Diabetic coma laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Tests, including blood sugar level, ketone level in blood and urine, blood level of nitrogen or creatinine and potassium in your blood, may be helpful for the diagnosis of the cause.

Diabetic coma was a more significant diagnostic problem before the late 1970s, when glucose meters and rapid blood chemistry analyzers became universally available in hospitals. In modern medical practice, it rarely takes more than a few questions, a quick look, and a glucose meter to determine the cause of unconsciousness in a patient with diabetes. Laboratory confirmation can usually be obtained in half an hour or less. Also, the astute physician remembers that other conditions can cause unconsciousness in a person with diabetes: stroke, uremic encephalopathy, alcohol, drug overdose, head injury, or seizure. Fortunately, most episodes of diabetic hypoglycemia, DKA, and extreme hyperosmolarity do not reach unconsciousness before a family member or caretaker seeks medical help. The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals extreme hyperglycemia (often above 1800 mg/dl (100 mM)) and dehydration. Test that may be done include:

• Blood osmolarity (concentration)
• BUN and creatinine levels
• Blood sodium level
• Ketone test
• Very high blood glucose

Evaluation for possible causes may include:

• Blood cultures
• Urinalysis

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