How can we help someone with diabetes if they have an emergency? (Diabetic Emergency)

Do you have a family member or friend who has diabetes? Have you ever heard of an emergency situation where someone's blood sugar level suddenly drops too low or too high? They may not be able to take care of themselves at this time. You can help save their life. So, if someone you know has diabetes, it's important to talk to them about what to do in an emergency.

What is a diabetic emergency?

Simply put, a diabetic emergency is when a person with diabetes has a dangerously low or high blood sugar level. This can cause severe symptoms and even be life-threatening. There are two main types of these conditions.

Such large changes in blood sugar levels can have a major impact on how our body functions, and therefore require immediate medical attention.

Emergency caused by low blood sugar - "Insulin shock"

This is a condition called severe hypoglycemia. This is when blood sugar levels drop to a very low level, usually below 60 mg/dL. Although it is called "insulin shock," this can occur not only in people taking insulin, but also in people taking certain medications for diabetes (e.g., sulfonylureas).

Why is this an emergency?

Think about it, our brain needs glucose (sugar) to function. When sugar levels drop too low, we can't think clearly and we can pass out. That means we can't treat this condition on our own. If we don't have anyone to help, it can even lead to death.

Reasons for low sugar

• Skipping a meal.
• Exercising more than usual.
• Drinking alcohol without food.
• Taking too much insulin, using the wrong type, or injecting it incorrectly.
• Taking the wrong dose of diabetes medication.

Symptoms of low sugar

Symptoms may initially include shivering and feeling hungry. However, if left untreated, the condition can worsen and lead to the following symptoms:

• Confusion.
• Blurred vision.
• Severe weakness.
• Seizures.
• Passing out.
• Coma.

How do you help someone with low blood sugar?

If someone has these symptoms, tell them to check their blood sugar levels. Next, help them follow the "15/15 rule."

1. Give 15 grams of quickly digestible carbohydrates:

• 3-4 glucose tablets.
• 120 milliliters (about half a cup) of fruit juice or a sugary drink (regular soda).
• A tablespoon of honey or sugar.

2. Wait 15 minutes: Then check your blood sugar again. If it's still low, give another 15-gram carbohydrate portion.

Emergencies caused by high blood sugar

Uncontrolled increases in blood sugar levels can lead to two serious emergencies.

1. Diabetic Ketoacidosis (DKA)

When there is not enough insulin to use glucose (sugar) for energy, our bodies start burning fat for energy. This process produces chemicals called ketones . When these ketones accumulate in the blood, the blood becomes acidic and can be toxic to the body. This is called DKA. This is a complication that most often occurs in people with type 1 diabetes, but it can also occur in people with type 2 diabetes and gestational diabetes.

Why is DKA an emergency?

This is a life-threatening condition. DKA is a leading cause of death, especially among children with diabetes.

Causes of DKA:

• Insulin problems: missing insulin doses, using expired insulin, insulin pump malfunctions.
• Illness: Some infections and medical conditions can cause DKA.
• Stress: Severe mental stress, conditions such as a heart attack.
• Some medications.

How to help in case of DKA?

If someone has early symptoms, ask them to check their urine ketone levels with a ``ketone test kit.`` If the ketone levels are high, they should call their doctor immediately. However, if they have serious symptoms, they should be taken to a hospital's emergency room (ETU) immediately.

2. Hyperosmolar hyperglycemic syndrome (HHS)

This occurs when blood sugar levels rise above 600 mg/dL and remain at that level for days or weeks. This can lead to severe dehydration and be life-threatening.

• HHS is common in people with Type 2 Diabetes.
• It doesn't develop quickly like DKA, it develops gradually over several days.
• In HHS, ketones do not accumulate in the blood like in DKA.

Causes of HHS:

• Poorly controlled type 2 diabetes.
• Infections such as pneumonia and urinary tract infections.
• Conditions such as heart attacks and strokes.
• Some medications.

Symptoms of HHS:

Symptoms may include dry mouth, excessive thirst, frequent urination, fever, rapid heartbeat, confusion, changes in speech, weakness on one side of the body, and loss of consciousness.

How can HHS help in this situation?

Call their doctor immediately. Then take them to a hospital's Emergency Treatment Unit (ETU) as soon as possible.

Diabetic Coma

This is the most severe form of a diabetic emergency. A prolonged state of unconsciousness caused by blood sugar levels that are too high (due to DKA or HHS) or too low (due to severe hypoglycemia) and left untreated. A person in a coma will not respond to speech or touch.

How do you help someone in a diabetic coma?

If a person with diabetes is unconscious and unresponsive, it could be a diabetic coma.

• Call 1990 or an emergency service number immediately.
• Follow the instructions given by the telephone operator.
• Do not put anything in your mouth (juice, sugar water) thinking that your sugar may be low. This can cause choking.
• If the person vomits, turn them on their side to prevent choking.

Diabetic Emergency Kit

Being prepared for an emergency can save your life or the life of someone you love. Keep these items close at hand, and make sure everyone in your home knows where they are.

• Insulin: If you use insulin, always keep a fresh supply that has not expired.
• Things to give when sugar is low: fruit juice, sugary drinks, or glucose tablets.
• Glucagon kit: To raise blood sugar levels if you lose consciousness. If you are caring for a diabetic, know how to use this.
• Ketone test kit: To test if DKA is suspected.
• A medical alert bracelet: This helps identify you as a diabetic in the event of an emergency.
• Complete information about the medications you take: There are even phone `apps` for this now.