The following symptoms and complaints may indicate ketoacidotic coma (diabetic ketoacidosis, DKA):
Symptoms of precoma
- Anorexia (loss of appetite).
- Nausea, vomiting
- Thirst
- Polydipsia (increased drinking)
- Polyuria (increased urination)
- Tendency to collapse
- Abdominal pain – due to pseudoperitonitis (pseudoperitonitis diabetica).
- Acidotic breathing (Kussmaul breathing) – very deep and slowed, regular, rhythmic breathing with acetone odor (ketone bodies).
- Disturbances of consciousness
Symptoms of coma
- Disturbances of consciousness
- Desiccosis (dehydration)
- Tachycardia – too fast heartbeat; > 100 heartbeats/min.
- Hypotension – blood pressure too low
- Oliguria (urine output < 500 ml/24 h)
- Anuria (urine output < 100 ml/24 h)
- Glucosuria – glucose in the urine.
- Extinguishing intrinsic reflexes
- Cardiac arrhythmias, unspecified
- Hyperglycemia > 350 mg/dl (> 20 mmol/l)
- Ketonuria – ketone bodies in the urine.
- Ketonemia – increased occurrence of ketone bodies in the blood.
- Metabolic acidosis – metabolic acidification of the blood.
- Anion gap > 12 mmol/l
The following symptoms and complaints may indicate hyperosmolar coma (hyperosmolar diabetic coma; hyperglycemic coma):
Symptoms of precoma
- Anorexia (loss of appetite).
- Nausea, vomiting
- Thirst
- Polydipsia (increased drinking)
- Polyuria (increased urination)
- Tendency to collapse
- Disturbance of consciousness
Symptoms of coma
- Disturbances of consciousness
- Seizures
- Desiccosis (dehydration)
- Tachycardia – too fast heartbeat: > 100 beats per minute.
- Hypotension – too low blood pressure
- Oliguria (urine output < 500 ml/24 h)
- Anuria (urine output < 100 ml/24 h)
- Glucosuria – glucose in the urine.
- Extinguishing intrinsic reflexes
- Cardiac arrhythmias, unspecified
- Hyperglycemia > 600 mg/dl (> 33.3 mmol/l)
- Serum osmolarity > 300 mosmol/kg H2O
- Barely acetonuria
- Anion gap < 12 mmol/l
