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Coma may be due to causes not directly related to diabetes. Diabetic coma requires differentiation (Table 27–10): (1) Hypoglycemic coma from excessive insulin or oral hypoglycemic agents. (2) Hyperglycemic coma with either severe insulin deficiency (DKA) or mild to moderate insulin deficiency (hyperglycemic hyperosmolar state). (3) Lactic acidosis, particularly when patients with diabetes have severe infections or cardiovascular collapse.

Table 27–10.Laboratory diagnosis of coma in diabetic patients.

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