Prevention

Good day-to-day control of your diabetes can help you prevent a diabetic coma. Keep these tips in mind:

• Follow your meal plan. Consistent snacks and meals can help you control your blood sugar level.
• Keep an eye on your blood sugar level. Frequent blood sugar tests can tell you whether you're keeping your blood sugar level in your target range — and alert you to dangerous highs or lows. Check more frequently if you've exercised because exercise can cause blood sugar levels to drop, even hours later, especially if you don't exercise regularly.
• Take your medication as directed. If you have frequent episodes of high or low blood sugar, let your doctor know. He or she may need to adjust the dose or the timing of your medication.
• Have a sick-day plan. Illness can cause an unexpected change in blood sugar. If you are sick and unable to eat, your blood sugar may drop. Before you get sick, talk with your doctor about how to best manage your blood sugar levels. Consider storing at least three days' worth of diabetes supplies and an extra glucagon kit in case of emergencies.
• Check for ketones when your blood sugar is high. Check your urine for ketones when your blood sugar level is over 250 mg/dL (14 mmol/L) on more than two consecutive tests, especially if you are sick. If you have a large amount of ketones, call your doctor for advice. Call your doctor immediately if you have any level of ketones and are vomiting. High levels of ketones can lead to diabetic ketoacidosis, which can lead to coma.
• Have glucagon and fast-acting sources of sugar available. If you take insulin for your diabetes, make sure you have an up-to-date glucagon kit and fast-acting sources of sugar, such as glucose tablets or orange juice, readily available to treat low blood sugar levels.

• Consider a continuous glucose monitor (CGM), especially if you have trouble maintaining stable blood sugar levels or you don't feel symptoms of low blood sugar (hypoglycemia unawareness).

  CGMs are devices that use a small sensor inserted underneath the skin to track trends in your blood sugar levels and transmit the information to a wireless device.

  These devices can alert you when your blood sugar is dangerously low or if it is dropping too fast. However, you still need to test your blood sugar levels using a blood glucose meter even if you're using a CGM. CGMs are more expensive than conventional glucose monitoring methods, but they may help you control your glucose better.

• Drink alcohol with caution. Because alcohol can have an unpredictable effect on your blood sugar, be sure to have a snack or a meal when you drink, if you choose to drink at all.
• Educate your loved ones, friends and co-workers. Teach loved ones and other close contacts how to recognize the early signs and symptoms of blood sugar extremes and how to give emergency injections. If you pass out, someone should be able to call for emergency help.
• Wear a medical ID bracelet or necklace. If you're unconscious, the ID can provide valuable information to your friends, co-workers and others — including emergency personnel.