The best way to prevent diabetic coma is to keep glucose (blood sugar) levels well under control. There are several steps that are essential to the careful maintenance of diabetes. They include:

• Create and maintain an appropriate meal plan. Patients should work with their physician and a registered dietitian on crafting and following a diet that controls their glucose. Lack of carbohydrates can trigger “starvation” ketosis, though this is often mild, and hypoglycemia, which may lead to coma.
  
  
• Check levels of glucose and ketones. Patients should perform glucose monitoring and ketone testing regularly as advised by their physician. This will help to warn them when their glucose is either too high or too low, or when they are in danger of complications such as diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic syndrome.

• Take medications carefully. Patients should always take their medications exactly as instructed by a physician. If treatments fail to control a patient’s diabetes, adjustments may be necessary. However, patients should not adjust dosages or quit taking medications without first consulting a physician.

Patients and physicians should also be alert to how nondiabetes drugs can affect glucose. For example, researchers in 2006 reported that some popular antibiotics can cause dangerously high or low glucose.

• Establish a sick-day plan. A physician can devise a plan to help prevent illnesses from escalating to life-threatening complications.
  
  
• Address dawn phenomenon and the Somogyi effect. Some patients are troubled by  rising levels of  glucose in the morning. A physician may recommend steps such as changing medication, snacking before bedtime or using an insulin pump.

• Control unstable diabetes. This continues to be a difficult therapeutic goal in many cases. Options to improve glycemic management may include an insulin pump, pancreas transplant or islet cell transplant. A possible option that a physician may prescribe for patients with type 1 diabetes or type 2 diabetes who use insulin is a newer injected antidiabetic agent called pramlintide (Symlin).

• Educate family, friends, co-workers and caregivers. Patients should teach those around them how to respond to diabetic emergencies such as a diabetic coma. This can be crucial to avoiding serious health consequences when diabetic individuals are unable to treat themselves. In the case of children, instruction should be provided to school and day-care employees, coaches, leaders of youth groups and so forth.
  
  
• Keep an emergency source of sugar at hand. These quick fixes for hypoglycemia (low blood glucose) include glucose tablets, glucose gels, nondiet soft drinks, fruit juice, hard candies and sugar packets. Some physicians recommend that to avoid overtreating hypoglycemia and causing high blood glucose, it may help to eat an initial predetermined amount, then wait 10 or 15 minutes before deciding whether to eat any more. Fatty foods such as chocolate and ice cream are less desirable because the body does not absorb them as quickly.
  
  
• Wear an ID bracelet or necklace that details the condition. Such jewelry can provide critical information to those who respond when a patient lapses into a diabetic coma.

Another possible option may be to get a diabetes assistance dog. Several organizations train dogs to sense dangerous changes in glucose and alert their diabetic owner. However, demand for these animals is reported to be far greater than the supply.