Diabetic Coma and hyperglycemic coma (High Blood Sugar)

By | 9 March 2021

Diabetic Coma and hyperglycemic coma (High Blood Sugar)

The level of sugar in the blood above normal is called hyperglycemia in medical language. Hyperglycemia can be seen in diabetics of all ages.

What are the causes of hyperglycemia?

  • Eating too much food,
  • Inactivity, not always exercising,
  • In the missing dose; taking oral antidiabetic drugs and insulin insufficient amount,
  • Having an infectious disease,
  • You are in a stressful period,
  • Inadequate treatment,
  • Using drugs that increase blood sugar (cortisone, etc.) can cause hyperglycemia.

There are two types of hyperglycemic coma:

  • Diabetic ketoacidosis coma (DKA)
  • Ketoacidosis coma (DKA)

It mostly develops in patients with insulin-dependent diabetes (Type 1). The most important factor here is insulin deficiency. In insulin deficiency, glucose cannot enter the cell and cannot be used as an energy source. In this case, the body turns towards fats. With the burning of oils, wastes called ketones emerge. Ketone bodies increase in the blood and pass into the urine, acetone comes out in the urine. With the increase in blood sugar, the increase of ketone bodies in the blood and urine, the patient becomes unconscious and if not treated, a coma develops. It is similar to symptoms of hyperglycemia (hyperglycemia).

Diabetic Coma and hyperglycemic coma Symptoms:

  • Don’t drink a lot of water
  • Frequent urination,
  • Weight loss
  • Nausea and vomiting
  • Weakness, sleepiness,
  • Acetone smell in-breath (reminiscent of rotten apple),
  • Rapid breathing, etc. if there are symptoms
  • If ketone comes out in your urine, call your doctor immediately! ….
  • How is ketoacidosis treated?
  • If your blood sugar is above 240 and the test result is ketone in your urine, call your doctor immediately and go to a health institution.
  • This is not something you should be treating yourself.

Hyperosmas hyperglycemic nonketotic coma (DNKK)

It usually occurs in middle-aged or elderly Type 2 diabetics who are not insulin-dependent.

It is very rare in people with type 1 diabetes. Diabetic hypersomnias and hyperglycemia coma may develop if there is a severe disease that causes deterioration of the general condition in people with type 2 diabetes. For example; The age of 70 years who have had heart attack, heart failure, lung infection, pancreatic infection, acute upper respiratory tract infection due to viruses, kidney failure or take excessive carbohydrate food or use drugs that control heart rhythm and blood pressure such as calcium channel blockers and oral antidiabetic drugs, and Diabetics on it can easily fall into this type of coma. These patients are mostly those who live alone and whose socioeconomic status is not good.


  • It is usually seen without ketoacidosis, with excessive hyperglycemia and excessive fluid loss.
  • Ketone production does not occur when blood glucose level increases in type 2 diabetics. Because there is insulin production in type 2 diabetes.
  • If enough fluid is not taken in the elderly, fluid loss (dehydration) occurs.


  • There is severe dehydration as in DKA (Diabetic Ketoacidosis) coma.
  • The difference is that there are no ketone bodies in the blood and acetone in the urine. However, hyperglycemia is more severe (300-600 mg/dl).
  • The treatment of these patients is basically the same as in DKA (Diabetic Ketoacidosis) coma. Since DNHK (Diabetic hypersomnias hyperglycemic coma) medicine is a condition that requires immediate assistance, you should call your doctor immediately!

Nowadays, there are also blood glucose devices that look for ketones in the blood. Obtaining Type 1 diabetes patients or patients with Type 2 diabetes who are prone to such coma from these devices will help diagnose coma early and not delay treatment.

What can you do to avoid a coma?

  • Regularly use insulin or oral sugar-lowering drugs at the dose recommended by your doctor.
  • Follow your medical nutrition treatment. If you do not know how to manage your medical diet, consult a dietician.
  • Be sure to get a blood glucose meter and learn to monitor your blood sugar yourself.
  • Do physical exercise regularly.
  • When you have a febrile illness, be treated without delay.
  • Regularly see your Diabetes doctor.