Diabetic Coma Symptoms, What You Need To Know

Diabetic coma symptoms are something we should all be aware of. It is true that type 1 diabetics are more likely to experience them than type 2, but as diabetics are living longer, the chance of experiencing symptoms is greater. One statistic is that up to 15% of diabetics will go into diabetic coma because of severe hypoglycemia.

What Is a Diabetic Coma?

Coma is another word for unconscious. A diabetic is in a coma if he cannot be wakened and can't respond to sounds and sights. It does not mean the person in a coma will die.

These days, with swift blood test results and treatment, a diabetic will come out of a coma very fast.

Diabetic medical alert bracelets and necklaces keep us from being misdiagnosed as drunk or epileptic when we cannot speak.

But just knowing you are a diabetic is not enough. If you are taken to an emergency room, the doctors look for diabetic alert charms.

But diabetic coma symptoms still need to be diagnosed correctly so the proper treatment is started, because there are three different types of coma, and the complications of all three are brain damage and death.

Click here to go to the home page for a diabetic life.

It Starts With High or Low Blood Sugar

Oddly, either chronic high blood sugar or sudden low blood sugar can trigger diabetic coma symptoms. That's why it's good to know how we react to both of them.

With high blood sugar, or hyperglycemia, you feel thirsty and have to urinate more often. You feel fatigue, and there is always nausea and vomiting, often for days.

You can feel short of breath and have stomach pain. There is a fruity or acetone smell to your breath and a fast heartbeat. The symptoms are not sudden.

But low blood sugar comes on very swiftly and can wake you out of a sound sleep. You feel shaky, nervous, tired and either hungry or nauseated. You sweat a lot and your heart races.

You can get irritated and even aggressive for no reason, and confusion makes it hard to think. Blurred vision can keep you from being able to read your meter as you try to check your blood sugar.

Get help fast. Someone needs to test your blood sugar, and if it is low, below 70, you are in a hypoglycemic reaction and need some orange juice or other sugary drink, or any quick source of glucose right now.

Test your blood sugar again in 15 minutes, and if it is not responding and your confusion, sweating and blurred vision remain, you need to be taken to the hospital. Paramedics can begin treating you as soon as they arrive, so call 9-1-1.

Diabetic Coma, the Three Sources

At the hospital, emergency room doctors will need to find out the source of your diabetic coma symptoms. Here are the possibilities:

  • Diabetic ketoacidosis (or acidosis)
  • Diabetic hyperosmolar syndrome
  • Hypoglycemia

In diabetic ketoacidosis, the muscle cells are starving because insulin is not available to them. So they break down fat cells for energy which produces ketones, leading to ketoacidosis.

Meanwhile sugar is building up in the blood because it is not being used by the muscle cells.

Severe hyperglycemia (high blood sugar) causes your body to dump sugar into the urine, taking a lot of water with it.

That leads to dehydration, unquenchable thirst and going to the bathroom often.

Dehydration causes shock, exhaustion and vomiting that can go on for 36 hours. It feels like the flu.

After a while you will see flushing and rapid breathing (hyperventilation). Then comes a diabetic coma.

In the hospital blood tests will show high blood sugar and metabolic acidosis with dehydration.

You would be treated with IV fluids including electrolytes to restore the balance of fluid in your blood. You are given insulin and monitored carefully to make sure your sugars do not dip too low (hypoglycemia).

Patients wake up quickly when fluid levels are corrected and blood sugar normalizes.

Diabetic Hyperosmolar Syndrome

Extremely high blood sugar over time leads to lethargy, confusion, sleepiness and slipping into coma.

This is seen more in nursing homes among older diabetics, but it can happen to anyone who ignores high blood sugars for too long. Patients do not feel thirsty, but dehydration grows, leading to a coma if not treated.

Blood tests show extremely high blood sugar, sometimes above 1,800, along with dehydration. After IV fluids and insulin therapy, these diabetic coma symptoms reverse.


Our brains need glucose to function. Too little and we pass out. These diabetic coma symptoms can happen fast.

The cause is usually too much insulin or too little food.

Doing a lot of exercise without food can drop your blood sugar to a dangerous low. Be aware that even two days after drinking alcohol your blood sugar can drop suddenly.

Here are three things diabetics need to know. They could save your life if hypoglycemia strikes.

  • Be careful with alcohol. Eat a snack with it or don't drink at all.
  • Wear a diabetic ID bracelet or necklace all the time.
  • Teach your friends and family the symptoms of low blood sugar. Tell them to call for help if you get confused, sweat profusely, or pass out.

If anyone in my family sees me sweating, they want to know why, and I'd better be able to explain clearly or they will take me to the hospital. Period.

Avoid High or Low Blood Sugar - Here's How

If you wear an insulin pump, check the tubing often. Kinks or disconnects will stop insulin delivery, making diabetic coma symptoms possible.

Manage your diabetes every day. Take your medicines and use your glucose monitor.

Do not skip insulin doses to lose weight. Some diabetics have tried this, endangering their lives for a few pounds.

Know what to do if you get sick by talking to your doctor. Any illness or trauma, any type of surgery affects blood sugar.

Congestive heart failure and kidney disease can cause hyperosmolar syndrome. Stomach flu often makes blood sugar drop.

Do not ever take illegal drugs. You could get severe high blood sugar, and you will neglect your health. Diabetics cannot take that chance.

Treating Diabetic Coma Symptoms In Someone Else

Call 9-1-1. If you are trained in diabetes treatment, while you are waiting you can test the person's blood sugar. If it is low, give an injection of glucagon.

If there is no glucagon you can rub honey or syrup on the inside of her cheek, but do NOT pour anything into her mouth.

If the sugar is not low, do nothing. Wait for the paramedics. Do not give insulin to an unconscious person.

I hope you never need to deal with diabetic coma symptoms. If you take care of your diabetic chores daily, you probably won't.

Return to diabetic symptoms from diabetic coma symptoms.

Misdiagnosing type 2 diabetes, how it happens and what you can do.