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Diabetic Emergencies

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Diabetic Emergencies

This is a disease in which blood sugar level is elevated when the body does not produce enough insulin, a hormone that helps our body use the sugar. People with this condition take insulin or oral hypoglycemic agents to keep their diabetes under control.

Types Of Diabetic Emergencies:


1.Hypoglycemic emergency (insulin shock)

2.Hyperglycemic emergency (diabetic coma)


Insulin shock is a true emergency, which requires prompt action!


1. Hypoglycemic Emergency:

(Insulin Reaction Or Insulin Shock)


This condition occurs when there is too much insulin in the body. There is rapid reduction in the level of sugar in the blood causing the brain cells to suffer.





Insulin excess (by taking too much medication)

Inadequate food intake

Heavy exercise

Alcohol ingestion

Onset of menses

Immediate postpartum period (after birth).

Blood Glucose Level:


Less than 70 mg/dl





Fast breathing

Fast pulse



Change in the level of consciousness


Numb hands or feet




Pale skin

2. Hyperglycemic Emergency

(Diabetic Coma)


This condition occurs when there is too much sugar and too little insulin in the blood and body cells do not get enough nourishment.


Blood Glucose Level:


250 - 800 mg/dl


Precipitating Factors:



Illness and infections

Eating too much sugar

Not taking prescribed medications

Inadequate insulin dosage

Emotional stress

Presentation Classic:





Deep and fast breathing


Increased urination



Change in the level of consciousness

A peculiar sweet or fruity-smelling breath

Blurred vision






Nausea, vomiting

Abdominal pain

Fall in body temperature.

Emergency Care

Distinguishing between the two types of Diabetic Emergencies can be difficult !


ASK "have you eaten today?"

ASK "have you taken your medication today?"


Someone who has eaten, but has not taken prescribed medication

may be in a diabetic coma.


Someone who has not eaten, but has taken

medication, may be having an Insulin shock.


Insulin Shock:


Low blood sugar is easiest to treat, and treatment generally rewards

the first aid provider with dramatic results


Quick acting sugar, like CANDY, FRUIT JUICE OR A SOFT DRINK!

If No Improvement - Repeat


Give an extra snack of carbohydrates and proteins.

If the problem persists or worsens then take the person to

the nearest health clinic.


Sugar given to a person in insulin shock can be life-saving!>


Diabetic coma:


Emergency medical care should be given in a hospital !


Insulin should be given.

Children 0.25 - 0.5 U/kg.

Adults 10% - 20% of total daily dose.


Protective Measures to Prevent a Hypoglycemic Episode


Take frequent small meals !



Always be alert to hypoglycemia following exercise, as the body

becomes more sensitive to insulin for up to 12 hours following a workout.

Use caution when taking drugs that promote hypoglycemia or

dampen the warning signs to it. Such drugs include blood pressure agents

known as beta blockers, sleeping pills, sedatives, and alcohol.

Have glucose tablets or fast acting carbohydrates readily available

should an episode occur.

Always test your blood glucose levels before using heavy

machinery, power tools, or operating a motor vehicle.

Train your friends and family to recognize the visual clues of an

impending hypoglycemic episode. Mental confusion and irritability are

the most easily recognized cues.

Protective Measures to Prevent a Hyperglycemic Episode


Regularly check your blood sugar !


1. Take your medication in the proper dosage.


Follow the diet according to the diabetic diet chart advised by the doctor.

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Thank you very much for the useful information regarding Diebetic conditions.

Here, I would like to advise one simple but very useful tool for the early case management of severe Diabetic patients, in Nepalese context.

This is simply an idea what I experienced very recently.


Last week, a saw a person lying (fainted) nearby Tahachal campus and was clouded by a huge mass of people looking at him without providing any assistance.

They were talking about epileptic condition (CHHARE ROG) and hesitated even to touch him with the fear of disease (CHHARE ROG) that would attack them if they touched him.


I, being a health related person, observed him carefully, guessed him to be a diebetic patient who missed his insulin dose.


I very quickly convinced people.With the help of other people, I brought him to hospital, and the guess came true.

We arranged some money for insulin, and hence he was treated and a life was saved.


Actually, after knowing him as a diabetic patient (not CHHARE ROG), people were ready to help him through physical and monitory means.

Therefore, in country like ours (where conservative thinking is still a problem), there must a provision of ID card for all diabetic patients for immediate rescue during emergency.


If he would have an IDENTITY of Diabetic patient, he could get better and earlier help of surrounding people.


Also, public awareness is the must.


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