Diabetic comas may start with marked thirst and the passage of more than normal amounts of urine, with the desire to void often. There may be nausea, vomiting with cramp pains in the tummy region, and the child becomes dehydrated from the fluid loss. Breathing may be long and labored. There may be headaches, lethargy and drowsiness.
As this increases, the patient slips into the unconscious state. A check will show that blood pressure has fallen, the pulse and heart rate are rapid, the skin and lips dry and parched.
This may be a medical emergency, and it is essential that the child be transferred to the emergency ward of a well equipped hospital as early as possible. Here the relevant tests will be carried out and the correct therapy started promptly. This may be lifesaving.
Diabetic coma occurs in diabetic patients in whom the blood-sugar levels are not under adequate control. There is too much sugar in the blood, as the diabetic does not take enough insulin. Coma may come on gradually, and may be preceded by thirst and drowsiness. The breath smells of acetone (like nail polish remover), the skin may be dry and hot, the pulse rapid and the breathing deep.
The patient may be a known diabetic. Check for identification in a pocket, wallet or handbag for data. If it is due to bypogivaemia (inadequate sugar), giving a teaspoonful of sugar or powdered glucose will help if the patient is still conscious and able to take fluids. If the patient is unconscious, do not give anything orally, as it may lead to blocked air passages and choking.
If unconscious, place in the stable side position and get to medical help as a matter of urgency. Often it will be unknown what the cause of the trouble is, in which case the sooner medical attention in a hospital emergency ward is secured the better.