How to deal with diabetic emergencies

Learn to identify and react to different kinds of diabetic emergencies while you wait for ER24 paramedics to arrive.

When someone is diagnosed with diabetes, their doctor will give them a management plan that includes medication, a diet, and exercise recommendations. Although the condition can be managed well, there can still be times when things go wrong.

Stacey-Lee Alcock, an Emergency Care Practitioner at ER24 West Metropole, explains the different kinds of diabetic emergencies, how to identify them and how to deal with a patient while you wait for expert help to arrive.

Diabetic emergencies can be divided into different categories:

• Hypoglycaemia: Blood sugar drops too low.
• Hyperglycaemia: Blood sugar rises too high.
• Diabetic ketoacidosis (DKA): This happens when the body isn’t producing enough insulin, and sugar cannot enter the cells. The body then breaks down fat into ketones, which can be harmful in large amounts.
• Hyperosmolar hyperglycaemic syndrome (HHS): Occurs when blood sugar levels rise significantly but without the presence of ketones.
• Diabetic coma: This is a serious condition that can result from diabetic ketoacidosis.

Recognising different diabetic emergencies

Alcock says these common symptoms show that someone is experiencing a diabetic emergency:

• Confusion
• Nausea and vomiting
• Excessive thirst
• Sweating
• Hot and dry skin
• Tiredness
• Loss of consciousness
• Being unable to wake up
• Seizures.

If you have a glucometer (a device that measures blood sugar levels), you can use it to check the person's blood sugar. This will help you determine if they have low blood sugar (hypoglycaemia) or high blood sugar (hyperglycaemia).

If you don't have a glucometer, Alcock suggests looking for these signs: Hypoglycaemia usually shows up as pale skin and excessive sweating, while hyperglycaemia typically appears as dry, hot skin and intense thirst.

Treating hypoglycaemia

If a person is hypoglycaemic and conscious, Alcock advises giving them something sweet to eat or drink to raise their glucose levels. “As nausea is a common symptom, people living with diabetes often find it easier to drink something sugary, rather than eating,” Alcock says. She adds that liquid raises blood sugar levels quicker than solid food.

If the patient is unconscious, lie them on their side to open their airways. Place some honey or jam on the inside of their cheeks for quick absorption by mucous membrane. “Place your finger carefully in their mouth to avoid them inadvertently biting down on your finger,” Alcock cautions.

Treating hyperglycaemia

If you’ve confirmed that somebody has hyperglycaemia and they are conscious, let them drink water and remind them to take their insulin as per their doctor’s instructions. “You can also take them to the nearest hospital to prevent DKA or HHS,” says Alcock. If the person becomes unconscious, turn them onto their side and call ER24 on 084 124 for emergency help.

Treating a diabetic coma

If you suspect someone is in a diabetic coma, call ER24 right away. In the meantime, Alcock advises turning the person onto their side. “This is to ensure their airway is open. If they stay on their back, their tongue could obstruct their airway,” she explains. Turning the patient on their side also prevents them from swallowing or choking on vomit or spit. Stay with them until paramedics arrive.

In the meantime, a trained Emergency Resource Officer at the ER24 Contact Centre can guide you on what to do while you wait for help to arrive. This may include phone instructions for CPR and other important information to keep the person stable.

In any emergency, call the ER24 Contact Centre on 084 124 for real help, real fast.