Diabetic Emergency First Aid

Treating a Hypo — Step by Step

1. 1

   Give Fast-Acting Glucose — 15–20g

   Choose one of the following:
   • 150–200ml of fruit juice or regular (non-diet) fizzy drink
   • 4–5 glucose tablets (such as Glucotabs)
   • 3–4 teaspoons of sugar dissolved in water
   • 5–6 jelly babies
   • Small tube of glucose gel (Glucogel)

2. 2

   Wait 15 Minutes and Recheck

   Check blood glucose after 15 minutes. If still below 4 mmol/L, repeat the fast-acting glucose. Do this up to 3 times.

3. 3

   Once Recovered — Give Longer-Acting Carbohydrate

   Once blood glucose is above 4 mmol/L and the person feels better, give a longer-acting carbohydrate snack to prevent a second hypo: a few biscuits, a sandwich, or their next meal if it is due.

Treating a Hyper

Mild to moderate hyperglycaemia often resolves with medication and hydration. However, severe hyperglycaemia can develop into diabetic ketoacidosis (DKA) in Type 1 diabetes, or hyperosmolar hyperglycaemic state (HHS) in Type 2 — both of which are medical emergencies.

For mild hyperglycaemia (11–15 mmol/L, well, not in distress):

• Encourage the person to drink plenty of water
• Ensure medication has been taken as prescribed
• Encourage gentle activity if appropriate
• Contact the GP or diabetes team if blood glucose does not come down

Call 999 or go to A&E urgently if the person has:

• Blood glucose above 15–20 mmol/L (especially in Type 1)
• Positive blood or urine ketones
• Vomiting, rapid or laboured breathing
• Confusion or drowsiness
• Severe abdominal pain
• Fruity (pear drop) smell on breath — indicates ketones

Knowing Where Things Are

If you are caring for someone with diabetes, make sure you know:

• Where the glucose tablets, juice or sugar are kept
• Where the blood glucose meter is and how to use it
• Whether the person has an emergency glucagon kit — and if so, where it is and how to use it
• What the person's target blood glucose range is
• Whether there is a Seizure/Emergency Action Plan from the diabetes team