Diabetic Coma in Grand Rapids, Michigan

Uncontrolled diabetes can lead to a life‑threatening emergency called diabetic coma, where a person becomes unconscious and cannot be awakened. This is a medical emergency that requires immediate treatment at a hospital, such as Corewell Health (formerly Spectrum Health) Butterworth Hospital, Trinity Health Grand Rapids, Metro Health – University of Michigan Health, or other emergency departments in the Grand Rapids area.

In West Michigan, where cold winters, seasonal infections (like flu), and variable activity levels can affect blood sugar, people living with diabetes should understand the warning signs and when to seek urgent care.

Types of Diabetic Coma

There are three main types of coma associated with diabetes:

  1. Diabetic ketoacidosis (DKA) coma
  2. Diabetic hyperosmolar (HHS) coma
  3. Hypoglycaemic (low blood sugar) coma

Each has different causes and warning signs, but all require emergency medical care.

Diabetic Ketoacidosis (DKA) Coma

What is DKA?

Diabetic ketoacidosis most often occurs in people with type 1 diabetes, but it can sometimes affect people with type 2 diabetes as well. It happens when there is not enough insulin in the body.

Without enough insulin, the body cannot use glucose (sugar) for energy. Instead, it breaks down fat for fuel. This process produces ketones, which are strongly acidic. When ketones build up, they make the blood too acidic, leading to DKA and, if untreated, DKA coma.

In Grand Rapids, DKA is a common reason for diabetes‑related emergency visits, especially during times of illness, infection, or when insulin doses are missed.

Common Causes of DKA

DKA can develop quickly, over hours to a day. Triggers include:

  • Missed or reduced insulin doses
  • Acute infections (such as flu, pneumonia, or urinary tract infections)
  • Other illnesses, surgery, or major stress
  • Faulty insulin pump or delivery problems
  • DKA as the first sign of type 1 diabetes in someone not yet diagnosed

Cold Michigan winters and seasonal viruses can increase the risk of infection, which can in turn trigger DKA.

Symptoms of DKA

Warning signs of DKA include:

  • Fruity or acetone smell on the breath
  • Extreme thirst
  • Frequent urination
  • Dry mouth or very dry skin
  • Nausea and vomiting
  • Abdominal (stomach) pain
  • Lethargy or unusual tiredness
  • Progressive drowsiness or confusion
  • Deep, rapid breathing

If these symptoms appear, especially in someone with type 1 diabetes in Grand Rapids, they should seek urgent care at a local emergency department or urgent care clinic.

Checking Ketone Levels

For people with type 1 diabetes in the Grand Rapids area, especially when blood sugars are high or during illness, checking ketone levels is very important.

How to Check Ketones

  • Blood ketone testing (preferred if available)
  • Urine ketone testing (if blood testing is not available)

You should check ketones if:

  • Blood glucose levels are very high (as directed by your diabetes care team)
  • You are sick (flu, COVID‑19, pneumonia, or other infections)
  • You have vomiting or cannot keep fluids down
  • Your blood sugars stay high despite taking insulin

Contact your primary care provider, endocrinologist, or local resources such as the Kent County Health Department or Grand Rapids Public Health for guidance on ketone monitoring and sick‑day management.

Diabetic Hyperosmolar Coma (HHS)

What is Hyperosmolar Coma?

A diabetic hyperosmolar coma (also called HHS – Hyperosmolar Hyperglycemic State) is caused by:

  • Very high blood glucose levels (hyperglycaemia)
  • Severe dehydration

This type of coma is more common in older adults with type 2 diabetes.

Causes and Risk Factors

Events that can lead to dangerously high blood glucose and dehydration include:

  • Infection or acute illness (such as flu or pneumonia – common in Michigan winters)
  • Forgetting or stopping diabetes medications or insulin
  • Reduced intake of fluids (not drinking enough water)
  • Increased intake of sugary foods or drinks
  • Limited access to care or difficulty managing diabetes alone

When blood glucose is very high, the kidneys try to remove the excess sugar through urine. This pulls large amounts of water out of the body, leading to severe dehydration.

Symptoms of Hyperosmolar State

A person with diabetic hyperosmolarity may:

  • Be extremely thirsty
  • Urinate often at first, then less as dehydration worsens
  • Have very dry mouth and skin
  • Feel weak or dizzy
  • Become confused or disoriented

They cannot drink enough water to replace the fluid loss. Without intravenous (IV) fluids, they may progress to hyperosmolar coma.

How Hyperosmolar Coma Develops

Hyperosmolar coma usually develops slowly over several days or weeks. This means:

  • If high blood glucose and dehydration are detected early
  • And treated promptly with fluids, insulin, and medical care

…coma can often be prevented.

People in Grand Rapids with type 2 diabetes—especially older adults living alone—should have regular check‑ups with their GP (doctor) or diabetes specialist and seek care quickly if they feel unwell or confused.

Hypoglycaemic (Low Blood Sugar) Coma

What is Hypoglycaemia?

Hypoglycaemia occurs when blood glucose falls too low. If the level becomes very low and is not treated, the person may:

  • Become unconscious (hypoglycaemic coma)
  • Have seizures

This can happen in people with type 1 or type 2 diabetes who use insulin or certain diabetes tablets.

Causes of Hypoglycaemic Coma

Common triggers include:

  • Taking an extra dose of insulin or diabetes medication
  • Taking a higher dose than prescribed
  • Exercising strenuously without eating extra food or adjusting medication
  • Missing a meal or snack
  • Drinking too much alcohol, especially without food

In Grand Rapids, changes in routine—such as more outdoor activity in summer or reduced appetite during illness in winter—can increase the risk of low blood sugar.

Symptoms of Hypoglycaemia

Early warning signs include:

  • Tremor or shakiness
  • Racing pulse or heart palpitations
  • Sweating
  • Weakness or lightheadedness
  • Intense hunger

If blood sugar drops further, symptoms may progress to:

  • Confusion
  • Altered or unusual behaviour
  • Slurred speech
  • Drowsiness
  • Loss of consciousness or seizures

Prolonged or frequent hypoglycaemic episodes should be avoided, as they can be dangerous and require review by a diabetes specialist.

First Aid for a Suspected Diabetic Coma in Grand Rapids

A diabetic coma is a medical emergency. Quick action can save a life.

What to Do

If someone with diabetes becomes unconscious or you suspect diabetic coma:

  1. Call 911 immediately

    • Ask for an ambulance and state that the person has diabetes and is unconscious.

  2. Do NOT give anything to eat or drink

    • They may choke if they are not fully conscious.

  3. Turn the person onto their side

    • This helps keep the airway clear and reduces the risk of choking if they vomit.

  4. Follow instructions from the 911 operator

    • Continue to monitor breathing and responsiveness until paramedics arrive.

  5. Do NOT give insulin

    • You cannot safely judge whether the coma is from high or low blood sugar.

  6. If trained and available, give glucagon

    • If you suspect low blood sugar and have been instructed by a healthcare provider:
      • Administer 1 mg of glucagon (injection or nasal form, if available) for rapid reversal of hypoglycaemia.

Paramedics will transport the person to the nearest appropriate emergency department, such as those at Corewell Health, Trinity Health Grand Rapids, Metro Health, or other West Michigan hospitals.

Diagnosis of Diabetic Coma

At the hospital, doctors in Grand Rapids will perform:

  • Physical examination
    • Checking vital signs and looking for medical ID bracelets or necklaces indicating diabetes.
  • Blood tests
    • Blood glucose level
    • Ketone levels
    • Electrolytes (sodium, potassium, etc.)
    • Kidney function and other markers
  • Medical history
    • Recent insulin or medication use
    • Illness, infection, or changes in routine

These tests help determine whether the coma is due to DKA, hyperosmolar state, or hypoglycaemia, and guide treatment.

Treatment for Diabetic Coma

Treatment depends on the type of diabetic emergency.

Treatment for Diabetic Ketoacidosis (DKA) Coma

  • Intravenous (IV) fluids to correct dehydration
  • Insulin by IV to lower blood glucose and stop ketone production
  • Potassium replacement and other electrolytes as needed
  • Treatment of any underlying infection or illness

Treatment for Hyperosmolar (HHS) Coma

  • Intravenous (IV) fluids (often large amounts) to correct severe dehydration
  • Insulin to lower blood glucose levels
  • Potassium and sodium replacement and careful monitoring
  • Treatment of the triggering cause, such as infection or missed medications

Treatment for Hypoglycaemic Coma

  • Intravenous glucose to rapidly raise blood sugar
  • Glucagon injection if IV access is not immediately available
  • Observation and investigation of the cause (medication error, missed meals, alcohol, etc.)

In all cases, rapid diagnosis and treatment in a Grand Rapids emergency department can be life‑saving and reduce the risk of long‑term complications.

Living with Diabetes in Grand Rapids, MI

Managing diabetes in West Michigan involves:

  • Regular follow‑up with your GP or diabetes specialist
  • Adjusting insulin and medications for seasonal changes in activity and diet
  • Planning for winter illnesses (flu shots, COVID‑19 boosters, sick‑day plans)
  • Staying hydrated, especially during summer heat and indoor heating in winter
  • Learning how to recognize and treat high and low blood sugar early

Local healthcare systems like Corewell Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health offer diabetes education programs, nutrition counseling, and endocrinology services.

Where to Get Help in Grand Rapids

In an emergency, always call 911.

You can also access:

  • Emergency departments

    • Corewell Health Butterworth Hospital
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Other local hospitals and urgent care centers

  • Your GP (primary care doctor)

  • Diabetes specialist / endocrinologist in the Grand Rapids area

  • Kent County Health Department and Grand Rapids Public Health for community resources and education

  • American Diabetes Association (local Michigan chapter)

  • Juvenile Diabetes Research Foundation (JDRF) – West Michigan chapter

These resources can help you create a diabetes management plan that reduces the risk of diabetic ketoacidosis, hyperosmolar coma, and hypoglycaemic coma.

Key Points About Diabetic Coma

  • Ketones are strongly acidic and can make the blood too acidic, leading to diabetic ketoacidosis (DKA).
  • Ketones build up excessively when insulin levels are too low.
  • Common causes of DKA include missed insulin doses and acute infections, especially in people with type 1 diabetes.
  • A fruity or acetone smell on the breath is a key symptom of ketoacidosis.
  • Diabetic hyperosmolar coma is caused by severe dehydration and very high blood glucose levels.
  • Hypoglycaemic coma occurs when blood sugar drops very low and is not treated quickly.
  • Any suspected diabetic coma in Grand Rapids requires immediate emergency care—call 911 and do not delay.