Risk factors

Anyone who has diabetes is at risk of a diabetic coma, but the following factors can increase the risk:

• Insulin delivery problems. If you're on an insulin pump, you have to check your blood sugar frequently. Insulin delivery can stop if the pump fails or the tubing (catheter) is twisted or falls out of place. A lack of insulin can lead to diabetic ketoacidosis.

• An illness, trauma or surgery. When you're sick or injured, blood sugar levels tend to rise, sometimes dramatically. This may cause diabetic ketoacidosis if you have type 1 diabetes and don't increase your insulin dosage to compensate.

  Medical conditions, such as congestive heart failure or kidney disease, also may increase your risk of diabetic hyperosmolar syndrome.

• Poorly managed diabetes. If you don't monitor your blood sugar properly or take your medications as directed, you'll have a higher risk of developing long-term complications and a diabetic coma.
• Deliberately skipping meals or insulin. Sometimes, people with diabetes who also have an eating disorder choose not to use their insulin as directed with the hope of losing weight. This is a dangerous, life-threatening practice that increases the risk of a diabetic coma.
• Drinking alcohol. Alcohol can have unpredictable effects on your blood sugar. Alcohol's sedating effects may make it harder for you to know when you're having low blood sugar symptoms. This can increase your risk of a diabetic coma caused by hypoglycemia.
• Illegal drug use. Illegal drugs, such as cocaine and ecstasy, can increase your risk of severe high blood sugar levels and conditions linked to diabetic coma.