Dehydration. If you have type 2 diabetes that gets very out of control due to infection, stress, surgery, cortisone or other factors, you can become severely dehydrated as well as have a very high glucose. This can even lead to coma, with an up to 50% morbidity if not treated quickly and effectively with large amounts of IV fluids, a small amount of insulin, control of the original cause and adjustment of elec.
Dehydration. Because high blood sugar is a diuretic, high blood sugar causes the urine to lose water and concentrate the serum. The serum sodium will go up which affects the cells of the brain and results in altered mental status and coma.
Life threat. This is a coma caused by significant elevations of blood glucose, which make the blood too thick and causes brain malfunction. There are many electrolyte abnormalities associated, and the care of the patient is critical, usually he or she is in the icu. Glucose needs to be lowered by IV insulin, and the other abnormalities need to be carefully fixed.
Coma due to diabetes. By your question I will assume he is in the hospital. This condition is due to poor control of diabetes either due to not taking medications or as a result of some inciting condition like infection amongst others, a better controll of diabetes will help prevent this. In summary it's a coma caused by caused by high glucose.
Diabetic emergency. Hyperosmolar coma is a medical emergency seen in type ii diabetics when the blood sugar reaches extremely high levels, typically higher than 600 mg/dl. Often it is precipitated by a physiologic stress such as infection, myocardial infarction, stroke or other acute illness. The very high blood glucose may lead to disordered mental functioning with possible seizures then to coma and death.
Dehydrated state. Hyperosmolar coma is the use of drugs like barbiturates to produce sedation plus using diuretics to cause a concentration of the blood. The sodium level in the blood is increased to the 150 range. The sedation reduces brain metabolic requirements while the hyperosmolarity helps reduce intracranial pressure.
Several causes. The most common is a form of diabetes out of control. It is life threatening and requires immediate attention.
Insulin. It is treated with an intravenous drip of Insulin and attention to proper fluid replacement. It is a potentially serious condition and should only be treated in the hospital, however, the treatment is usually sucessful. It happens when the sugar becomes very high, frequently over 5-600.
Coma. It should be treated in an intensive care unit (ICU) with close monitoring of the blood glucose and other electrolytes (salts) and treatment to slowly decrease the blood glucose.
Insulin and fluid. Insulin and saline are administered intravenously and other medications added depending on the clinical findings and lab tests.
Insulin and acidosis. Hi. DKA is an insulin deficient state that contrary to lay bias, occurs in both type 1's AND type 2's. The nonketotic hyperosmolar, hyperglycemic state is a condition that occurs in type 2's; they have enough insulin to prevent ketoacidosis but not enough to prevent profound hyperglycemia and hyperosmolarity. It takes FAR LESS insulin to prevent ketoacidosis than it does to prevent hyperglycemia.