Diabetic Emergencies: Understanding Blood Sugar Imbalances

Diabetes is a chronic condition affecting millions of Canadians, where the body either doesn't produce enough insulin (Type 1) or can't effectively use the insulin it produces (Type 2). Insulin is a hormone that regulates blood sugar (glucose), which is the body's primary source of energy. When blood sugar levels become dangerously high or low, it can lead to a diabetic emergency, requiring immediate first aid.

At Ready 4 Everything Training and Supplies, we teach that understanding the nuances of diabetic emergencies is crucial, as the appropriate first aid response differs based on whether the blood sugar is too high or too low. Recognizing the signs and acting quickly can prevent serious complications, including seizures, coma, or even death.

The Two Main Diabetic Emergencies:

1. Hypoglycemia (Low Blood Sugar): This is generally the more common and immediate emergency in first aid, as it can worsen rapidly. It occurs when a person with diabetes has too much insulin, has missed a meal, or has over-exercised, causing their blood sugar to drop dangerously low.

2. Hyperglycemia (High Blood Sugar): This occurs when a person with diabetes has too little insulin, has eaten too much, or is ill/stressed. While serious, it typically develops more slowly than hypoglycemia.

Recognizing the Signs and Symptoms:

It can be challenging to distinguish between hypoglycemia and hyperglycemia without a blood glucose meter. However, for first aid purposes, it's generally safer to assume hypoglycemia if you are unsure, as giving sugar to someone with low blood sugar is immediately beneficial, while giving it to someone with high blood sugar is unlikely to cause immediate harm if professional medical help is on the way.

Signs of Hypoglycemia (Low Blood Sugar - often rapid onset):

• Behavioral Changes: Irritability, confusion, argumentativeness, anxiousness, mood changes (may appear drunk).

• Skin: Pale, cool, clammy (sweaty).

• Pulse: Rapid, strong.

• Breathing: Normal or shallow.

• Other: Dizziness, headache, hunger, trembling, weakness, blurred vision, unresponsiveness or seizure in severe cases.

Signs of Hyperglycemia (High Blood Sugar - often gradual onset):

• Skin: Warm, red, dry.

• Pulse: Rapid, weak.

• Breathing: Deep, rapid (Kussmaul breathing) or fruity-smelling breath (like nail polish remover).

• Other: Increased thirst, frequent urination, nausea, vomiting, abdominal pain, fatigue, unresponsiveness.

What to Do: Immediate First Aid

A. For a Conscious Person with Suspected Diabetic Emergency (When in Doubt, Give Sugar!):

1. Call 911: If the person's condition does not improve quickly after administering sugar, or if they are unresponsive or show signs of shock, call 911 immediately.

2. Give Sugar:

• If the person is conscious and able to swallow: Give them a fast-acting sugar source (about 15-20 grams of carbohydrate).

• Glucose tablets (follow package instructions)

• 1/2 cup (125 mL) of juice (orange, apple)

• 1/2 can of regular pop (not diet)

• 4-5 hard candies

• 1 tablespoon of honey or syrup

• Do NOT give chocolate or fatty foods, as they are absorbed too slowly.

3. Monitor and Reassess: Stay with the person. Their symptoms should improve within 10-15 minutes.

4. Provide Complex Carbohydrates: Once symptoms improve, offer a more complex carbohydrate like a sandwich or crackers to help stabilize blood sugar levels.

B. For an Unresponsive Person with Suspected Diabetic Emergency:

1. Call 911 Immediately: This is a medical emergency.

2. Do NOT Give Anything by Mouth: An unresponsive person cannot swallow safely, and there is a high risk of choking or aspiration.

3. Ensure ABCs: Check for open airway, breathing, and circulation. Be prepared to start CPR if they become unresponsive and stop breathing normally.

4. Recovery Position: If the person is unresponsive but breathing normally, place them in the recovery position (on their side) to protect their airway.

5. Maintain Body Temperature: Keep them warm with a blanket.

6. Administer Glucagon (if available and trained): Some individuals with diabetes carry a glucagon emergency kit. If trained and authorized (e.g., in a workplace setting with specific protocols), you might administer glucagon, which helps raise blood sugar.

Why Knowing the Difference and Acting Matters:

Hypoglycemia can be rapidly corrected by giving sugar. If it's severe and prolonged, it can lead to irreversible brain damage. Hyperglycemia requires insulin and medical management. While giving sugar to a hyperglycemic person won't cause immediate harm in a first aid context (since EMS is on the way for both scenarios), the critical difference lies in the rapid response needed for low blood sugar. Your ability to recognize the signs and provide immediate sugar can prevent a life-threatening situation from escalating.

Ready 4 Everything: Empowering Confident Response to Diabetic Emergencies

At Ready 4 Everything Training and Supplies, our comprehensive first aid courses provide detailed training on recognizing and managing diabetic emergencies. We emphasize:

• How to differentiate between hypo- and hyperglycemia.

• The immediate, practical steps for administering sugar.

• When to call EMS and what information to provide.

• Understanding the role of glucagon (in relevant courses).

We equip you with the knowledge and confidence to support individuals experiencing these critical blood sugar imbalances, whether in your home, community, or workplace.

Your Action Item: Could you confidently respond to a diabetic emergency? Don't leave it to guesswork. Sign up for first aid courses for your organization today to gain the vital skills to recognize and manage diabetic emergencies effectively, safeguarding the well-being of those around you.