Diabetes Emergency Treatments: What to Do in Critical Situations
Essential strategies and step-by-step guides for effectively managing diabetes during emergencies to prevent serious complications.
Diabetes can lead to life-threatening emergencies if blood glucose levels are not properly managed. Knowing how to respond to acute episodes of both high and low blood sugar is crucial for individuals living with diabetes and their caregivers. This guide covers the essential knowledge and procedures for handling diabetes emergencies, including preparedness strategies, step-by-step treatment options, and answers to common questions.
Understanding Diabetes Emergencies
People with diabetes, especially those using insulin or certain oral medications, can experience rapid fluctuations in blood sugar that may develop into serious medical emergencies. The two most dangerous situations are hypoglycemia (dangerously low blood sugar) and hyperglycemia (dangerously high blood sugar), each with distinct causes and treatments.
Common Causes of Diabetes Emergencies
- Missed insulin or medication doses
- Illness, infection, or severe stress
- Unplanned physical activity or changes in routine
- Not eating enough carbohydrates or delayed meals
- Errors in insulin dosing
Emergency Treatments for Hypoglycemia
Hypoglycemia occurs when blood sugar drops below 70 mg/dL. Early treatment is vital because severe hypoglycemia can lead to unconsciousness, seizures, or even death if not treated immediately.
Recognizing Symptoms
- Shakiness or trembling
- Sweating or chills
- Rapid heartbeat
- Irritability, anxiety, or confusion
- Drowsiness or weakness
- Headache
- Blurred vision
- Slurred speech
- Loss of coordination
Severe Symptoms
- Seizures or convulsions
- Loss of consciousness
Step-by-Step Immediate Treatments for Hypoglycemia
- Check blood glucose: Confirm hypoglycemia (below 70 mg/dL) using a glucose meter or continuous glucose monitor. If no device is available but symptoms are present, begin treatment.
- Administer 15 grams of fast-acting carbohydrates:
- 4 ounces (about 120 ml) of juice or regular soda (not diet)
- 3–4 glucose tablets
- 5–6 hard candies
- 1 tablespoon of sugar, honey, or syrup
- Wait 15 minutes: Re-check blood sugar. If still low, repeat the above step.
- Follow up: Once blood sugar is back to normal, eat a small snack if the next meal is more than an hour away.
When to Seek Emergency Help
- If symptoms do not improve after initial treatment
- If the person is unconscious, having seizures, or unable to swallow
- If there is no access to glucose or glucagon
What others are reading
Treating Severe Hypoglycemia: Glucagon Administration
For severe cases when the person cannot safely consume food or drink, glucagon is the emergency treatment. Everyone at risk for severe hypoglycemia should have a glucagon kit or nasal spray, and those close to them should know how to use it.
Glucagon Emergency Kit (Injection)
- Mix the provided liquid and glucagon powder just prior to injection.
- Inject into the muscle of the upper arm, thigh, or buttocks.
- May cause nausea or vomiting as side effects.
Glucagon Nasal Powder
- Ready to use, no mixing required.
- Spray into one nostril while the person is lying on their side.
- Works even if the person is unconscious or unable to swallow.
Emergency Treatments for Hyperglycemia
Hyperglycemia means blood glucose levels are too high (often 300 mg/dL or higher). If untreated, this may develop into diabetic ketoacidosis (DKA), a life-threatening illness more common in type 1 diabetes but possible in type 2.
Recognizing Symptoms
- Frequent urination
- Increased thirst
- Dry mouth
- Fatigue or weakness
- Nausea or vomiting
- Stomach pain
- Shortness of breath
- Fruity-smelling breath
- Confusion
Step-by-Step Immediate Treatments for Hyperglycemia
- Check blood sugar: Use a meter to confirm high glucose.
- Administer insulin: Take a fast-acting insulin dose as directed by your healthcare provider. Never guess the dose—consult your diabetes action plan.
- Drink plenty of water: This helps flush excess glucose through urine and combat dehydration.
- Rest: Avoid vigorous physical activity until glucose levels have returned to a safe range, as exercise may increase ketone production if insulin is missing.
- Monitor ketones: Use urine test strips if blood sugar remains high.
When to Seek Emergency Help
- Two blood sugar readings in a row of 300 mg/dL or higher
- Signs of DKA: nausea, vomiting, abdominal pain, fruity breath, deep rapid breathing, confusion
- Presence of moderate to large ketones in urine
- Unable to keep down fluids
- Rapidly deteriorating condition or severe dehydration
Diabetes Emergency Preparedness
Preparation is key for managing diabetes during emergencies such as natural disasters, power outages, or public health crises, when access to medical supplies or care may be limited.
Creating a Diabetes Care Kit
- Insulin, oral diabetes medications, and syringes
- Blood glucose meter and extra batteries
- Lancets, lancing devices, and test strips
- Continuous glucose monitor (CGM) sensors, if used
- Glucagon emergency kit or nasal spray
- Ketone test strips
- Alcohol wipes and bandages
- Quick-acting carbohydrates (glucose tablets, juice, honey)
- Empty container for safe disposal of sharps
- 1–2 week supply of all medications and supplies in a waterproof bag
Important Medical Information
- Copies of prescriptions and recent medication dosages
- Doctor and pharmacy contact information
- Photo ID and health insurance card copy
- Details of insulin pump or CGM devices
Check expiration dates on all supplies every few months and replace items as needed. Keep your kit in a location known to family and caretakers.
Tips to Prevent Diabetes Emergencies
- Test blood glucose regularly, as advised by your doctor.
- Act promptly at the first sign of low or high blood sugar.
- Adhere to prescribed medication schedules and insulin dosing.
- Maintain a routine for meals and physical activity.
- Inform friends, family, and coworkers how to recognize and respond to emergencies, especially how to use a glucagon kit.
- Have fast-acting carbohydrates available at all times.
- Keep an updated diabetes management plan from your healthcare provider.
Table: Comparing Hypoglycemia and Hyperglycemia Emergencies
| Feature | Hypoglycemia (Low Blood Sugar) | Hyperglycemia (High Blood Sugar) |
|---|---|---|
| Typical Causes | Too much insulin, skipped meals, intense exercise | Missed medication, infection, stress, overeating |
| Blood Glucose Threshold | < 70 mg/dL | > 300 mg/dL (emergency) |
| Key Symptoms | Shaking, sweating, confusion, seizures | Increased thirst, urination, fruity breath, nausea |
| Immediate Treatment | 15g fast-acting carbohydrate; repeat until resolved | Take insulin (if prescribed), drink water, seek help if no improvement |
| Emergency Treatment | Glucagon injection or nasal spray | Hospitalization if severe DKA symptoms or unable to treat at home |
| Prevention | Monitor glucose, eat regularly, educate support network | Adhere to meds, monitor for infections, adjust for stress/illness |
Frequently Asked Questions (FAQs)
What immediate actions should I take during severe hypoglycemia?
If the person is conscious and able to swallow, give 15 grams of fast-acting carbohydrate and repeat after 15 minutes if needed. If unconscious or unable to swallow, use a glucagon emergency kit and call emergency services.
How can I recognize diabetic ketoacidosis (DKA)?
Symptoms include nausea, vomiting, abdominal pain, rapid breathing, confusion, fruity-scented breath, and very high blood glucose. Presence of ketones in urine is a key indicator. DKA is a medical emergency — seek hospital care immediately.
Should I adjust insulin doses during illness or stress?
Illness or severe stress can cause blood sugar to rise. Follow your sick day action plan from your doctor, test your glucose more often, and never stop insulin unless instructed by a medical professional.
How can I prepare for diabetes emergencies when traveling or during disasters?
Pack a diabetes care kit with all needed supplies for 1–2 weeks. Bring extra prescriptions, identification, and learn how to access local medical care. Always have fast-acting carbohydrates and water available.
Why can’t exercise always be used to lower high blood sugar in emergencies?
Exercise can risk worsening ketosis if insulin is lacking. Do not exercise if you have symptoms of DKA or your blood sugar is above your doctor’s threshold without enough insulin, as this may make the condition worse.
Key Takeaways
- Immediate recognition and treatment of hypo- and hyperglycemia are critical for preventing severe outcomes in diabetes emergencies.
- Glucagon (injection or nasal spray) is the standard emergency remedy for severe hypoglycemia.
- For hyperglycemia, insulin and hydration are primary; hospitalization may be necessary for severe cases.
- Disaster preparedness includes having a stocked diabetes care kit and educating loved ones.
Resources for Further Support
- Educate all household members and close contacts on how and when to use glucagon kits.
- Consult with your healthcare provider to develop a written diabetes emergency action plan.
- Regularly review supply expiration dates and update your preparedness kit.
- https://www.healthline.com/health/diabetes/how-to-lower-blood-sugar-quickly-emergency
- https://www.healthline.com/health/severe-hypoglycemia/emergency-treatments
- https://www.cdc.gov/diabetes/articles/diabetes-care-emergencies.html
- https://www.healthline.com/health/video/how-to-lower-blood-sugar-quickly-emergency
- https://my.clevelandclinic.org/health/diseases/7104-diabetes
- https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20047963
- https://www.chp.gov.hk/en/static/80037.html
- https://www.healthline.com/health/video/diabetes-blood-sugar-spikes-levels
- https://www.healthdirect.gov.au/diabetes
- https://californiahealthline.org/news/article/insulin-medi-cal-expands-patient-access-diabetes-supplies/
References
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