Emergencies in diabetes – do you know enough? (expert speak)

Would you know what to do in case of a diabetic emergency? Here are some tips for you to be prepared.

By: Pavitra Sampath | | Updated: March 24, 2015 12:01 pm

Arun is a 52-year-old energetic and a busy entrepreneur. With everything going his way, he has only one stumbling block – he suffers from diabetes. Although his wife keeps a watch on his diet and exercise routine, she worries about an emergency situation if Arun’s sugar level were to fall. Like Arun, there are a number of people who suffer from the disease. India is quickly becoming the diabetic capital of the world and with almost every household having one diabetic, it’s only wise that you know more about diabetic emergencies. We spoke to our expert Dr Rajiv Kovil, leading diabetologist, about what you should have at hand in the case of an emergency.

Dr Kovil says, ‘the three most common complications related to diabetes are hypoglycaemia (low sugar), diabetic ketoacidosis (high blood sugar) and hyperosmolar non-ketotic coma, a condition where the person’s blood sugar goes above 600 units.

Again, in hypoglycaemia , there are basically three main types:

Mild hypoglycaemia is where the patient feels uneasiness, dizziness, excessive sweating etc. In such a case, all the person has to do is have an extra serving of some carbohydrates (candy, chocolate or fruit juice).

In the case of moderate hypoglycaemia, the patient experiences severe symptoms like excessive sweating, cold palms and feet, dizziness, palpitations, confusion, irritability, pale skin, trembling, weakness, anxiety, etc. In such a case, he/she will require someone to take care of him/her. The best way to quickly raise the sugar level is to place sugar or honey under the patient’s tongue and immediately seek medical attention.

Severe hypoglycaemia is where the patient needs to be hospitalised for low sugar and treated accordingly. Symptoms include headache, poor coordination, severe confusion, fainting spells, numbness in the mouth and tongue and finally coma. In such a situation, the caretaker should immediately seek emergency medical attention.

According to Dr Rajiv Kovil, ‘The red flag in the case of people suffering from hypoglycaemia is called the triad – display of classic symptoms, low glucose level and the indication that the person responds well after eating something sweet.’

The best way to help a patient out of a diabetic episode is to give him/her at least 15 grams, of any of the following foods:

four to six pieces of hard candy
half a cup of fruit juice with sugar
half a cup of any soft drink (not the diet variety)
one tablespoon of honey
one tablespoon of sugar
one tablespoon of corn starch
one glucose tablet

Dr Kovil advises, ‘Moderate to severe hypoglycaemia should be assessed properly. Severe hypoglycaemia in elderly patients and those who suffer from hypoglycaemia unawareness (those who do not experience the symptoms of hypoglycaemia) require a thorough check up and identification of the possible risk factors. It is paramount to managing diabetes appropriately.’

The other two diabetic emergencies are due to high blood sugar. ‘High blood sugar leads to the breakdown of fat cells and the formation of ketone or blood acids. This is an extremely dangerous condition which can lead to severe complications such as coma or death,’ says Dr Rajiv Kovil.

The symptoms of both the conditions are, excessive thirst, frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath and confusion. Both diabetic ketoacidosis and diabetic hyperosmolar non-ketotic coma are extremely serious conditions, which require immediate hospitalization. If a person is at risk of suffering from either of the two conditions, he/she can monitor their blood sugar levels and ketone levels in their urine through home test kits.

Lastly, Dr Kovil says, ‘It is important to realise that not all patients show similar symptoms. While some may show no symptoms at all, others might manifest the disease differently. In either case, it is essential to get regular check-ups from a good diabetologist. In case of patients who suffer from diabetic ketoacidosis or hyperosmolar non-ketotic coma, their doctor must make it a point to check for other underlying conditions such as infections or malfunctions of organs.’

Read more about causes, symptoms, diagnosis and treatment of diabetes.

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