Diabetic coma natural history, complications and prognosis

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

Left untreated, a diabetic coma can be fatal. Prognosis of diabetic coma depends on whether the patient is treated promptly and properly.

Complications related to nonketotic hyperosmolar coma

• Acute circulatory collapse (shock)
• Blood clot formation
• Brain swelling (cerebral edema)
• Increased blood acid levels (lactic acidosis)

People with diabetic ketoacidosis need close and frequent monitoring for complications. Surprisingly, the most common complications of DKA are related to the treatment:

• Hypokalemia and often, potassium depletion
• Cerebral edema ^[1]
• Hyperglycemia
• Ketoacidemia
• Fluid and electrolyte depletion ^[2]
• Aspiration
• Unrecognized renal tubular necrosis
• Pulmonary edema ^[3]

Patients who develop this syndrome are often already ill. The death rate with this condition is as high as 40%.

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