Diabetes symptoms can sometimes turn into an emergency quickly and suddenly. It is essential to know the signs of an emergency and what to do if one arises.
In type 1 diabetes, the immune system destroys the cells that produce insulin. Type 2 diabetes reduces the body’s ability to respond to insulin. Consequently, the body does not produce enough insulin to manage the glucose.
Most diabetic emergencies relate to disruptions in a person’s blood sugar levels, but complications relating to diabetes can also lead to problems.
Knowing the signs and being able to respond promptly may save lives. Here are some of the most common emergencies that can arise, their warning signs, and what to do.
Hypoglycemia happens when blood sugar levels are too low, usually below 70 milligrams per deciliter (mg/dl). Without treatment, such low levels of blood sugar can lead to seizures and are a medical emergency.
Hypoglycemia can occur for many reasons, but in diabetes, it usually stems from the use of insulin or other medications that control blood sugar. Blood sugar levels may drop dangerously low when a person:
- takes more insulin than they need for their current food intake or exercise levels
- consumes too much alcohol
- misses or delays meals
- does more exercise than they expected to do
Early warning signs
The warning signs of hypoglycemia include:
- confusion, dizziness, and nausea
- feeling hungry
- feeling shaky, irritable, or anxious
- sweating, chills, and pale, clammy skin
- rapid heartbeat
- weakness and tiredness
- tingling in the mouth area
- headaches
- seizures
- coma or loss of consciousness
- weight loss if hypoglycemia persists
If a person tests their blood sugar levels when they experience these symptoms, they may be below 70 mg/dl.
Action to take
If a person is experiencing low blood sugar, the American Diabetes Association (ADA) recommends the following action:
- Take 15 grams (g) of carbohydrate and wait 15 minutes before testing blood sugar levels.
- If levels are still below 70 mg/dl, take another 15 g of carbs, wait, and test again.
- When glucose levels are above 70 mg/dl, eat a meal.
- If symptoms persist, seek medical help for any underlying condition.
However, it may not always be possible to identify and prevent severe hypoglycemia. If a person experiences regular hypoglycemia despite following the treatment plan, or if changes in blood sugar level occur suddenly they should see a doctor.
Hyperglycemia is when blood sugar levels are
Early warning signs
The person may notice:
- increased thirst
- the need to urinate more frequently
- headaches
- blurry vision
- fatigue
Action to take
In mild cases, ways of resolving this include:
- exercising more
- eating less
- changing the dose of insulin or other medication
Diabetic ketoacidosis occurs when the body does not have enough insulin to allow glucose to enter the cells properly. The cells do not have enough glucose to use for energy, so, instead, the body breaks down fat for fuel. It is more common in people with type 1 diabetes.
When this happens, the body produces substances known as ketones. High levels of ketones are toxic because they can raise the acidity levels of the blood.
This may happen for various reasons including:
- low insulin levels, due to not taking insulin or because another factor stops the insulin from working correctly
- not eating enough when a person is ill
- heart attack
- stroke
Warning signs
The warning signs include:
- feeling thirsty or having a dry mouth
- frequent urination
- fatigue
- dry or flushed skin
- nausea, vomiting, or abdominal pain
- difficulty focusing
- confusion
- difficulty breathing
- a fruity smell on the breath
Action to take
If a ketone test shows that ketones are present and a blood glucose test shows that a person’s blood sugar levels are 240 m/dl or above, it is advised to seek medical help.
Hyperglycemic hyperosmolar syndrome (HHS) occurs when blood sugar levels become dangerously high, usually
People with poorly controlled type 2 diabetes are more prone to HHS, but people without diabetes — or a diagnosis of diabetes — might experience it.
The following factors may increase the risk:
- infections, including pneumonia, a urinary tract infection, and sepsis
- the use of some medications, including some psychiatric treatments and diuretics, which can lead to dehydration
- not following treatment for diabetes
- having undiagnosed diabetes
- misuse of some substances
- having another health condition, such as a heart attack, a stroke, or a pulmonary embolism (lung clot)
Early warning signs
Symptoms include:
Blood tests may show a person’s blood glucose level is above 600 mg/dl.
Action to take
If a person has these symptoms, they or someone else should seek medical help at once. The person will require treatment in the hospital, which will include rehydration, the use of insulin, and any necessary treatment for an underlying cause.
Processes that occur with diabetes can also affect the immune system. As a result, a person with diabetes will have a
Common infections that can occur with diabetes include:
- skin infections that can lead to ulceration
- urinary tract infections, which may spread to the kidneys
- ear infections
- respiratory infections, including pneumonia and influenza
- gastrointestinal and liver infections
- gum disease
Minor infections can spread to deeper tissue, possibly leading to sepsis and other potentially life-threatening complications.
Warning signs and action
If a person experiences a fever, pain, and swelling in any part of their body, they should seek medical advice. An infection can become rapidly become serious when a person has diabetes.
Diabetes can harm almost every system in the body and increase the risk of many other diseases. People with diabetes can experience a range of problems,
- cardiovascular disease, which may lead to a heart attack or a stroke
- poor circulation that leads to ulcers in the legs
- vision loss
- kidney failure
- obesity
Poorly controlled diabetes, a history of infections, and having other health conditions all increase the risk of these complications.
A diabetic emergency happens when symptoms relating to diabetes overwhelm the body. At this point, home treatment is unlikely to help, and delaying medical care could cause permanent damage or death.
Some of the signs that can indicate a serious problem include:
- chest pain that radiates down the arm
- difficulty breathing
- a fever
- a severe headache and weakness in one side of the body
- seizures
- loss of consciousness
If there are signs of an emergency, the person should go to the emergency room, or they or someone with them should call 911 immediately.
It is not always possible to prevent an emergency, but recognizing the signs can improve the chances of early treatment and a full recovery.
Strategies that can help to reduce the risk of an emergency include:
- following the treatment plan
- eating balanced, regular meals
- limiting alcohol and sugary drinks
- treating infections early
- exercising regularly
No specific medication or procedure can stop a diabetic emergency once it occurs, but emergency planning can increase the chances of getting prompt help.
People with diabetes should:
- let their friends know they have diabetes
- wear a medical ID so that people will know what to do in an emergency
- keep a mobile phone charged and ready to contact emergency responders
- know who to call with questions about diabetes emergencies
Diabetes is a serious and complex condition, and an emergency can arise for various reasons.
Managing the condition through medication and a healthful lifestyle, ensuring that others know the person has diabetes, and learning as much as possible about diabetes and its complications can reduce the risk of an emergency arising.