Diabetic Emergencies: A Quick Guide

Diabetes mellitus is a condition in which your body does not produce enough insulin or has an irregular response to the hormones naturally produced by the pancreas. This can lead to high blood sugar levels. And if no medical attention is given instantaneously, a range of life-threatening emergencies can arise from untreated episodes.

As a diabetic, caregiver, or first aid staff, knowing what to do in a diabetic emergency is crucial in ensuring the patient’s safety until professional help arrives. This quick guide overviews the most common diabetic emergencies and how to handle them. If you have any questions or need more information, consult your doctor or diabetes educator.

Remember that this article is not meant to replace professional medical advice – if you experience any emergency, please seek immediate medical assistance. You may inquire about CPR First Aid’s first aid training and certification at Level 1/174 Gilles St, Adelaide 5000.

Why Knowing About Diabetes Prevalence is Important?

Based on the 2017-18 self-reported data from the Australian Bureau of Statistics, 2017-18 National Health Survey, there was an estimated 1 in 20 Australians with diabetes. In addition, data shows prevalence increases with age. We should also consider that many people have undiagnosed diabetes that has not been accounted for.

So why is prevalence data important? Firstly, it helps identify how big of a problem diabetes is in Australia, with 1.7 million people affected. Secondly, it can help to highlight which groups of people are most at risk of developing the condition.

Common Diabetic Emergencies

Diabetes from decades ago used to be fatal. Although there is no known cure for diabetes, science and technology, management, life support responses, and education can all aid in the delay of disease progression.

Medical News Today has outlined some of the most common diabetic emergencies – what are the warning signs and how to handle these situations.

Severe Hypoglycemia

Severe hypoglycemia occurs when your blood sugar (glucose) level drops too low. It can happen suddenly and without warning. If not treated, it can lead to unconsciousness or even death.

Warning signs of severe hypoglycemia include:

• feeling very shaky
• sweating
• confusion
•  difficulty speaking
•  drowsiness or sleepiness – seizures
•  coma

Emergency care for severe hypoglycemia

1. The best way to treat severe hypoglycemia is to make the affected person eat or drink something that will raise the blood sugar level quickly. This can be a glass of orange juice, a slice of bread, or a candy bar. 
2. If the person is conscious but unable to eat or drink, they may need an injection of glucagon, a hormone that raises blood sugar levels. 
3. If the patient loses consciousness, call triple zero (000) for medical assistance.

Hyperglycemia

Hyperglycemia is when the body has too much sugar in the bloodstream because there is no insulin. There are high levels of sugar in the blood and urine. If untreated, it can lead to serious problems such as ketoacidosis, coma, and even death.

Warning signs of hyperglycemia can include:

• feeling very thirsty
• having to urinate frequently
• feeling tired
• blurred vision

First aid for hyperglycemia

1. Check the person’s blood sugar level and treat it if it is high (over 11mmol/L)
2. If an insulin injection combined with medication potentiated the lowering of blood glucose, give the person a sugary drink or food if they are feeling dizzy, shaky, or faint
3. Calling 000 if the person does not have diabetes and their blood sugar level is very high or if they are having trouble breathing
4. Stay and closely monitor the patient until medical help arrives

In order to prevent these kinds of emergencies, do more physical activities, eat less and, if necessary, visit your doctor for insulin adjustments.

Diabetic Ketoacidosis (DKA)

Severe ketoacidosis is a serious diabetes consequence that can occur when your body produces too many ketones. Ketones are produced when your body breaks down fat for energy. Too many ketones can lead to a build-up of acids in your blood. This can happen to people with type 1 diabetes when sick or under stress.

Common warning signs of ketoacidosis are:

• increased thirst or dry mouth
• frequent urination
• nausea and vomiting
• abdominal pain
• confusion or lethargy
• difficulty breathing
• fruity smell on the breath

First aid steps for severe ketoacidosis

1. Call 000 or your local Adelaide emergency number.
2. Check the person’s blood sugar level and monitor closely.
3. Administer insulin if prescribed.
4. Monitor the person’s vital signs, including blood pressure, pulse, and respiration.
5. Give the person fluids as directed by a medical professional.
6. Keep the person calm and comfortable until medical help arrives. If you are with someone experiencing ketoacidosis, it is essential to stay calm and call for medical help immediately.

Hyperglycemic Hyperosmolar Syndrome (HHS)

HHS happens when your blood sugar gets too high, and your body cannot make enough insulin to bring it down. This can cause the sugar in your blood to pull water out of your cells leading to dehydration. It can also make your blood too acidic, resulting in severe organ damage if not treated immediately.

Hyperglycemic hyperosmolar syndrome can happen to anyone but mainly affects people with poorly controlled type 2 diabetes. Blood glucose levels spike up to 33.3mmol/L and above.

Common warning signs of HHS are:

• extreme thirst or dry mouth
• weak and rapid pulse
• nausea and vomiting in children
• low-grade fever in adults
• confusion or coma
• temporary paralysis
• loss of consciousness

Emergency care for HHS

1. Check the person’s blood sugar level and give insulin if it is high.
2. Give the person IV insulin therapy – the first line of therapy
3. Call for medical help right away.
4. Do not give the person anything to eat or drink until they can see a doctor.
5. If the person has seizures, turn them on their side to prevent them from choking on vomit.
6. Stay with the person until medical help arrives.

Infections

Due to blood vessel and peripheral nerve damage in the diabetes aftermath, blood flow is reduced in the extremities increasing the chances of infection.

What are common infections for people with diabetes?

• Skin and soft tissue infections
• Urinary tract infections
• Gastrointestinal infections
• Respiratory infections
• Foot infections

People with diabetes are also at increased risk for developing serious infections, such as sepsis or pneumonia. Treatment can be complicated because many of these individuals also have other medical conditions, such as heart disease or kidney disease. Therefore, it is essential to see a healthcare provider promptly if any signs or symptoms of infection manifest.

How to Prevent Diabetic Emergencies?

Diabetic emergencies can be life-threatening, but they are preventable with proper care. Here are some tips to help prevent them: 

1. Keep your blood sugar levels under control. This means knowing your target range and checking your blood sugar regularly. If your blood sugar gets too high or too low, take steps to bring it back into your target range.
2. Wear a medical alert bracelet or necklace that says you have diabetes. This way, if you have a diabetic emergency and cannot speak, paramedics will know to look for signs of low blood sugar or high blood ketones.
3. Carry diabetes supplies such as glucometer, fast-acting carbohydrates, and insulin.
4. Know the signs and symptoms of low blood sugar and high blood ketones and what to do if you experience them.
5. Have a plan in an emergency, such as who to call and where to go for help.

I am a Caregiver of a Diabetic Patient. Where Can I Renew my First Aid Certificate

CPR First Aid RTO NO 21903 is a compliant and leading Express and Regular first aid training provider. If you are looking only to renew your first aid certificate in Adelaide CBD or one of our several locations in Australia, contact us anytime to know more details.

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