The 7 Most Common Diabetes-related Medical Emergencies
Rapid treatment is crucial if you're experiencing stroke symptoms.(ISTOCK)Type 2 diabetes can damage blood vessels and nerves, so just about every part of your body can be affected by the disease. Diabetes care generally focuses on day-to-day living to prevent complications, such as eating right and exercising, but it's also important for you to know how to get help if you have one of these medical emergencies. Controlling your blood sugar can lower the chances of all of the following emergencies (with the exception of hypoglycemia). You should also keep an eye on your cholesterol and blood pressure to reduce the risk of heart attack and stroke. Amputation Tell your doctor right away if you notice any foot injuries, no matter how small, because they can rapidly lead to amputation. You may be referred to a hospital if your condition is serious. Some hospitals and centers now have "limb salvage" programs to help you keep your feet, such as New York University Medical Center; the Wisconsin Heart Hospital outside of Milwaukee; Riverside Methodist Hospital in Columbus, Ohio; and University Foot & Ankle Institute at various locations in California. Ask your doctor where you can find the best foot-saving expertise in your area. Heart attack The death rate from heart disease is two to four times higher in adults who have diabetes than those without it. You should be aware of heart attack symptoms, such as chest pain, shortness of breath, and nausea; call 911 immediately if you experience them. Next Page: Hyperglycemia [ pagebreak ]Diabetes ComaIgnoring diabetes symptoms is risky Watch videoMore about diabetes complications Hyperglycemia High blood sugar can result from not taking enough insulin, eating too much, or being sick or stressed. Symptoms include excessive thirst, exce Continue reading >>
First Aid For People With Diabetes
The prevalence of diabetes increased 382% from 1988 to 2014. According to the National Diabetes Statistics Report, this growth correlates with the upsurge of visits to the emergency room from people in a life-threatening diabetic crisis. As the condition continues to rise so does the likelihood of providing first aid for someone with diabetes. Understanding Diabetes First-aid providers have important choices to make before providing care to a diabetic. The best way to effectively manage a diabetic emergency is through understanding the mechanisms behind the medical condition. Every cell in the body requires glucose as a foundation of energy. People with diabetes, though needing glucose, have an inability to process, or metabolize, it efficiently because the pancreas is either producing too little insulin or none at all—either way, glucose can accumulate to dangerously high levels. A healthy pancreas regulates the production of insulin proportionate to the amount of glucose in the blood. Classification of Diabetes Type 1 diabetes is primarily an autoimmune condition manifesting in children and young adults. These people do not produce insulin; they require routine injections of insulin to aid in glucose metabolism. Without insulin injections type 1 diabetics cannot use the sugar in their blood for energy. People with Type 2 diabetes produce small amounts of insulin, or they cannot properly use the insulin hormone, also known as insulin resistance. This condition usually develops later in life. Many people with type 2 diabetes use diet, exercise, and other non-insulin medications. Some Type 2 diabetics however, may require supplemental insulin. What is a Diabetic Emergency? With six million people using insulin in the United States, the incidence of too much or too litt Continue reading >>
Hyperglycemia In Diabetes
Print Diagnosis Your doctor sets your target blood sugar range. For many people who have diabetes, Mayo Clinic generally recommends target blood sugar levels that are: Between 80 and 120 mg/dL (4 and 7 mmol/L) for people age 59 and younger who have no other underlying medical conditions Between 100 and 140 mg/dL (6 and 8 mmol/L) for people age 60 and older, those who have other medical conditions, such as heart, lung or kidney disease, or those who have a history of low blood sugar (hypoglycemia) or who have difficulty recognizing the symptoms of hypoglycemia Your target blood sugar range may differ, especially if you're pregnant or you develop diabetes complications. Your target blood sugar range may change as you get older, too. Sometimes, reaching your target blood sugar range is a challenge. Home blood sugar monitoring Routine blood sugar monitoring with a blood glucose meter is the best way to be sure that your treatment plan is keeping your blood sugar within your goal range. Check your blood sugar as often as your doctor recommends. If you have any signs or symptoms of severe hyperglycemia — even if they're subtle — check your blood sugar level. If your blood sugar level is 240 mg/dL (13 mmol/L) or above, use an over-the-counter urine ketones test kit. If the urine test is positive, your body may have started making the changes that can lead to diabetic ketoacidosis. You'll need your doctor's help to lower your blood sugar level safely. Glycated hemoglobin (A1C) test During an appointment, your doctor may conduct an A1C test. This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. An A1C level of 7 perc Continue reading >>
Diabetic Emergencies – Diagnosis And Clinical Management: Diabetic Ketoacidosis In Adults
Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus. It is characterized by the triad of hyperglycemia, ketosis, and metabolic acidosis.1 DKA complicates mainly patients with Type 1 diabetes mellitus, where it may be the first manifestation of the disease, and rarely people with Type 2 diabetes.1 A special heterogeneous syndrome of "ketosis – prone diabetes (KPD)," in usually adult patients who may lack the typical clinical phenotype of autoimmune Type 1 diabetes, has recently been identified. While initially the condition was thought to be limited to persons of non-Caucasian ethnicity (African-Americans and Hispanics), its prevalence appears to be increasing worldwide.2 DKA is an emergency situation and hospitalization of the patient is necessary for immediate treatment. Its frequency is reported as 4.8 – 8.0 episodes per 1000 diabetic patients.3,4 The mortality rate is 2.5 – 9% and increases along with age, level of consciousness on admission, degree of hyperosmolality and acidosis, as well as severity of azotemia.5,6 In the US, hospitalizations due to DKA reach 100,000 and the cost of treatment has been reported as 1 billion dollars per year.7… The criteria for the diagnosis of DKA are shown in Table 1.1.8,9 DKA can be mild, moderate, or severe. It is considered severe when the arterial blood pH is less than 7.0, the concentration of plasma bicarbonate is less than 10 mEq/L, and the anion gap is greater than 12 mEq/L. In severe DKA, the patient is in stupor or in coma. Notably, the severity of DKA does not necessarily coincide with the degree of hyperglycemia. DKA can rarely be seen without marked hyperglycemia (euglycemic DKA), and in one series of 722 consecutive episodes of DKA only 1.1% had blood glucose levels less than 180 mg/dl (1 Continue reading >>
Quick And Dirty Guide To Diabetic Emergencies
Diabetes Mellitus Diabetes Mellitus is a systemic disease of the endocrine system resulting from the insufficiency/dysfunction of the pancreas. It is a complex disorder of fat, carbohydrates, and protein metabolism. Diabetes mellitus is potentially lethal, putting the patient at risk for several types of medical emergencies. It is characterized by a lack of insulin, or a persons inability to use insulin. In order to properly manage the numerous calls for diabetics, it is important for EMS professionals to have a basic knowledge of diabetes (DM) before dealing with the associated emergencies that may arise as a result of the disease. Diabetes is the seventh leading cause of death in the US, as well as, it is estimated that 5 + million US citizens become diabetic annually and don't realize they have the disease until an emergency arises. To truly understand the signs and symptoms of the various related conditions, we must first, comprehend some basic pathophysiology. The primary energy fuel for cells is glucose. Glucose is a simple sugar that accounts for approximately 95 percent of the sugar in the bloodstream after gastrointestinal absorption. Thus, it is the blood glucose level that EMS and other health care practitioners are most interested in determining. The key function of insulin (A hormone secreted by the beta cells in the pancreas) is to move glucose from the blood into the cells, where it can be used for energy. However, insulin does not directly carry glucose into the cell, it triggers a receptor on the plasma membrane to open a channel allowing a protein helper (through the process of facilitated diffusion), to carry the glucose molecule into the cell. As long as any insulin is available in the blood, is active, is effective, and is able to stimulate the rece Continue reading >>
Diabetic Emergencies: Warning Signs And Steps To Save Someone’s Life
A diabetic can develop hyperglycemia (raised blood sugar) or hypoglycemia (low blood sugar). Giving sugar will be lifesaving if blood sugar is low, and is unlikely to do harm if sugar levels are raised. Diabetics usually know how to control their condition, but even people who’ve had diabetes for years or decades may be susceptible to an attack. Low Blood Sugar (Hypoglycemia) Symptoms: This can occur if the blood sugar-insulin balance is incorrect. A person with diabetes often recognizes the warning signs: Feels shaky and weak Skin is pale and feels cold and clammy Confused, irritable, and behaving irrationally Rapid, but full and pounding pulse; patient may tell you that his heart is pounding Patient will quickly lose consciousness if he is not given some sugar If you know a patient has diabetes and he fails to respond to sugar or his condition begins to worsen, call for medical help immediately. A person recently diagnosed with diabetes is more susceptible to a “hypo” attack, especially while he is becoming used to balancing his sugar-insulin levels. What to Do for Hypoglycemia 1. Sit patient down. Reassure him and help him to sit down on a chair or on the floor if he is feeling faint. 2. Give sugar. If the patient is fully conscious and alert, give him a sugary drink, such as fruit juice, or some glucose tablets. People with diabetes often carry a dose of glucose concentrate or have some sugary food on hand as a precaution. 3. Check response. If the patient improves quickly after eating or drinking something, follow this with some slower-release carbohydrate food, such as a cereal bar, a sandwich, a piece of fruit, biscuits and milk, or the next meal if the timing is right. 4. Find medication. Help the patient find his glucose testing kit and medication and let Continue reading >>
Diabetic Emergency: Recognizing And Responding
Responding to a diabetic emergency is not complicated, however, diabetic emergencies can be deadly if untreated. Fortunately, most diabetics are well informed about their disease and know when and how to take action. For example, a good friend of mine who is diabetic was directing me in a play rehearsal when she suddenly started slurring her words. She then blurted out, “Get me juice!” Luckily, some was available and within seconds of drinking it her condition started to improve. If you suspect someone is having a diabetic emergency, ask the person if you can help them. Ask if they are diabetic and whether they are having a diabetic emergency. Most diabetics will tell you what they need. If they are unable to communicate with you, but conscious, check to see if they have a medical alert tag. These tags can tell you if the person is diabetic. Once you have established that the person is having a diabetic emergency, have them consume something with sugar in it, preferably in liquid form. Juice, soda, or water mixed with sugar are good choices. Do not give them diet soda – this has no sugar. If no liquid form of sugar is available, candy is a good choice. Hypoglycemia – low blood sugar – is frequently the cause of diabetic emergencies. Giving a hypoglycemic diabetic sugar will usually improve their condition quickly. Do not worry about giving sugar to a diabetic who is suffering from high sugar levels — called hyperglycemia. Giving a hyperglycemic diabetic sugar will not make their condition worse. After a diabetic consumes sugar, their condition should improve quickly. If their condition doesn’t improve within five minutes, call 911. If a diabetic person becomes unconscious do not try to put food or liquid in their mouth. Call 911. If you know CPR, check for Continue reading >>
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Diabetic Emergencies: Warning Signs And What To Do
Diabetes symptoms can quickly turn into emergencies. The disease of diabetes was the seventh leading cause of death in the United States in 2010, claiming nearly 70,000 lives. Responding promptly to symptoms of a diabetic emergency can be lifesaving. Causes and types Both type 1 and type 2 diabetes inhibit the body's ability to manage blood sugar levels. Type 1 diabetes does so by destroying the cells that produce insulin. Type 2 diabetes reduces how responsive the body is to insulin, while not enough insulin is produced to counter the sugar in the body. Hence, most diabetic emergencies are related to disruptions in a person's blood sugar levels. Occasionally, even too much of a drug being used to treat diabetes can trigger a diabetic emergency. The most common diabetic emergencies include the following: Severe hypoglycemia Hypoglycemia is when blood sugar levels are abnormally low. When blood sugar dips very low, it becomes a medical emergency. Hypoglycemia normally only occurs in people with diabetes who take medication that lowers blood sugar. Blood sugar levels may drop dangerously low when a person is: consuming too much alcohol exercising, especially without adjusting food intake or insulin dosage missing or delaying meals overdosing on diabetic medication Diabetic ketoacidosis Diabetic ketoacidosis occurs when the body does not have enough insulin to break down glucose properly, and hormones that normally work opposite insulin are high. Over time, the body releases hormones that break down fat to provide fuel. This produces acids called ketones. As ketones build up in the body, ketoacidosis can occur. Common causes of ketoacidosis include: uncontrolled or untreated diabetes an illness or infection that changes hormone production an illness or infection that chang Continue reading >>
Treating Diabetes Emergencies
Blood sugar levels that are too high or too low can quickly turn into a diabetic emergency without quick and appropriate treatment. The best way to avoid dangerously high or low blood glucose levels is to self-test to stay in tune with your body and to stay attuned to the symptoms and risk factors for hypoglycemia, diabetic ketoacidosis, and hyperglycemic hyperosmolar nonketotic syndrome. Low Blood Sugar Emergencies (Hypoglycemia) Hypoglycemia is sometimes called insulin reaction because it is more frequent in people with diabetes who take insulin. However, it can occur in either type 1 or type 2 diabetes, and is also commonly caused by certain oral medications, missed meals, and exercise without proper precautions. The typical threshold for hypoglycemia is 70 mg/dl (3.9 mmol/l), although it may be higher or lower depending on a patient's individual blood glucose target range. Symptoms include erratic heartbeat, sweating, dizziness, confusion, unexplained fatigue, shakiness, hunger, and potential loss of consciousness. Once a low is recognized, it should be treated immediately with a fast-acting carbohydrate such as glucose tablets or juice. High Blood Sugar Emergencies (DKA or HHNS) Extremely high blood glucose levels can lead to one of two conditions diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS; also called hyperglycemic hyperosmolar nonketotic coma). Although both syndromes can occur in either type 1 or type 2 diabetes, DKA is more common in type 1 and HHNS is more common in type 2. Continue reading >>
Diabetes In The Emergency Department And Hospital: Acute Care Of Diabetes Patients
Go to: Hyperglycemic Crisis: DKA and HHS Diabetic ketoacidosis (DKA) accounts for more than 110,000 hospitalizations annually in the United States, with mortality ranging from 2 to 10%4–6. Hyperglycemic hyperosmolar state (HHS) is much less common but confers a much greater mortality7. Patients with DKA classically present with uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration. On the other hand, HHS is defined by altered mental status caused by hyperosmolality, profound dehydration, and severe hyperglycemia without significant ketoacidosis6,8. Initial evaluation In the Emergency Department, the primary goals are rapid evaluation and stabilization. All patients with severe hyperglycemia should immediately undergo assessment and stabilization of their airway and hemodynamic status, with consideration of administration of naloxone for all patients with altered mentation to reverse potential opiate overdose, and thiamine for all patients at risk for Wernicke’s encephalopathy. In cases requiring intubation, the paralytic succinylcholine should not be used if hyperkalemia is suspected as it may acutely further elevate potassium. Immediate assessment should also include placing patients on oxygen, measure O2 saturation and cardiac monitoring as well as obtaining vital signs, a fingerstick glucose, intravenous (IV) access, and a 12-lead electrocardiogram to evaluate for arrhythmias and signs of hyper-and hypokalemia. Emergency Department evaluation should include a thorough clinical history and physical examination, as well as a venous blood gas,9,10 complete blood count, basic metabolic panel, and urinalysis; a urine pregnancy test must be sent for all women with childbearing potential. An important goal of this evaluation is id Continue reading >>
St John First Aid Guide For Diabetic Emergencies
Support the patient on their side and call 111 for an ambulance. 2. If conscious, give the patient some sugar If the patient is still fully conscious and able to swallow, give a sweetened drink, chocolate or glucose sweets to suck an improvement usually occurs within minutes. When the patient is more alert, offer a more substantial carbohydrate meal of a sandwich or several sweet biscuits. It is common for these patients to be unconscious. If so, support the patient on their side and call 111 for an ambulance. In this situation, DO NOT give the patient anything to eat or drink. Give frequent reassurance during recovery because the patient may be confused until fully recovered. If the patient has improved with the intake of carbohydrate, medical advice is still necessary because a further deterioration may occur at any time. The patient should see a doctor. If the patient does not improve after swallowing the sweet food or drink, or if further deterioration occurs and swallowing becomes difficult call 111 for an ambulance. If concious, give the patient some sugar. DO NOT try to give the patient a dose of insulin because this can be dangerous unless a medical assessment has been carried out and the patients blood sugar level tested. Have the information on hand when you need it the most. Continue reading >>
Diabetic Emergencies
It is estimated that more than 20 million people in the United States have diabetes, with an estimated six million people being unaware they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through making health food choices, exercise and frequently checking blood glucose levels. Diabetics may experience life-threatening emergencies from too much or too little insulin in their bodies. Too much insulin can cause a low sugar level (hypoglycemia), which can lead to insulin shock. Not enough insulin can cause a high level of sugar (hyperglycemia), which can cause a diabetic coma. Symptoms of insulin shock include: Weakness, drowsiness Rapid pulse Fast breathing Pale, sweaty skin Headache, trembling Odorless breath Numbness in hands or feet Hunger Symptoms of diabetic coma include: Weak and rapid pulse Nausea Deep, sighing breaths Unsteady gait Confusion Flushed, warm, dry skin Odor of nail polish or sweet apple Drowsiness, gradual loss of consciousness First aid for both conditions is the same: If the person is unconscious or unresponsive, call 911 or your local emergency number immediately. If an unconscious person exhibits life-threatening conditions, place the person horizontally on a flat surface, check breathing, pulse and circulation, and administer CPR while waiting for professional medical assistance If the person is conscious, alert and can assess the situation, assist him or her with getting sugar or necessary prescription medication. If the person appears confused or disoriented, give him or her something to eat or drink and seek immediate medical assistance. READ IN EMERGENCIES A-Z Continue reading >>
Diabetic Emergencies
Tweet Diabetes can become serious in the short term if blood sugar levels become either too high or too low. The following information details what to do in an emergency. This covers low blood sugar (hypoglycemia), very high blood sugar (diabetic ketoacidosis) and what to do if you are left without your diabetes medication and/or supplies. What counts as a diabetic emergency? It can be a difficult area sometimes to know what counts as a genuine emergency. News reports in recent years have highlighted that a significant number of ‘999’ ambulance call-outs have not been necessary - for example to treat mild hypoglycemia which, in some cases, has been successfully treated befor e the ambulance has arrived. This isn’t to say that conditions, such as hypoglycemia, are not dangerous but that it’s important to know when a situation really is an emergency so that an ambulance is not unnecessarily called. When should I call an ambulance? An ambulance will be needed if someone has either very high or very low blood sugar levels that presents an immediate danger and neither they nor anyone around is confidently able to treat them. Ketoacidosis and Hyperosmolar Hyperglycemic Nonketotic Syndrome are both life threatening conditions. Hypoglycemia can also be life threatening in some cases. Someone with diabetes that is unconscious is one of the situations in which you should call for an ambulance. If you have doubts about whether the situation is serious enough to warrant an ambulance, call 111. Severe hypoglycemia Hypoglycemia can become dangerous if it is not treated quickly, particularly if it is a result of an insulin overdose. Severe hypoglycemia is generally recognised as hypoglycemia involving: Convulsions (fitting) Unconsciousness Hypoglycemia can often be treated at Continue reading >>
Must Read Articles Related To Diabetes Emergencies
A A A Diabetes Emergencies With the changes in regulations in air travel, patients with diabetes are concerned about what they can, and cannot pack in their carry-on luggage. From the TSA website: Notify the Security Officer that you have diabetes and are carrying your supplies with you. The following diabetes-related supplies and equipment are allowed through the checkpoint once they have been screened: Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, biojectors, epipens, infusers, and preloaded syringes; Unlimited number of unused syringes when accompanied by insulin or other injectable medication; lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs, meter-testing solutions; Insulin pump and insulin pump supplies (cleaning agents, batteries, plastic tubing, infusion kit, catheter, and needle); Insulin pumps and supplies must be accompanied by insulin. Glucagon emergency kit; Urine ketone test strips; Unlimited number of used syringes when transported in Sharps disposal container or other similar hard-surface container. Sharps disposal containers or similar hard-surface disposal container for storing used syringes and test strips. Insulin in any form or dispenser must be clearly identified. If you are concerned or uncomfortable about going through the walk-through metal detector with your insulin pump, notify the Security Officer that you are wearing an insulin pump and would like a full-body pat-down and a visual inspection of your pump instead. Advise the Security Officer that the insulin pump cannot be removed because it is inserted with a catheter (needle) under the skin. Advise the Security Officer if you are experiencing low blood sugar and are in need of medical assistance. You have the op Continue reading >>
