Diabetes First Aid Management
Diabetes is the 6th most potent and silently killing pandemic taking over one million lives a year globally.
Each year the number of people dying from diabetes or diabetes emergency conditions increases alongside the rising obesity epidemic level as the two conditions tend to be found together in the predominant number of deceased patients.
Introduction To Diabetes
Diabetes is a chronic, lifelong medical condition that happens when the pancreas fails to produce enough insulin, or the body develops a resistance to its own insulin. Untreated, the accumulation of insulin will lead to a high blood glucose level, often called a high blood sugar level.
Types of diabetes:
- ”Type 1 diabetes is an auto-immune disease that often develops in childhood and requires lifelong treatment with insulin.
- ”Type 2 diabetes is more commonly recognized in adulthood and requires a treatment combination of diet, exercise, oral medication, and sometimes insulin.
- ”Gestational diabetes” is a relatively common condition specific to pregnancy, and diabetes can also occur due to another disease or as a side effect of medication.
People living with diabetes are required to manage their blood sugar levels externally by monitoring what they eat, adjusting their insulin or other medication doses, and frequently testing their own blood glucose levels. When blood glucose levels are too high or too low, people with insulin levels out of the normal range may require first aid or treatment at a medical facility.
Low Blood Sugar Hypoglycemia
Hypo means low. Low blood glucose levels result from having too much insulin or other blood glucose-lowering medication. The onset of hypoglycemia could be caused by inadequate or delayed carbohydrate intake after their usual insulin or oral medication dose, exercise without adequate carbohydrate intake, or due to another illness or excessive alcohol intake.
Competitors in ultra-marathon endurance events, who do not have diabetes, can also become energy depleted and develop low blood glucose levels requiring First Aid management.
Hypoglycemic events range from those that can be self-managed to severe episodes where medical intervention is required.
The brain requires a continuous supply of glucose to function normally and developing fetuses in the womb strip glucose from the blood, depleting the normal levels and requiring external management.
When blood glucose levels fall below normal levels, symptoms and signs may include:
• Sweating
• Pale skin, especially in young children
• A rapid
• Shaking, trembling or weakness
• Hunger
• Light-headedness or dizziness
• Headache
• Mood or behavioral changes, confusion, inability to concentrate
• Slurred speech
• Inability to follow instructions
• Unresponsive
• Seizure
If a person with diabetes has a diabetes management plan, that plan should be followed. If a person with diabetes reports low blood glucose level or exhibits symptoms or signs of hypoglycemia, they should immediately:
• Stop any exercise, rest, and recover with a high-sugar sports drink or glucose tablets.
• If the person can follow simple commands and swallow safely, it is recommended that first aid providers administer 15-20 grams glucose tablets (4 – 5 x 4-gram glucose tablets) to treat symptomatic hypoglycemia. If glucose tablets are not available, we suggest administering high glucose food and drink in the form of confectionery, including but not limited to:
- Jellybeans and Jelly Babies (5 to 20 depending on the brand)
- Full-strength sugary drinks or sugar-sweetened beverages (approx. 200 MLS)
- Fruit juices (approx. 200 MLS).
- Honey, liquid glucose, sugar (3 teaspoons)
- Glucose gels (15 g of glucose gel)
Monitor for improvement in their condition. A reversal of their symptoms would be expected within 15 minutes after the treatment has been given. If symptoms or signs of hypoglycemia persist after ten to fifteen minutes, and the person can still follow simple commands and swallow safely, administer a further 4 x 4g glucose tablets or alternatives as listed above.
Once recovered, give a snack with longer-acting carbohydrates, for example, bread, a glass of milk, a piece of fruit, snack-size tub of yoghurt (Do not give diet or ”sugar-free” versions of products in treating hypoglycemia).
If it is their normal mealtime, then have them eat that meal. Call for an ambulance immediately if the person deteriorates, does not improve with treatment, seizes, or falls unconscious.
• If the person is unresponsive and not breathing normally, commence resuscitation following the DRSABCD protocol.
• If the person is unconscious but breathing, lie the person on their side, ensure the airway is clear, and continue management.
Insulin Pumps
If the person is wearing an insulin pump, they may ”suspend” their own pump as part of a personal diabetes management plan. First aiders should not touch any insulin pump being worn by the person. They should manage and provide treatment for hypoglycaemia as listed above.
Use Of Glucagon to Treat Severe Hypoglycemia
Family members of and careers for people with diabetes may be trained in the use of the GlucaGen® HypoKit®. These kits contain an injection of Glucagon, which triggers the liver to release stored glucose, resulting in raised blood glucose levels. The Glucagon is administered by injection. Give Glucagon in the case of a severe hypoglycaemic event, when the person is unconscious or seizing and cannot swallow safely.
High Blood Glucose or Hyperglycaemia
Hyper means high. Hyperglycaemia means having a high blood glucose level. Common causes of hyperglycaemia include inadequate insulin levels or incorrect doses of diabetes oral medications, infections, or excess carbohydrate intake.
Hyperglycaemia can develop over hours or days. Many people do not experience symptoms of hyperglycaemia until their blood glucose levels are excessively high. Their vision may become blurry as the first indicator that they need to seek immediate medical treatment and assessment.
Frequent urination and spontaneously’ wetting pants” could indicate the onset of diabetes at any age but might be overlooked in young children as bladder control issues by parents.
Hyperglycaemia can also occur at the time of initial diagnosis of diabetes and may go unrecognised until the person is clearly unwell. If untreated, the person gradually deteriorates and can become comatose.
When blood glucose levels remain above normal levels, symptoms and signs may include:
• Excessive thirst
• Frequent urination
• Dry skin and mouth, with sunken eyes (signs of dehydration)
• Recent weight loss
• Rapid pulse
• Nausea and vomiting
• Abdominal pain
• Rapid breathing
• Fruity sweet smell of acetone on the breath, similar to paint thinner or nail polish remover
• Confusion, a deteriorating level of consciousness, or unresponsiveness.
If a person with diabetes has a diabetes management plan, that plan should be followed. If the person has no management plan and has symptoms or signs of hyperglycaemia, they should be assessed by a healthcare professional.
• If the person is unresponsive and not breathing normally, commence resuscitation following the DRSABCD protocol.
• If the person is unconscious but breathing, lie the person on their side and ensure the airway is clear and maintained.
First Aid for Life
First Aid skills, once learned, are a skill you retain for life. While technology continues to advance and protocols change, the basics are the same globally and, when applied correctly, allow you to save a life at worst and potentially prevent a situation from escalating into a medical emergency at best.
FACE is an accredited RTO specializing in providing First Aid courses Australia-wide.
Please drop by our FACE Home page to find a venue and course near you. Need a little motivation to gain your certification? Peruse our FACE Blog page for a range of topics, and take our First Aid Quiz to test your general First Aid knowledge.