Diabetic Emergencies (HB)
Diabetes is a common problem these days. In our context, low blood sugar is the most likely problem.
Normally as you go about the day, your body balances the sugar in your bloodstream by secreting insulin from your pancreas. In diabetics, this process is impaired or absent, and there is not enough insulin to help get the sugars where they need to go.
When there is a change to diet or activity level without a corresponding change to diabetic medications, this balance can be disrupted and the patient’s sugar (available to their cells) can drop. This form can come on quickly and is called hypoglycemia.
Signs and Symptoms
A patient having diabetic problems might present as disoriented, irritable, and combative. They could also be fatigued.
If the problem is severe enough, the patient may experience a change in mental status toward unconsciousness.
Red Flags
Significantly altered mental status is the biggest red flag for patients in a diabetic emergency.
Treatment
Patients with hypoglycemia need sugar, and they need it fast. Easy to digest forms are the most appropriate. So give the patient honey, juice, or candy.
If the patient is unconscious you can still attempt to give them sugar. Place the patient in the recovery position, and rub the honey or sugar source between their gum and cheek on the side closest to the ground. If hypoglycemia is the problem they will be able to absorb enough sugar to bring up the level of consciousness.
If the patient is experiencing HYPERglycemia, giving them sugar will not hurt them, so the treatment is always to give sugar. These patients will also need aggressive hydration.