Symptoms
The warning signs of diabetes include:

• Feeling thirsty or having a dry mouth
• Frequent urination
• Fatigue
• Dry or flushed skin
• Nausea, vomiting, or abdominal pain
• Difficulty focusing
• Confusion
• Difficulty breathing
• Fruity smell on the breath

Causes

Hypoglycemia happens when blood sugar levels are too low. Without treatment, such low levels of blood sugar can lead to seizures and become life-threatening. Hypoglycemia can occur for many reasons, but, in diabetes, it usually stems from the use of insulin or other medications that control blood sugar. Blood sugar levels may drop dangerously low when a person:

• Takes more insulin than they need for their current food intake or exercise levels
• Consumes too much alcohol
• Misses or delays meals
• Does more exercise than they expected to do

Treatments

If you have signs and symptoms of diabetic ketoacidosis or hyperglycemic hyperosmolar state, you may be treated in the emergency room or admitted to the hospital. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes:

• Fluid replacement. You’ll receive fluids — usually through a vein (intravenously) — until you’re rehydrated. The fluids replace those you’ve lost through excessive urination, as well as help dilute the excess sugar in your blood.
• Electrolyte replacement. Electrolytes are minerals in your blood that are necessary for your tissues to function properly. The absence of insulin can lower the level of several electrolytes in your blood. You’ll receive electrolytes through your veins to help keep your heart, muscles and nerve cells functioning normally.
• Insulin therapy. Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you’ll receive insulin therapy — usually through a vein.

As your body chemistry returns to normal, your doctor will consider what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional evaluation and treatment.

If your doctor suspects a bacterial infection, he or she may prescribe antibiotics. If a heart attack seems possible, your doctor may recommend further evaluation of your heart.