Caring for People with Diabetes in Emergency Situations – A Beginners Caregivers Guide

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Medically Reviewed by Dr. Soumya Hullanavar, Chief Specialist, DRC Bangalore

If the balance between the amounts of blood sugar and insulin is off, diabetes sufferers may experience problems. Usually, they can take action to stop the symptoms and fix the problem.

However, there may be moments when they are helpless and you will need to intervene to save their life. It could be beneficial to discuss what to do in an emergency if you know someone who has diabetes.

Emergency care for diabetes
Emergency Care for Diabetes

Hypoglycemia

Doctors refer to this as low blood sugar. When someone’s blood glucose level is higher than their insulin level, it occurs. Hypoglycemia is also referred to as “insulin shock.”

People with type 1 diabetes are more likely to get it, but it can also happen to people with type 2 diabetes who take insulin and other blood sugar-regulating medications.

 When they: Forget to eat a meal , Increased physical activity; alcohol use; excessive insulin use

Most diabetics are able to detect low blood sugar thanks to early warning indicators like trembling and hunger. To prevent severe hypoglycemia from developing, which could result in a seizure or a diabetic coma, it must be treated as quickly as possible.

Some people are unaware when they have low blood sugar. This is known as hypoglycemic ignorance. They might exhibit early symptoms, but not always. They may instead suddenly experience acute hypoglycemia. People with diabetes who have had the disease for a long period tend to be more unaware.

What it appears to be:

Severe hypoglycemia can cause the following symptoms: confusion, blurred vision, seizures, and fainting.

Things you can do

If you believe they are becoming “low,” ask them to have their blood sugar checked. Give them the assistance they need to comply with the 15/15 rule: Eat 4 ounces of fruit juice or ordinary soda, 3-4 glucose tablets or gels, 1 tablespoon of honey or sugar, or 15 grams of fast-acting carbohydrates, then wait 15 minutes. They should eat extra carbohydrates and retest their blood sugar if they don’t feel better after that.

Hypoglycemia-related unconsciousness is a medical emergency. They could choke if you try to offer them food or liquid.

To boost their blood sugar to a safe level, you should administer a glucagon shot, not insulin, if you know how. Next, dial 911.

A person who is unconscious will often awake 15 minutes after receiving glucagon. After they do, while you wait for assistance, give them sips of ordinary cola or fruit juice if they can drink.

Glucose ketoacidosis

When you don’t have enough insulin, your liver must quickly break down fat into ketones for energy, which the body can’t process, resulting in diabetic ketoacidosis, or DKA. An accumulation of ketones can poison you by altering the chemistry of your blood. You might lose consciousness.

The most frequent complication of type 1 diabetes is DKA, which can also occur in cases of type 2 diabetes and gestational diabetes, which is acquired during pregnancy. The individual may not have consumed enough food or may require more insulin than usual.

• Had a low blood sugar episode due to an insulin response while they were sleeping

The most frequent DKA trigger is being ill or infected. It can also be brought on by some medications or severe stress, such as experiencing a heart attack. DKA can occur quickly, typically in less than a day.

What it appears to be:

Early warning signs include: • Extreme thirst • Dry mouth • Frequent urination

The following signs and symptoms are more serious: persistent fatigue; dry or flushed skin; fruity-smelling breath; nausea, vomiting, or stomach discomfort; difficulty breathing; and feeling woozy, disoriented, or fainting.

Encourage anyone who exhibits early symptoms to use a ketone test kit to check their urine. Calling their doctor is advised if their ketones are high. Take them right away to the emergency department or urgent care center if they exhibit serious symptoms.

Hyperosmolar hyperglycemia (HHS)

Hyperglycemia, or high blood sugar, can also result in potentially significant issues. Although HHS is less frequent than DKA, it is more hazardous. It is a type 2 diabetes condition with extremely high blood sugar levels (above 600 mg/dL) but no or very little ketones.

The majority of cases of HHS—previously known as hyperosmolar hyperglycemic nonketotic syndrome—occur in older adults with uncontrolled diabetes who are ill or infected. Pregnant obese women with uncontrolled diabetes may also be affected.

Over the course of days or even weeks, their blood sugar levels rise, and their body tries to get rid of the extra glucose by increasing urination. They become severely dehydrated and may develop HHS if they don’t consume enough fluid to keep up. It may result in unconsciousness, death, or convulsions.

What symptoms are present include: a dry mouth, cool hands and feet, warm skin without perspiration, a fever over 101 degrees, constant thirst, frequent urination, dark urine, nausea, vomiting, stomachaches, confusion or hallucinations, slurred speech, and weakness on one side of the body.

Call their doctor, then take them to the ER or urgent care, is what you can do.

Preeclampsia

Preeclampsia, a hazardous illness associated with high blood pressure that can endanger the health of both the mother and the unborn child, is increased by having diabetes when you are pregnant, whether it be type 1, type 2, or gestational. Even though they haven’t reached complete development yet, the baby may need to be born. Preeclampsia’s specific cause is unknown.

Preeclampsia is not always cured by delivery. If after the birth of their child, mothers’ problems persist, they will require medical attention. Additionally, even if a woman didn’t have preeclampsia while she was pregnant, she can still develop it after giving birth.

What it looks like: Many pregnant women who have preeclampsia don’t feel sick or believe that their symptoms are typical of pregnancy. 

Some of the most severe signs include:

• Headache that won’t go away • Severe swelling of the face, hands, and feet — a dent is left when you press your finger into the puffiness — Pain under the right ribs or in the right shoulder — Low back pain with any other symptom — Gaining more than 2 pounds in a week — Vomiting later in the pregnancy — Anxiety and shortness of breath they experience

What you can do is contact their physician. They might need to go to the hospital right away.

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