[Coma in type 2 diabete mellitus on metformin treatment]

Non traumatic coma in diabete mellitus has two origins : hypo- or hyperglycemia. Coma with hyperglycemia can be due to ketoacidosis, hyperosmolar state or lactic acidosis. The present observation reports on a type 2 diabete mellitus patient presenting with a coma while the patient was on metformin and glibenclamide treatment. On admission, biologicals tests showed major acidosis, hyperglycemia and hyperosmolarity. No metformine accumulation was demonstrated by analytical measure. In this case, the association of hyperosmolar state and metabolic acidosis prove the difficulty of the differential diagnosis.