In this lesson, you'll learn how to treat a patient with a blood sugar emergency. Some things to keep in mind about blood sugar problems:
- Signs and symptoms are the same for low blood sugar and high blood sugar
- Blood sugar issues will get worse without treatment
- Without treatment, a patient could become unresponsive and die
The three most common signs and symptoms of someone experiencing a blood sugar issue are:
- Confusion
- Coordination issues
- Talking nonsense
A person with a blood sugar issue might also randomly fidget with something and appear quite out of it.
Pro Tip #1: Even though the signs of high blood sugar are the same as those for low blood sugar, in patients suffering from high blood sugar, those symptoms will come on much more slowly and will likely be less intense.
How to Treat a Blood Sugar Event
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and introduce yourself to the victim.
"Hi, my name's _____. I'm a paramedic. I'm going to help you."
Pro Tip #2: When a patient has high blood sugar, the body will try to rid itself of it through urination, and failing that, through hyperventilation. Which is why, in patients with high blood sugar, you'll often notice a hint of fruit or cheap wine on their breath. The reason for this is called ketoacidosis – a byproduct of unused sugars in the body that become toxic.
Pro Tip #3: If a patient is showing signs of a blood sugar issue, rule it out using sugar – either over-the-counter products like soda or professional glucose products specifically for diabetic events.
Follow the pro tip above as long as the patient is coherent enough to follow commands and isn't getting agitated or aggressive. Then begin encouraging the consumption of sugar or glucose.
Warning: A patient can only consume a glucose or sugar product if they are able to swallow safely. If their sugar event has escalated to the point where they cannot control their swallow reflex, it's too late. Sugar will need to be administered through an IV or by intermuscular injection.
If the patient did have low blood sugar, you should notice improvements in 10 to 15 minutes. If the symptoms aren't improving after 15 minutes, there could be something else going on; call 911 and activate EMS.
Professional glucose products like tabs and gels are your best bet, as they're designed for quick absorption. They're also encased in more stable packaging, meaning they can withstand freezing temperatures and other environmental threats.
If you don't have any glucose products available, a full-sugar soda is your best option. Candy bars aren't a bad option either. However, more fibrous snacks will take too long to be absorbed by the body.
Pro Tip #4: Most patients with sugar problems will know the dosage of sugar or glucose they need in emergencies like this. Read labels on the packaging and multiply or divide as needed to get the proper dosage.
Keep in mind that high fructose corn syrup burns much more quickly compared to the longer-acting dextrose you'll find in many glucose products.
If this was the patient's first sugar event, follow up with EMS to make sure they get the help they need moving forward.
If this wasn't the patient's first sugar event, and they can explain what likely caused it, help them get back on their plan to avoid it happening again. And encourage them to check-in with their physician to make sure everything is all right.
A Word About Diabetic Emergencies
Diabetes mellitus is one of the leading causes of death and disability in the U.S. In 2016, 29 million Americans had diabetes, while another 86 million had prediabetes – a condition that increases your risk for developing type 2 diabetes and other chronic diseases like kidney disease, heart disease, gum disease, stroke, and amputations.
The Two Types of Diabetes
Type 1 Diabetes – Also known as juvenile diabetes or insulin-dependent diabetes, this condition results in a body that produces little to no insulin. Which is why most people who have type 1 diabetes inject themselves with insulin daily.
Type 2 Diabetes – More common than type 1 diabetes, type 2 is characterized by a body that produces insulin, but either the cells can't use it effectively or not enough is being produced. People with type 2 diabetes can often improve their symptoms and regulate their blood glucose levels with dietary changes and sometimes medications.
High Blood Glucose
High blood glucose, or hyperglycemia, is when the body's insulin level is too low, and the sugar level is too high. However, the body cannot transport that sugar into the cells without insulin. Which results in a body that's about to have an energy crisis.
The body then attempts to meet its need for energy by using other stored food and energy sources, such as fats. However, converting fat to energy is less efficient, produces waste products, and increases the acidity level in the blood, causing a condition known as diabetic ketoacidosis (DKA), which could ultimately result in a diabetic coma.
Low Blood Glucose
The exact inverse of the above – Low blood glucose, or hypoglycemia, occurs when the body's insulin level is too high, and the sugar level is too low.
This can happen for a number of reasons, including when the patient:
- Takes too much insulin
- Fails to eat adequately
- Over-exercises and burns off sugar faster than normal
- Experiences great emotional stress
Regardless of whether you're dealing with a patient who has type 1 diabetes or type 2 diabetes, the signs and symptoms are the same:
- Dizziness, drowsiness, or confusion
- Irregular breathing
- Abnormally weak or rapid pulse
- Feeling and looking ill
- Abnormal skin characteristics