Worst Case Scenario: Diabetic Coma

Diabetic coma is an emergency. You cannot be prepared in advance. If you have the feeling of an extreme high or low blood sugar you should call your local emergency number. You need to ensure help before you pass out.

If there is a person with you instruct him/her about it. If this person is familiar with diabetes care he/she should:

  1. Test your blood sugar.
  2. If the blood sugar level is lower than 70 mg/dL (3.9 mmol/L), administer an injection of glucagon. If glucagon isn’t available, rub glucose gel, honey or non-sugar-free syrup on the inside of the unconscious person’s cheek. No insulin should be given!
  3. If the blood sugar level is above 70 mg/dL, wait for medical help to arrive. Don’t give sugar to someone whose blood sugar isn’t low.

Let the emergency care team know about the diabetes and what steps have been taken, if any.

Diabetic ketoacidosis: over-the-counter ketones test

You can easily find ketone tests at your pharmacy. Ask your doctor about testing and recording methods. Urine tests are simple, but to get good results you have to follow directions carefully.

Here’s how most urine tests go:

  • Get a sample of your urine in a clean container.
  • Place the strip in the sample (you can also pass the strip through the urine stream).
  • Gently shake excess urine off the strip.
  • Wait for the strip pad to change color. The directions will tell you how long to wait.
  • Compare the strip pad to the color chart on the strip bottle. This gives you a range of the amount of ketones in your urine.
  • Record your results

Small or trace amounts of ketones may mean that ketone buildup is starting. You should test again in a few hours.

Moderate or large amounts are a danger sign. They can poison the body. Never exercise when your urine checks show moderate or large amounts of ketones and your blood glucose is high. These are signs that your diabetes is out of control.

Diabetic ketoacidosis is a life-threatening medical condition. If you develop mild signs and symptoms, contact your doctor immediately.

If your doctor suspects diabetic ketoacidosis he/she will do some tests. Sometimes additional tests may be needed to help determine what triggered the episode of diabetic ketoacidosis or what damage the ketoacidosis may have caused.

Blood tests used in the diagnosis of diabetic ketoacidosis will measure: blood sugar level, ketone level, and blood acidity. Other tests may include: blood electrolyte tests, urinalysis, chest X-ray, or an electrocardiogram.

If you’re diagnosed with diabetic ketoacidosis, you may be treated in the emergency room or admitted to the hospital. Treatment usually involves a three-pronged approach: fluid replacement, electrolyte replacement, and insulin therapy.

Hyperglycemia

Your blood sugar level is an essential measure for your health. You have to learn how to monitor it and to make it part of your daily routine. Your doctor or a diabetes educator can help you with this.

An appropriate diet and some physical activity can help you lower your blood glucose level.

But there are special cases as well. If you have a high level of blood sugar you may check for ketones in your urine. If you have ketones you should not exercise. This may cause the opposite effect.

If you think you have hyperglycemia contact your doctor.

More info on hyperglycemia can be found here.

During a hyperglycemic event

Treating Hyperglycemia

Your blood sugar level can be lowered by exercising. However there is a counter indication to that. In case your blood sugar level is above 240 mg/dl, you may check your urine for ketones. If you have ketones, you should not exercise. Exercising with ketones is counterproductive, and may make your blood sugar level even higher.

Making changes in your food intake can help as well. Your dietitian can help cutting the amount of food you eat. If exercising and dieting are not enough then your doctor may change your medication or insulin, or even the timing of that.

Work with your doctor to find the safest way for you to lower your blood glucose level.

Hyperglycemia can be prevented with good diabetes management. Another important practice is to learn to detect hyperglycemia early so that you can  treat it before it worsen.