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What is a diabetes emergency

You never know how you are going to respond to a crisis until it happens. That’s why we practice in schools with drills for fire and other emergency situations. So we are prepared when something happens. But what happens when the crisis is something you would never think to plan for, like accidentally using the wrong insulin pen and injecting way too much insulin? What would you do?

That happened to Carol when she was away from home, and like most of us with diabetes, she tried to handle it on her own. Eventually, she knew it was time to get help. Watch Carol's story.

Stories like this make me think that is exactly the thing I need to prepare for. But how?

Treating hypoglycemia or low blood sugar

Experiencing hypoglycemia (hypo) or low blood sugar is nothing to mess around with. Once you recognise a low blood sugar, usually identified as anything below 3.9 mmol/L you should take action. That means knowing how much active insulin is in your system still (if on fast-acting or mealtime insulin) and eating or drinking fast sugar or glucose. This can be in the form of fruit juice, sweets, glucose tabs or gels. Typically it’s recommended to follow the rule of 15: take 15 grams of carbs, wait 15 minutes, check your blood sugar again. Repeat this process until your blood sugar comes back up. Recheck again an hour later to ensure you don’t have a rebound high blood sugar or persistent low. While this is a commonly used rule, it is always best to discuss with your healthcare team the best plan for you to follow.

Hypoglycemia is not the only potential diabetes related emergency. Diabetes is a complex condition that affects many different organs and functions in the body.

When Hyperglycemia or high blood sugar becomes dangerous

There are so many factors that can cause your blood sugar to rise that it is not uncommon to experience hyperglycemia if you are living with diabetes. When your blood sugar goes up, there are a few different ways you can help your body bring it back down. Take exercise, for example. Did you know your leg muscles are among the biggest muscles in your body? Taking a walk can be quite effective in bringing your blood sugar down. Some exercise can increase your blood glucose though so keep an eye on levels and speek with your diabetes team for more information and to discuss what works for you.

Hyperglycemia can be a serious problem if left untreated. It is important to take action as soon as you detect it. Either with medication, exercise, or even practicing meditation to reduce stress. If left untreated and blood sugar rises too high or remains high for a period of time, a condition called ketoacidosis can occur. This is a serious condition that can lead to a diabetic coma. With diabetes, either your body cannot produce insulin or cannot use it effectively. Without insulin addressing your rising blood sugar, your body breaks down fats to use for energy. When your body breaks down fats, it produces waste products called ketones. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. However, when the body cannot release all the ketones, they build up in your blood, which can lead to ketoacidosis.

Ketoacidosis can be life-threatening and needs immediate treatment. If your blood sugar is high and you experience the following symptoms, contact your healthcare team immediately to discuss how to care for this condition.

  • Shortness of breath
  • Breath that smells fruity
  • Nausea and vomiting
  • Very dry mouth

How do you know if it is a “real emergency”?

When you are diagnosed with diabetes you learn fairly early, through trial and error, how your body reacts to different experiences. You also likely know when things aren’t quite right. But how do you know when it is a “real emergency”? How do you know when it is time to seek help?

Diabetes related emergencies could be defined as any point when symptoms become overwhelming and self-treatment is no longer effective.

The following signs can indicate a serious problem. If you experience any of these signs and are not able to treat them on your own, contact your local emergency line right away.

  • chest pain that radiates down the arm
  • difficulty breathing
  • a high fever
  • a severe headache and weakness in one side of the body

Tell those around you that if they observe any of the following signs, they should contact emergency services immediately.

  • seizures
  • loss of consciousness

Be prepared for emergencies – plan ahead

Emergency planning can improve the chances that the signs and symptoms experienced don’t result in a less than favourable outcome.

People with diabetes can prepare by:

  • letting friends and loved ones know about your diabetes and informing them of how they can help you identify blood sugar trouble
  • wearing a medical ID so that people will know what to do in an emergency
  • keeping a mobile phone charged and ready to contact emergency responders
  • speaking with your doctor about
    • whether you should buy a glucagon kit and how and when to use it. As well as ensuring friends and family know how to use it too.
    • how to handle times of crisis and who to call with questions about diabetes emergencies.

 

The views expressed in the Accu-Chek blog are not necessarily those of Roche Diabetes Care Limited or our publishers. The content is provided for general information only. It is not intended to amount to advice on which you should rely - you must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content. Although we make reasonable efforts to ensure that the content is up to date, we make no representations, warranties or guarantees, whether express or implied, that the content is accurate, complete or up-to-date.

 

16 November 2019