First Baptist Church, Texas City
Safety Team

It has been estimated that as much as one-third of the U.S. population is either diabetic or is an undiagnosed diabetic. Long-Term diabetes can lead to chronic wounds (usually to the lower extremity, loss of feeling in the lower extremities (peripheral neuropathy) and kidney failure. Quick recognition of diabetic emergencies will aid in treatment. Diabetic emergencies are divided into two categories: high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia).

Both types of diabetic emergencies have similar symptoms, but will have some subtle differences. Common symptoms include, bot not limited to: weakness/tremors and confusion (or brain fog). Subtle differences include: changes in body temperature and loss of consciousness.

 

Severe cases of hyperglycemia are called diabetic ketoacidosis (DKA). These are blood sugars levels typically higher than 300 mg/dL in most adults, but in long-term diabetics is usually above 500 mg/dL (milligrams of glucose per deciliter of blood). In patients with DKA, keen observation is key to quick diagnosis. Look for a fruity aroma to the breath (often confused with an acetone smell). Elevated body temperatures and elevated breathing rates are often seen with them. Insulin in the body is used to convert and transport sugar to cells as usable energy, and this releases heat in the body (calorie consumption). The only treatment for these patients is administration of insulin and must be done slowly so as to not put the patient into shock. For patients with blood glucose above 500 mg/dL, blood glucose rates must not be dropped more than 30% per hour. Initiating a 9-1-1 call for these patients is key to treatment. Place them in a position of comfort, and withhold any food or drink. If they have a glucometer and are able to use it, have them check their sugar and note the result for EMS.

 

In cases of hypoglycemia, the patient will exhibit altered mental status, and this can take many forms, such as anger, aggression or confusion. Most will complain of not feeling well, feeling weak or having hand or body tremors. The treatment for these patients is the introduction of glucose (sugar) into their system. But caution must be exercised when trying to give glucose. The patient must be alert enough to have an intact gag reflex and the ability to swallow. Never attempt to give anything by mouth to an unconscious person. If the gag reflex and ability to swallow is intact, give small amounts of juice, glucose tabs or oral glucose liquid. The patient usually has these with them, but a small amount of glucose tabs will be available at the first aid station at the coffee bar.