Diabetes is a chronic condition requiring diligent management to maintain stable blood sugar levels. Even with careful adherence to treatment plans, individuals can experience acute complications demanding immediate medical attention. Recognizing emergency signs and knowing when to seek professional care is important for people with diabetes and their support networks. Prompt action can significantly improve outcomes and prevent serious health consequences.
Recognizing Severe Low Blood Sugar
Severe low blood sugar, known as hypoglycemia, occurs when blood glucose levels drop dangerously low, typically below 54 mg/dL. This level can impair brain function and the individual’s ability to self-manage. While mild-to-moderate hypoglycemia might be treated at home with fast-acting carbohydrates, severe episodes require emergency intervention.
Symptoms indicating a need for emergency care include profound confusion, disorientation, or an altered mental state. An individual might appear drowsy, have difficulty speaking coherently, or be unable to follow simple commands. Seizures or a loss of consciousness are clear indicators of a severe hypoglycemic event.
If a person experiencing these symptoms cannot be roused or is unable to swallow safely, call emergency services. Attempting to give food or drink to someone unconscious or unable to swallow can lead to choking. Immediate professional medical help is necessary to restore blood sugar levels and prevent potential brain damage.
Identifying High Blood Sugar Crises: DKA and HHS
High blood sugar can lead to two distinct, serious emergencies: Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS). Both conditions involve dangerously elevated blood glucose levels but differ in their underlying mechanisms and some key symptoms.
Diabetic Ketoacidosis (DKA) develops when the body, lacking sufficient insulin, begins to break down fat for energy, producing acidic substances called ketones. This leads to an accumulation of ketones in the blood, making it acidic. Symptoms often develop quickly, sometimes within 24 hours, and include extreme thirst, frequent urination, nausea, vomiting, and abdominal pain. A distinctive fruity odor on the breath, rapid and deep breathing (Kussmaul respiration), confusion, and weakness are also common signs. DKA is more common in individuals with Type 1 diabetes but can also affect those with Type 2 diabetes.
Hyperosmolar Hyperglycemic State (HHS) involves extremely high blood sugar levels and severe dehydration without significant ketone production or blood acidity. This condition typically develops more gradually, over days or even weeks. Symptoms include extreme thirst, frequent urination, and profound dehydration.
Mental status changes, such as confusion, disorientation, drowsiness, or even coma, are prominent features. Vision changes, seizures, and weakness can also occur. HHS is seen more frequently in older adults with Type 2 diabetes. While DKA involves the presence of ketones and acidosis, HHS is characterized by severe dehydration and highly concentrated blood due to extremely high glucose levels.
Seeking Immediate Emergency Care
If any severe symptoms of low or high blood sugar are present, seek immediate emergency medical attention. Waiting can lead to serious complications, including brain damage, coma, or death. Call 911 or your local emergency number rather than attempting to drive a severely ill person to the hospital. Emergency medical personnel are equipped to provide immediate care during transport.
When emergency responders arrive or upon reaching the emergency room, be prepared to provide necessary information. This includes the individual’s medical history, current medications, recent blood sugar readings if available, their type of diabetes, and their last meal or insulin dose. Providing this information helps medical staff quickly assess the situation and administer the most appropriate treatment. Prompt action improves outcomes for diabetes emergencies.