Know the Symptoms of a Diabetes Emergency

Find Out Before You're in a Crisis

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When you are diagnosed with diabetes, there's a lot to learn. In addition to the day-to-day basics of diabetes management and treatment, there's learning to recognize the signs and symptoms of two potential diabetes-related conditions: hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). These can occur at any time and need to be treated immediately to avoid a medical emergency.

Causes of Hyperglycemia

Your blood sugars can rise to dangerous levels when you haven't taken enough insulin (if you are type 1) or when your insulin receptors are not working as they should (with type 2).

Perhaps you miscalculated the number of carbohydrates you ate at a meal, or you were under stress or had an illness. Each of these situations can lead to hyperglycemia.

Symptoms That Need Attention

If you have these symptoms please call your health care professional and/or go to the emergency room:

  • Increased thirst
  • increased urination
  • Nausea/vomiting
  • Deep and/or rapid breathing
  • Abdominal pain
  • Fruity smelling breath
  • Loss of consciousness

Another type of dangerous situation is called Hyperglycemic hyperosmolar nonketotic syndrome (HHNS). This is defined as a dangerously high blood sugar that is >600 mg/dL. It is typically brought on either by an infection, such as pneumonia or a urinary tract infection, or poor management of your blood sugar. If left untreated, it can result in coma and even death.

Signs and symptoms include:

  • extreme thirst
  • confusion
  • fever (usually over 101 degrees Fahrenheit)
  • weakness or paralysis on one side of the body

    The best way to prevent HHNS is to take your medications as directed and to keep in contact with your healthcare team when your blood sugar is consistently >300 mg/dL.

    When to See a Doctor

    It's a good rule of thumb to get your urine checked for ketones if your blood sugar is over 240 mg/dl. Hyperglycemia can progress to a condition known as diabetic ketoacidosis (DKA).

    When blood sugar goes too high, ketones start to build up in the blood and it becomes too acidic. Cell damage can occur and if it continues to progress, it can cause coma or death. DKA needs immediate medical intervention.

    Causes of Hypoglycemia

    Hypoglycemia occurs when your blood sugar drops too low (usually below 60 mg/dl), although the tipping point can vary from person to person. Hypoglycemia may be treated at home if the symptoms are not yet severe and the blood sugar has not fallen too low.

    Symptoms That Need Attention

    If you have these symptoms please call your health care professional and/or go to the emergency room:

    • Trembling or weakness
    • Lack of coordination
    • Drowsiness or confusion
    • Headache
    • Dizziness
    • Double vision
    • Convulsions or unconsciousness

    When it comes to emergency care, use these symptoms as a guideline, but also listen to your instinct. If you feel that something is wrong, it is never a bad idea to call your healthcare professional or go to an emergency room.

    Treatment

    You can relieve symptoms of hypoglycemia within minutes by taking glucose tablets, a glass of orange juice, or other fast sugar sources such as regular soda, cake decorating gel or a few sugar cubes. If your blood sugar has a tendency to fall very low, very quickly, you might carry glucagon with you in addition to glucose tablets.

    Glucagon is an injection that stimulates the liver to release sugar into the blood. It can be self-administered and usually brings the blood sugar up to an acceptable level within 15 minutes.

    Hypoglycemia can be life-threatening if left untreated, resulting in coma and death. If your blood sugar is severely low, or if taking in some form of sugar is not raising the blood sugar, or if you're vomiting or unconscious and therefore unable to take in a sugar source, you need emergency care as soon as possible.

    It's a good idea to have some kind of identification that lets emergency personnel know that you have diabetes, like an ID bracelet or wearable emblem.

    It can speak for you when you are unable to speak for yourself.

    Sources: 

    American Diabetes Association. Hyperglycemia (High Blood Sugar). http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html

    American Diabetes Association. Hypoglycemia (Low Blood Sugar). http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

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