For the more than 34 million Americans living with Type 1 and Type 2 diabetes, controlling blood sugar is the primary focus of our days. After all, when blood sugar gets too high or too low, particularly for prolonged periods, we become at serious risk for some major health complications - heart disease, kidney disease, eye conditions, nerve damage, and a slew of others. But perhaps the scariest of all diabetes-related complications is the diabetic coma.


What is a diabetic coma?

A diabetic coma occurs because blood glucose levels are dramatically and dangerously too high or too low. Yes, a severe fluctuation either way can be the culprit. People who suffer from a diabetic coma are rendered unconscious and unresponsive to sounds or other stimulation. It is a life-threatening emergency that requires immediate medical attention. If not treated right away, a diabetic coma can result in irreversible brain damage and death.


Causes of a diabetic coma

As stated, diabetic comas are the result of an extreme high or low in blood sugar for a prolonged period of time. Prior to falling into a diabetic coma, most individuals are suffering from one of these conditions.


Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis occurs when the body’s cells don’t receive the glucose they need to create energy because there is not enough insulin in the body to properly process blood sugar. Without adequate insulin, blood sugar begins to quickly elevate to dangerous levels. Additionally, because the body cannot burn this excess sugar, it turns to burning fat for fuel and this process creates an acid called “ketones”, which quickly build up and become toxic. Left untreated, diabetic ketoacidosis can lead to a diabetic coma. It’s important to note that DKA is far more common in people with Type 1 diabetes than type 2, as those with Type 1 do not produce any insulin, which logically puts them at greater risk.

Diabetic hyperosmolar syndrome

This condition occurs when blood sugar hits 600 mg/dL or above, which is pretty darn high. When blood glucose gets this elevated, it can cause the blood to become almost syrupy in thickness. Plus, all the excess sugar triggers a filtering process requiring the person urinate to the point of excessive dehydration. If left untreated, diabetic hyperosmolar syndrome can result in diabetic coma. In fact, according to the Mayo Clinic, 25% to 50% of people suffering from this disorder fall into a comatose state. Diabetic hyperosmolar syndrome tends to be more prevalent in those with Type 2 diabetes.



The brain needs glucose in order to function properly. If you’re diabetic testing and management plan is off for any reason and results in a blood sugar level that is excessively low, it can leave the brain starving for the energy it needs and the body shuts down. As a result, you might pass out and, if left untreated, slip into a diabetic coma.


Factors that put you at greater risk for a diabetic coma

Anyone with Type 1 or Type 2 diabetes faces some risk level for a diabetic coma. That being said, there are certain factors that can raise or lower blood sugar levels, increasing your risk.


Illness or trauma

When you’re severely injured or become seriously ill, blood sugar tends to rise in response. Often the elevation is minimal. Sometimes, however, it can be dramatic, and this can lead to ketoacidosis in those with Type 1 diabetes.


Missing meals or insulin treatments

There is nothing more important to maintaining blood sugar control than following your doctor-recommended diabetes lifestyle and medication plan. When you skip meals it impacts blood glucose, and when you miss an insulin treatment you’re setting yourself up for extreme elevations, which heighten the risk of diabetic coma.

Insulin delivery issues

If you use an insulin pump to deliver your medication, it’s important to make sure it is functioning properly and that the infusion set catheter is not twisted or creased, as this can impede insulin delivery. A prolonged lack of insulin can lead to diabetic ketoacidosis, which can result in a diabetic coma if left untreated.


Excessive drinking

While moderate amounts of alcohol can cause blood sugar to rise, overdoing it can lead to dangerous drops in blood sugar, particularly in those with Type 1 diabetes. What’s more, alcohol can impede judgment and your sense of awareness, making it harder to discern that you’re, in fact, having a hypoglycemic episode. Moderation is key when it comes to diabetes and alcohol.


Not testing enough or properly

This one is the big game changer because whether you have Type 1 or Type 2 diabetes, regular blood sugar testing is entirely in your control. Most of us using glucose meters and test strips should be testing multiple times each day according to our doctors. It’s the only way to spot and address those daily fluctuations that, if left alone, can lead to far more serious problems. If you’re not following your testing and treatment schedule, you are dramatically increasing your risk for major complications, including diabetic coma.


Symptoms of high blood sugar and ketoacidosis

  • Thirst or an excessively dry mouth
  • Frequent urination
  • Nausea and vomiting
  • Fruity odor on the breath
  • Confusion or an inability to focus
  • Labored breathing/Shortness of breath
  • Rapid heartbeat
  • Extreme fatigue

Symptoms of low blood sugar

  • Nervousness/Feelings of Anxiety
  • Exhaustion
  • Weakness
  • Hunger
  • Sweating
  • Lightheadedness
  • Confusion
  • Nausea
  • Difficulty speaking/annunciating

If you experience any of the signs of high or low blood sugar, test yourself immediately and follow your doctor-prescribed treatment plan to raise or lower blood glucose effectively. If you don’t start to feel better and see your blood sugar return to target levels, seek emergency assistance.


Two extra precautions

The of the greatest dangers of a diabetic coma is the fact that you will be unresponsive when it happens. You won’t be able to react to your own condition, which is why it’s a good idea to do the following:

  1. Consider a medical ID bracelet or necklace. If you’re unconscious, this simple ID will provide emergency personnel rushing to your aid a better idea of your condition and how to treat it.
  1. Educate friends and family members. Hopefully, you’ll never experience a diabetic coma. However, if you do it will likely be alongside friends or family members. Make sure they know what to do by educating them on the telltale signals of extreme blood sugar fluctuations. Also, make sure that if you pass out, they know to call for emergency help immediately. If you, in fact, are falling into a diabetic coma, there’s no time to wait around and see if you improve.

We hope you found this post informative and insightful. At Diabetic Warehouse, we’re committed to keeping you up to date with the latest news and tips on living with diabetes. We’re also committed to saving you up to 65% on doctor-recommended diabetic supplies from leading manufacturers, such as Accu-Chek, One Touch, FreeStyle, Dexcom, Medtronic, Clever Choice, True Metrix and many others.


Diabetic Warehouse is a trusted supplier of diabetes care products and accessories. For more information and to explore a complete range of products, including glucose meters and test strips, insulin syringes, pen needles, continuous glucose monitoring systems, and more, visit

1 THOUGHTS ON “Diabetic Coma: Causes, Symptoms and Risks”

by Gabriela Villavicencio Ramos

Thanks for the information it really help me alot Iam taking care of my mom she has diabetis