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Recognizing & Responding to a Diabetic Emergency – QG

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Category: Health & Safety

⚡ Recognizing & Responding to a Diabetic Emergency

A diabetic emergency can occur when blood sugar becomes dangerously low or high. Symptoms may develop gradually or appear quickly.

If the person is unconscious, having a seizure, unable to swallow safely, severely confused, or having difficulty breathing, call 911 immediately.

Signs of Low Blood Sugar

Low blood sugar, also called hypoglycemia, may cause:

  • Shaking
  • Sweating
  • Hunger
  • Dizziness
  • Weakness
  • Headache
  • Pale skin
  • Irritability
  • Anxiety
  • Confusion
  • Difficulty speaking
  • Poor coordination
  • Unusual behavior
  • Blurred vision
  • Sleepiness
  • Seizures
  • Loss of consciousness

Low blood sugar may develop quickly. A person may appear intoxicated even when they have not used alcohol.

Helpful Resources: Browse Temperature & Basic Health Monitoring for products, equipment, services, or supplies related to this section.

Treating Low Blood Sugar

If the person is awake, able to follow directions, and can swallow safely:

  1. Check their blood sugar if a meter or continuous glucose monitor is available.
  2. Give approximately 15 grams of fast-acting carbohydrate.
  3. Wait 15 minutes.
  4. Check the blood sugar again when possible.
  5. Repeat if it remains low or symptoms continue.
  6. Once the person improves, provide a snack or meal if the next regular meal is not soon.

Examples of approximately 15 grams of fast-acting carbohydrate include:

  • 4 ounces of fruit juice
  • 4 ounces of regular soda
  • 3 to 4 glucose tablets, depending on the label
  • One tube of glucose gel, depending on the label
  • 1 tablespoon of sugar or honey

Use the person’s individual diabetes plan when one is available.

Chocolate, baked goods, and high-fat snacks may work too slowly for initial treatment.

Call 911 for Severe Low Blood Sugar

Call 911 if the person:

  • Is unconscious
  • Is having a seizure
  • Cannot swallow safely
  • Is severely confused
  • Does not improve after treatment
  • Has been injured
  • Does not have a safe source of glucose available
  • Has symptoms that may have another serious cause

Do not put food, drinks, glucose tablets, gel, honey, or medication into the mouth of someone who is unconscious, having a seizure, or unable to swallow.

Using Glucagon

Glucagon is an emergency medication for severe low blood sugar. It may be available as a nasal spray, injection, or prefilled device.

If the person cannot safely take sugar by mouth:

  1. Call 911.
  2. Give glucagon if it is available and you know how to use it.
  3. Follow the product instructions.
  4. Place the person on their side if they are breathing normally.
  5. Monitor breathing and responsiveness.
  6. Begin CPR if they are not breathing normally.
  7. Give oral sugar only after the person is fully awake and can swallow safely.

Glucagon may cause vomiting. Keeping the person on their side can help reduce the risk of choking.

Emergency evaluation may still be necessary even if the person wakes up.

Signs of High Blood Sugar

High blood sugar, also called hyperglycemia, may cause:

  • Increased thirst
  • Frequent urination
  • Dry mouth
  • Blurred vision
  • Headache
  • Weakness
  • Fatigue
  • Nausea
  • Abdominal discomfort
  • Difficulty concentrating

Follow the person’s diabetes plan for checking blood sugar, medication, fluids, and ketones.

Do not give extra insulin unless the person’s established plan or a healthcare professional directs it.

Signs of Diabetic Ketoacidosis

Diabetic ketoacidosis, or DKA, is a medical emergency. It occurs more often in people with type 1 diabetes but can occur in others.

Warning signs include:

  • Very high blood sugar
  • Moderate or high ketones
  • Nausea or vomiting
  • Abdominal pain
  • Deep or rapid breathing
  • Fruity-smelling breath
  • Severe thirst
  • Frequent urination
  • Dry skin or mouth
  • Weakness
  • Confusion
  • Extreme sleepiness
  • Loss of consciousness

Call 911 or seek emergency care for signs of DKA, especially when vomiting, breathing changes, confusion, or inability to keep fluids down is present.

Signs of Hyperosmolar Hyperglycemic State

Hyperosmolar hyperglycemic state, or HHS, is another life-threatening high-blood-sugar emergency. It occurs more often in people with type 2 diabetes.

Possible signs include:

  • Extremely high blood sugar
  • Severe thirst
  • Frequent urination followed by reduced urination
  • Very dry mouth and skin
  • Severe weakness
  • Confusion
  • Vision changes
  • Seizures
  • Loss of consciousness

Call 911 for these symptoms.

If You Are Unsure Whether Blood Sugar Is Low or High

Check the person’s blood sugar if equipment is available, but do not delay calling 911 for severe symptoms.

If the person is awake and can swallow safely, fast-acting sugar is generally used when low blood sugar is suspected. A small amount of sugar may briefly increase high blood sugar, but untreated severe low blood sugar can quickly cause seizures, unconsciousness, or death.

Do not give anything by mouth if the person cannot swallow safely.

When Illness Affects Diabetes

Fever, infection, vomiting, diarrhea, missed medication, reduced food intake, and dehydration can make blood sugar difficult to control.

During illness:

  • Follow the person’s sick-day plan.
  • Check blood sugar as directed.
  • Check ketones when instructed.
  • Continue medication according to professional guidance.
  • Drink fluids as allowed.
  • Contact the diabetes care team when readings remain abnormal.
  • Seek help if the person cannot keep fluids down.

Do not stop insulin without guidance simply because the person is eating less.

Preventing Diabetic Emergencies

  • Take medication as directed.
  • Eat meals and snacks according to the diabetes plan.
  • Check blood sugar as recommended.
  • Carry fast-acting glucose.
  • Keep glucagon available.
  • Check glucagon expiration dates.
  • Wear medical identification.
  • Tell trusted people how to help.
  • Plan for exercise, illness, and schedule changes.
  • Store insulin and testing supplies correctly.
  • Avoid mixing alcohol with diabetes medication without medical guidance.
  • Keep emergency information accessible.

Driving with low blood sugar can be dangerous. Check and treat blood sugar according to the person’s healthcare plan before driving.

Quick Diabetic-Emergency Checklist

  • Look for shaking, sweating, confusion, or unusual behavior.
  • Check blood sugar when possible.
  • Give 15 grams of fast-acting carbohydrate if the person is awake and can swallow.
  • Recheck after 15 minutes.
  • Give glucagon for severe low blood sugar when available.
  • Call 911 for unconsciousness, seizures, inability to swallow, or failure to improve.
  • Do not give anything by mouth to an unconscious person.
  • Call 911 for vomiting, deep breathing, fruity breath, severe dehydration, or confusion with high blood sugar.
  • Do not give extra insulin unless directed by an established plan or healthcare professional.

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Important Health & Safety Notice

The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.

Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.