Diabetic Crisis: Signs to Look For and Immediate Actions
Diabetic emergencies can be life-threatening situations that require immediate attention. These emergencies include severe hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic syndrome (HHS), infections, and complications related to diabetes. Each has distinct warning signs and recommended actions.
**1. Severe Hypoglycemia**
Severe hypoglycemia, a medical emergency, can occur in diabetes due to various reasons such as insulin overuse, alcohol consumption, missed meals, or excessive exercise. Warning signs include shaking, sweating, confusion, irritability, rapid heartbeat, dizziness, seizures, or loss of consciousness. If the person is conscious, give fast-acting carbohydrates such as glucose tablets, fruit juice, or sugary snacks. If unconscious or having seizures, call emergency services immediately and administer glucagon if available.
**2. Hyperglycemia**
Hyperglycemia occurs when blood sugar levels are high due to insulin deficiency or the body's inability to respond to insulin. Symptoms include increased thirst, frequent urination, fatigue, blurred vision, headache. Check blood glucose and ketones if possible. Ensure hydration and administer insulin as prescribed. Seek medical advice if blood glucose remains high or ketones are present.
**3. Diabetic Ketoacidosis (DKA)**
DKA is a serious complication that can occur when the body does not have enough insulin to allow glucose to enter cells, leading to the production of ketones and a rise in acidity levels of the blood. Missed insulin doses, illness, infection, or undiagnosed type 1 diabetes can cause DKA. Warning signs include blood sugar >250 mg/dL, nausea, vomiting, abdominal pain, fruity-smelling breath, rapid breathing, confusion, drowsiness, and signs of dehydration like dry mucous membranes and poor skin turgor. DKA is life-threatening and requires immediate medical attention.
**4. Hyperosmolar Hyperglycemic Syndrome (HHS)**
HHS is a medical emergency that can affect people with poorly controlled type 2 diabetes, but it can also affect people without diabetes. Causes include illness, infection, dehydration, and missed medication. Warning signs include extremely high blood sugar (often >600 mg/dL), severe dehydration, weakness, confusion, seizures, or coma.
**5. Infections in Diabetes**
People with diabetes are at increased risk of infections such as skin infections, urinary tract infections, and pneumonia. Warning signs include redness, swelling, warmth, pain in skin areas, fever, chills, or unusual fatigue. Seek prompt medical evaluation and treatment with antibiotics as prescribed, maintain good blood sugar control to promote healing and reduce risk.
**6. Chronic Diabetes Complications**
These include macrovascular (e.g., atherosclerosis leading to heart attacks or strokes) and microvascular complications (e.g., retinopathy, nephropathy, neuropathy). Symptoms vary widely depending on the complication, such as vision changes, numbness or pain in extremities, kidney dysfunction signs, or cardiovascular symptoms. Regular monitoring, strict blood glucose control, lifestyle modifications, and medical management are crucial to prevent progression.
In all diabetic emergencies, early recognition and prompt treatment are critical to prevent severe outcomes such as seizures, coma, organ failure, or death. If in doubt, seek emergency medical care immediately.
[1] Diabetes UK. (2021). Diabetic emergencies. Retrieved from https://www.diabetes.org.uk/guide-to-diabetes/complications/diabetic-emergencies [2] American Diabetes Association. (2021). Diabetic ketoacidosis. Retrieved from https://www.diabetes.org/diabetes/diabetic-ketoacidosis [3] Mayo Clinic. (2021). Hyperglycemic hyperosmolar state. Retrieved from https://www.mayoclinic.org/diseases-conditions/hyperglycemic-hyperosmolar-state/symptoms-causes/syc-20376142
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