- Diabetic hyperosmolar syndrome, especially if you're middle-aged or older
Certain factors can increase the risk of diabetic coma no matter what type of diabetes you have, including:
- Insulin delivery problems. If you're on an insulin pump, you have to check your blood sugar frequently, and one of the reasons for this is that a kink in the insulin pump tubing may stop all insulin delivery. Even tubeless pumps can sometimes have problems that cause insulin delivery to stop. A lack of insulin can quickly lead to diabetic ketoacidosis if you have type 1 diabetes.
- An illness, trauma or surgery. When you're sick or injured, blood sugar levels tend to rise, sometimes dramatically. This may cause diabetic ketoacidosis if you have type 1 diabetes and don't increase your insulin intake to compensate. Other medical conditions, such as congestive heart failure or kidney disease, may increase your risk of diabetic hyperosmolar syndrome.
- Poorly managed diabetes. If you don't monitor your blood sugar properly, or take your medications as directed, you'll not only have a higher risk of developing long-term complications, but also have a higher risk of diabetic coma.
- Deliberately skipping insulin. Sometimes, people with diabetes who also have an eating disorder choose not to use their insulin as directed with the hope of losing weight. This is a dangerous, life-threatening practice that increases the risk of diabetic coma.
- Drinking alcohol. Alcohol can have unpredictable effects on your blood sugar, sometimes dropping blood sugar levels as long as a day or two after the alcohol was consumed. This can increase your risk of a diabetic coma caused by hypoglycemia.
- Illegal drug use. Illegal drugs, such as cocaine and Ecstasy, can increase your risk of severe high blood sugar levels, as well as your risk of diabetic coma.
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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