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Commonest Diabetic Emergencies

“I feel tired and exhausted” in a patient with a diabetic condition can mean an underlying emergency.

Patients with diabetes can have high sugar as well as low sugar.

The commonest diabetic emergencies are:

Hypoglycemia – low sugars
Hyperglycemia leading to diabetic keto acidosis or hyperosmolar state
Infections commonly cellulitis, urinary infection
Silent heart attack
Stroke

Emergency

What It Means

Why It Happens

How It Feels

What to Do
Hypoglycemia

Low sugar levels in blood
- Skipping meal
- Too much insulin or diabetic drugs
Tiredness, confusion, seizures, passing out
- Recognise it
- Check blood glucose
- Take 2 spoons of sugar if conscious
  “Rule 15-15”-15 g carb and check sugars after 15 minutes
- If unconscious, rush to emergency room
Hypoglycemia

High sugar levels
- Inadequate insulin
- Infections
- Any other illness in the body
Tiredness, extreme thirst, peeing often, breathlessness, belly pain
Take to emergency room immediately
- will need insulin and intravenous fluids immediately
Infections

Infection in the urine, lung, skin, etc.

High sugar levels lower body immunity causing increased risk of infections

Tiredness, fever, burning urination (urine infection), cough (lung infection), swelling and pain in feet (skin infection)

Take to emergency room to identify the infection and to start on antibiotics
Silent heart attack

Blockage of blood vessels supplying the heart

Diabetes can accelerate the formation of blockages in vessels

Tiredness, heaviness, profuse sweating, nausea, vomiting, may not be typically chest pain alone

Take to emergency room for ECG, blood tests
Stroke

Blockage of blood vessels in the neck and brain

High sugar levels can increase the plaque formation in vessels

Facial weakness, arms weakness, slurred speech, can be transient also

Time is brain Take to emergency room immediately for evaluation and imaging

Managing Diabetic Emergencies Tips: ABCDE

A – Ask for help if you are feeling tired. It could be an emergency!!!

B – Blood sugar testing strips at home – glucometer is very handy in emergencies like low sugars.

C – “Chocolate in your pocket” at all times – immediately helps for low sugars in case of a missed meal during travel, etc.

D – Diet and drug harmony go hand in hand in preventing complications of diabetes. Also digitize your latest medical reports including HbA1c, ECG, creatinine in your mobile using apps like Bluestar diabetic app, Medical ID app for use anytime, anywhere, anyplace.

E – Emergency kit at home containing glucometer, chocolate/sugar sachets and emergency contact number might be lifesaving!!!

Dr. Vidya Saketharaman
Consultant Emergency Care
Kauvery Hospital Chennai