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Causes for this condition vary; in the case of diabetes, it could be due to too much food too quickly or forgetting to inject oneself with insulin, while in the case of hypoglycemia it could be due to a lack of food, too much exercise for current conditions, or to an insulin or other medication overdose. While no particular amount of sugar in the blood is generally recognized as the starting point to acute problems of glucose management (people vary), usually the person who has hyperglycemia has a blood glucose reading of 500 mg/ dL (28 mmol/ L) or more is at risk of hyperglycemic osmotic coma (the high gluocse sort), while a patient whose blood glucose level is 50 mg/dL (3 mmol/L) or less is at risk of a hypoglycemic diabetic coma.

Without performing a blood glucose test, it is difficult to tell with certainty whether the coma is caused by hypoglycemia or hyperglycemia as symptoms can be similar.

In both cases, the coma is caused by brain cell malfunction. In the case of hypoglycemia, there simply isn't enough glucose in the blood, leaving brain cells without enough glucose to satisfy their metabolic needs. In the case of hyperglycemia, while glucose is plentiful, indeed too plentiful, the consequences of so much blood glucose produce chemistry abnormalities which cause brain cells to malfunction. These include cell dehydration due to osmotic pressure, electrolyte balance problems both inside brain cells and in the blood, and in some cases acidosis.

• Call for help. Use an emergency telephone number, or transport to an emergency room or clinic or doctor's office for immediate medical care.

Other first aid measures include:

• If working equipment (ie, glucose meters) are available, a blood glucose level reading should be taken immediately. NEVER GIVE INSULIN unless you are completely confident you know what you're doing and are sure the patient is NOT HYPOGLYCEMIC. Mistakes with insulin can kill, and quickly.

• If the patient is conscious and suffering from hypoglycemia, administer sugar (fruit or orangeOranges are the fruits of an orange tree, one of the most common citrus fruits. Oranges are widely grown in warmer climates and are distributed worldwide. The name "orange" refers both to the fruit and its color — the color is named for the fruit. The fla juice, glucose or white sugar dissolved in juice or water), glucose tablets or gel, sugary drinks (NOT diet drinks), etc. Artificial sweetners DO NOT WORK. Avoid fatty, oily, or protein rich foods if possible, for digestion and absorption of the sugar will be delayed. A chocolate bar is not as good as a sugary tea, for instance, nor is regular milk (high fat content) in comparison to skim milk (much lower fat content). If suffering from hyperglycemia, do not feed the patient. Push water while conscious instead. And get the patient to medical treatment promptly.

• If the patient is unconscious and suffering from hypoglycemia, glucose gel may be rubbed on the lips and gums in the hopes that it will be absorbed through the mucous membraneThe mucous membranes (or mucosa are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. It is at several places continuous with skin: at the nostrils, the lips, the ears, the genitourinary area, and ths. Even a hard sugar candy might help, placed between cheek and gum. To avoid chokingIn medical use, choking is the blocking of a person's trachea by a foreign object, vomitus, blood or other fluids. Choking is a medical emergency. The first aid for choking is to call for help using the emergency telephone number, then to clear the obstru, no other food or drink should be given to any unconscious person. Regardless of whether they are hypoglycemic or hyperglycemic.

• If a blood test is not possible, and sugars are given, immediate improvement after administering sugars should begin (within five to fifteen (5-10) minutes). If this does not occur, it wasn't hypoglycemia. The diabetic coma was (is) probably the result of hyperglycemia. This requires quite different and prompt medical treatment. Failure to receive that treatment may result in acidosisIn physiology, acidosis is any condition tending to elevate the hydrogen ion concentration of arterial plasma, making the blood more acidic. Generally, acidosis is said to occur when pH falls below 7. Respiratory acidosis Results from decreased ventilatio, perhaps ketoacidosis and death. The additional sugars given should not immediately harm the patient, but they must receive medical treatment as quickly as possible.

First aid providers are encouraged to test blood glucose if possible. If not, give sugar in some form. _Never_ give insulin without compelling evidence that the problem is hyperglycemia. Giving too much sugar is less dangerous to the hyperglycemic patient than giving insulin to the hypoglycemic patient.

Doctors recommend that:

• Diabetic patients should always carry glucose tablets and/or a tube of glucose gel in case of hypoglycemia. Another good place for emergency glucose is in the refrigerator, if you are at home.

• Diabetic patients should wear a "Medic-Alert" (TM) or other bracelet or jewelry identifying them as diabetic. Otherwise, a diabetic coma could be mistaken for drunkennessintoxication Drunkenness in its most common usage, is the state of being intoxicated with alcohol (i. ethanol) to a sufficient degree to impair mental and motor functioning. Effects of alcohol on the body Alcohol is a potent drug and consequently it has a, especially by the uninformed. Undertrained policeFor the band, see The Police. For the Polish town, see Police, Poland. Police forces are government organisations ostensibly charged with the responsibility of maintaining law and order. The word comes from the French, and less directly from the Greek pol have been known to place patients into the local 'drunk tank' instead of obtaining medical attention for them. This can result in death. Diabetics have died because they were treated as intoxicatedintoxication Drunkenness in its most common usage, is the state of being intoxicated with alcohol (i. ethanol) to a sufficient degree to impair mental and motor functioning. Effects of alcohol on the body Alcohol is a potent drug and consequently it has a instead of suffering from a medical emergency.

• Friends and family of diabetic patients should learn how to give first aid in a diabetic emergency, and how to operate the diabetic person's blood glucose meter. If possible, they should also learn how and when and why to give insulin injections if necessary.

If a diabetes patient has young children living with him/her, it is also very important to teach them the appropriate local emergency telephone number.