Recognizing and Responding to a Diabetic Emergency: A Guide for Bystanders

Diabetes is a chronic condition that affects how your body regulates blood sugar. Diabetic emergencies occur when blood sugar levels become dangerously high (hyperglycemia) or critically low (hypoglycemia). These emergencies require prompt action to prevent serious complications and even death.

This guide equips you with the knowledge and skills to recognize a potential diabetic emergency in a person and outlines the steps you should take to help until medical assistance arrives.

Understanding Diabetic Emergencies

There are two main types of diabetic emergencies:

• Hyperglycemia (High Blood Sugar): When blood sugar levels soar above a safe range, it can lead to a condition called diabetic ketoacidosis (DKA). Symptoms of DKA develop gradually over hours or days and include:

  • Excessive thirst and urination
  • Fruity-smelling breath
  • Nausea and vomiting
  • Abdominal pain
  • Drowsiness or confusion
  • Difficulty breathing

• Hypoglycemia (Low Blood Sugar): A sudden drop in blood sugar levels can cause a hypoglycemic reaction. Symptoms of hypoglycemia can come on quickly and worsen rapidly. These include:

  • Sweating
  • Shaking
  • Hunger
  • Palpitations
  • Anxiety
  • Irritability
  • Confusion
  • Drowsiness
  • Blurred vision
  • Seizures (in severe cases)
  • Loss of consciousness (in severe cases)

Recognizing the Signs of Trouble

Not everyone with diabetes experiences the same symptoms during an emergency. However, there are some general signs that can indicate a potential problem:

• Altered Behavior: The person may appear confused, disoriented, or exhibit unusual behavior compared to their baseline.
• Changes in Speech: Slurring or difficulty speaking can be a sign of altered mental state due to high or low blood sugar.
• Visible Distress: Sweating, trembling, or pale skin can indicate a physiological response to imbalanced blood sugar.
• Loss of Consciousness: If the person becomes unresponsive, it’s a critical sign requiring immediate medical attention.

Steps to Take in a Diabetic Emergency

If you suspect someone is experiencing a diabetic emergency, here’s what you should do:

1. Stay Calm and Assess the Situation: Take a moment to gather yourself and observe the person’s condition. Are they conscious and alert? Are they able to communicate?

2. Call for Emergency Help: Dial emergency services (e.g., 112 in Europe or 911 in the US) immediately. Time is critical in a diabetic emergency, and medical professionals are best equipped to handle the situation.

3. Identify if the Person Has Diabetes: If possible, try to determine if the person has diabetes by looking for a medical identification bracelet or asking if they carry glucagon (a medication used to treat severe hypoglycemia).

4. Administer Glucagon (if Available): If the person is unconscious and you have access to a glucagon emergency kit and are trained on its use, administer the glucagon injection according to the kit’s instructions. Glucagon is specifically used for severe hypoglycemia and should not be administered if the person is conscious or if you suspect high blood sugar.

5. Provide Oral Glucose (if Conscious and Alert): If the person is conscious, alert, and experiencing symptoms of hypoglycemia, offer them a source of quickly absorbed sugar. This could be four ounces of fruit juice, regular soda (not diet), or commercially available glucose tabs or gels.

6. Monitor the Person: While waiting for emergency services, keep the person calm and comfortable. If they are conscious, encourage them to sip water after consuming a sugary drink.

7. Avoid Giving Anything by Mouth (if Unconscious): If the person is unconscious or has difficulty swallowing, do not attempt to give them anything by mouth. This could lead to choking.

8. Note the Time: Keep track of the time when you first noticed the symptoms and when the person consumed any sugary drinks or medication. This information can be valuable for medical professionals when they arrive.

Additional Tips

• Learn about Diabetes: Familiarize yourself with the signs and symptoms of diabetic emergencies. The more informed you are, the better equipped you’ll be to respond effectively.
• Carry a Glucagon Emergency Kit (if Applicable): If you know someone with diabetes who is at risk for severe hypoglycemia, encourage them to carry a glucagon emergency kit and ensure you understand how to use it in case of an emergency.
• Educate Others: Spreading awareness about diabetes and how to recognize emergencies can empower others to help in similar situations.

FAQ on Responding to a Diabetic Emergency

Q: What if I can’t tell if the person has high or low blood sugar?

A: In this situation, err on the side of caution and call emergency services immediately. Here’s why:

• Both hyperglycemia and hypoglycemia can be life-threatening if left untreated.
• Medical professionals can assess blood sugar levels and provide the most appropriate treatment.

Q: Should I give the person food or drink if I’m unsure if they have diabetes?

A: It’s generally not recommended to give food or drink to an unconscious person. Choking is a risk, and you might worsen the situation if they have high blood sugar. However, if the person is conscious and alert, you can offer a small amount of sugary drink (like fruit juice) and monitor their response.

Q: Can I give the person insulin if I think they have high blood sugar?

A: Do not administer insulin unless you are a trained medical professional. Incorrect insulin administration can be dangerous.

Q: What should I do if the person starts to vomit?

A: If the person vomits, turn them on their side to prevent aspiration (inhalation of vomit into the lungs). Clear their airway with caution and continue monitoring them until help arrives.

Q: What should I do if the person has a seizure?

A: Stay calm and clear the area around the person to prevent injury. Do not restrain them. Cushion their head with something soft and time the seizure with your watch. Call emergency services immediately.

Remember: You are not expected to diagnose or treat the diabetic emergency. Your primary role is to call for help, keep the person safe, and provide basic support until medical professionals arrive. By following these steps and staying calm, you can make a significant difference in someone’s life during a diabetic emergency.