World Diabetes Day – 14 November 2018

With over 425 million people living with diabetes, it is a growing concern for individuals, families, communities and governments. It’s not a problem that is going to go away, but it is something we can each learn about in order to help detect early warning signs, improve the care for our family and friends who have it, and be prepared to assist someone having a diabetic emergency. World Diabetes Day is a great time to be reminded of this common condition and the actions to take if encountering such an emergency.

What to look for

As with many illnesses and conditions, one of the best ways to help manage diabetes is to catch it early and begin the necessary treatment or changes to one’s lifestyle for minimising the effects it has on the individual. Here are a few symptoms and signs you can watch out for in yourself or a loved one.

• Increased thirst
• Increased hunger (especially after eating)
• Dry mouth
• Frequent urination or urine infections
• Unexplained weight loss (even though you are eating and feel hungry)
• Fatigue (weak, tired feeling)
• Blurred vision
• Headaches

It’s important to note, however, that Type 2 Diabetes can develop without any warning signs. Many who have Type 2 Diabetes don’t even realize it. That is why it is important to talk to your doctor about your risks, especially if you know of a family history of diabetes. There are tests available to help determine whether or not you need treatment or if diet and activities can make an impact on improving your health.

Understanding diabetes

Every cell in the body requires glucose as a foundation of energy. People with a healthy pancreas are able to process the foods they eat in a way that regulates the production of insulin proportionate to the amount of glucose in the blood. However, people with diabetes have an inability to metabolize glucose efficiently because the pancreas is either producing too little insulin or none at all. This causes blood sugars to accumulate to dangerously high levels.

Type 1 Diabetes is primarily an autoimmune condition. It often manifests in children and young adults whose bodies do not produce insulin. It is treated with routine injections of insulin to aid in glucose metabolism. Without these injections, Type 1 diabetics cannot use the sugar in their blood for energy.

In Type 2 Diabetes, the body’s cells are unable to use sugar properly. This results in there being too much glucose in the blood. Some patients may also experience insulin resistance, a condition that sees the body making the hormone but being unable to use it or respond to it properly. It’s reassuring to know that Type 2 Diabetes is often treatable with changes to your diet and lifestyle. In some cases, Type 2 diabetics also require non-insulin medications to help manage their condition. There are occasions, though, where Type 2 Diabetes does need to be treated with insulin supplementation.

What is a diabetic emergency?

More often than not, a diabetic emergency affects patients who are already aware that they have diabetes. It is usually caused by mismanagement of their insulin treatments. Learning the signs and symptoms of hypoglycemia (low blood sugar levels) versus those of hyperglycemia (raised blood sugar levels) will help you know which steps to take to assist someone suffering from either condition.

Hypoglycemia

Each person with diabetes may have different symptoms of hypoglycemia. If you have diabetes, you can keep a log of instances when you suffer from hypoglycemia, which will help you learn to spot your symptoms early and take action.

Early symptoms include:

• Confusion
• Dizziness
• Hunger
• Irritability
• Pounding heart; racing pulse
• Pale skin
• Sweating
• Trembling
• Weakness
• Anxiety
• Headaches

Later in this article we will discuss actions to take in a diabetic emergency involving hypoglycemia. But first, let’s also look at hyperglycemia symptoms so as to differentiate between the two, since treatment can vary depending on which condition is experienced.

Hyperglycemia

There are two significant complications that result from hyperglycemia. One is Diabetic Ketoacidosis (DKA), a severe condition typically resulting from rising blood glucose over 130 mg/dL. If untreated, it can lead to a diabetic coma or death.

Warning signs and symptoms of DKA include the following:

• Very dry mouth
• Excessive thirst
• Frequent urination
• Increased blood glucose
• Dry or flushed skin
• Fatigue
• Abdominal pain
• Nausea and vomiting
• Difficulty breathing
• Fruity odor on breath
• Confusion

The second complication is Hyperglycemic Hyperosmolar Syndrome (HHS). This life-threatening condition is different from DKA in that it involves extremely high blood glucose without the presence of ketones.

Warning signs and symptoms of HHS include the following:

• Signs of dehydration
• Weakness
• Leg cramps
• Vision problems
• An altered level of consciousness

Recognition is key

Knowing a person has diabetes is crucial. Individuals with diabetes often wear or carry an I.D. to alert first-aid providers of their condition. They also tend to keep glucose gels, tablets or other sugar sources readily available. You may ask specific questions that will help you determine the correct action plan for helping someone who is experiencing a diabetic emergency. Here are some to use:

• Have you eaten recently? If so, what did you have?
• Have you been active?
• Have you taken any medications today?
• Do you have a glucometer? (If so, assist a conscious and willing person with checking their blood glucose.)

If the person has eaten and not taken their medication(s), hyperglycemia is likely what they are experiencing.

If they have not eaten but took medications on time, they may be having a hypoglycemic attack.

Hypoglycemia is more common that hyperglycemia because the body is constantly burning energy. For this reason, we will cover first aid actions you can take to assist someone experiencing a hypoglycemic event.

Taking action

If you have determined a conscious person is suffering from hypoglycemia, it is important to first ensure they are seated and comfortable to keep them safe from a fall. The next step is to offer them a source of simple sugar such as candy, juice, non-diet soda, raisins or their own glucose gel or tablets. NEVER give an unconscious person food or liquids, though.

If the diabetic responds positively to the intake of sugars, they should recover fairly quickly and be able to take over the management of their care. However, if you do not note significant improvement, or find a casualty unconscious or not responding, it is important to call 111 for additional medical advice and assistance.

If you believe the person is suffering from DKA or HHS, urgent first-aid treatment is critically vital. In any emergency, remain calm, assess the person and the scene, help where you can, then call emergency services if needed.

Having an action plan before encountering an emergency will help you maintain a clear mind and implement the right steps to provide life-saving first-aid treatment.

You may like to take your preparations one step further by enrolling in one of our first aid courses.