People with diabetes should wear or carry I.D. information (such as an
alert bracelet) that emergency medical staff can find. They should always
carry a sugar source, such as glucose tablets or raisins.
Check for ketones using a simple urine test available at pharmacies. Perform
this test every 4 - 6 hours if blood sugar goes above 240, or any time the
person with diabetes is sick, unusually thirsty, has a dry mouth, is urinating
frequently, or has vomited. Warning signs that ketoacidosis is getting serious:
- Flushed face
- Dry skin and mouth
- Nausea or vomiting
- Stomach pain
- Deep, rapid breathing
- Fruity breath odor
If these symptoms occur, call the doctor or go to
the emergency room right away. If left untreated, this condition will
lead to coma and even death.
Dangerously low blood sugar (Severe
Low blood sugar can occur in diabetics when they use too much insulin, exercise
too much, or have not eaten enough food. It can develop quickly in people with
diabetes. Symptoms of low blood sugar typically appear when the sugar level
falls below 70. Watch for:
Monitor the person closely. If symptoms become worse
-- confusion, seizures, or unconsciousness -- give the person a shot
of glucagon. If you don't have glucagon, call 911 immediately.
If you have a blood sugar test kit available, do a blood sugar check. If the
level is low, the person with diabetes should eat something with sugar: fruit
juice, several teaspoons of sugar, a cup of skim milk, or regular soda. If
you don't have a test kit handy, sugar should be eaten anyway -- it
can't hurt. Symptoms should subside within 15 minutes. If the symptoms don't
subside, more sugar should be eaten and the sugar level tested again.
AFTER the symptoms subside, more substantial food can be eaten. Use simple
sugar FIRST to get the situation under control. Real food won't produce enough
sugar and takes too long to digest.
Don't panic. Glucagon works very fast -- usually within 15 minutes. While
you are waiting for the person to revive, keep him on his side to prevent choking.
If the person is not better in 15 minutes, call 911.
Have glucagon stored for emergencies. Make sure everyone in your home, babysitters,
and caregivers know how to use it. Periodically remind everyone how to use
it. Check the expiration date.
Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care 2003;26:1902-1912.
Diabetic ketoacidosis. What it is and how to prevent it. Am Fam Physician.2005;71:1721.
McDermott MT. Endocrine Secrets. 4th ed. St. Louis, MO: Mosby.
Review Date: 5/10/2007
Reviewed By: Robert Hurd, MD, Professor of Endocrinology, Department of Biology, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.
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