Diagnosis of Diabetes

Emergency Diabetic Conditions

Diabetic Ketoacidosis

Diabetic ketoacidosis or DKA, also known as "diabetic coma", is a life-threatening complication of type 1 diabetes that occurs when a complete or relative loss of insulin leads to an excessive amount of glucose and acids in the bloodstream. It is defined as a blood sugar level of >240mg/dL, in addition to the release of ketones (substances that are made when the body breaks down fat for energy) in the blood or urine, and a pH level < 7.3. Diabetic ketoacidosis may be the presenting symptoms in 15-67% of persons with previously undiagnosed type 1 diabetes. It is rarely seen in type 2 diabetes.

Symptoms of diabetic ketoacidosis include:

• Nausea and vomiting
• Deep and rapid breathing
• Abdominal pain
• Elevated blood glucose
• Rapid heartbeat
• Coma
• Death

Hypoglycemia

Hypoglycemia, also known as "insulin shock", is a complication that occurs if the blood glucose levels fall below normal and can be caused by insufficient intake of food, exercise, or alcohol consumption. Hypoglycemia occurs most commonly in persons using insulin and those who are attempting to achieve tight control of glucose levels. At the extreme, repeated episodes of hypoglycemia (glucose < 65mg/dL) can lead to permanent brain damage (hypoglycemia encephalopathy) or death.

Symptoms of hypoglycemia include:

• Sweating
• Trembling
• Headache
• Hunger
• Rapid heartbeat
• Mood changes
• Neurologic symptoms
• Confusion and disorientation
• Weakness
• Combativeness
• Coma (rare)
• Seizures (rare)
• Death (rare)

These symptoms should be promptly treated with juice, glucose tablets, glucose gel or another source of quick-acting carbohydrate, which should carried and available at all times. Severe hypoglycemia can be treated with glucagon, which may be injected intramuscularly or intravenously.