14.10 Diabetic coma and comatose diabetics

Untreated type I diabetes may become manifest by diabetic coma, as stated above; this condition is not common with untreated type II diabetes. However, with both forms, coma may arise from an overdose of insulin, which will lead to hypoglycemia, i.e. a lack of glucose in the blood. Since the brain depends on glucose, it will pass out. Now, if you find a known diabetic in a comatose state, what do you do – give him glucose or insulin? Since the hypoglycemic coma is more immediately life-threatening than the hyperglycemic one, you must always use glucose first. Only if that doesn't help should you try insulin. Of course, you will also try to determine the blood glucose level as soon as possible and then adjust the treatment accordingly.