Medical Emergencies in Diabetes

The short term complications are also called the medical emergencies in diabetes. There are three main medical emergencies that can occur in diabetes. They are:

• Hypoglycemia  or Low Blood Sugar
• Non-Ketotic Hyper Osmolar Coma or Hyperosmolar Hyperglycemic State (HHS)
• Diabetic ketoacidosis or high levels of ketones

Hypoglycemia

A blood glucose level of less than 70 milligrams per deciliter is called hypoglycemia. This condition results from too much of insulin and too little glucose in the blood. If the level goes below 50 mg/dL it can result in Insulin shock or coma. Hypoglycemia also called as insulin reaction is the most common medical emergency in diabetes especially in those taking insulin. The reason for a drop in the blood glucose levels are:

• Skipping or delaying a meal
• Eating too few carbohydrates
• Exercising longer than normal
• Having too much of insulin

Signs and Symptoms

Early signs and symptoms

• Sweating
• Tremors
• Visual disturbances
• Head ache
• Fast heart beat
• Hunger
• Weakness

Later signs and symptoms

• Slurred speech
• Drunken like behavior
• Drowsiness
• Confusion

Emergency signs and symptoms

• Convulsions
• Coma

What to do?

As soon as you suspect hypoglycemia check your blood glucose levels. If it is below 70 mg/dL eat or drink something that will raise your blood glucose level quickly. Good examples include a candy, regular soft drink, half a cup of grape juice and glucose tablets. If after 15 minute you still experience the symptoms you repeat the treatment. If the symptoms persists in spite of that contact your doctor. In case you become unconscious or you cannot swallow you will be administered glucagons injection to raise your blood glucose levels.

Hyper Osmolar Hyperglycemic State (HHS)

When your blood glucose reaches dangerously high level the blood becomes thick and syrupy. This medical emergency in diabetes is called hyperosmolar, hyperglycemic state. The blood glucose level may reach as high as 600 mg/dL.This is not utilized by the body and so excreted in the urine. This leads to excess formation of urine and subsequent dehydration.

HHS is more common in people with Type II diabetes, especially people who do not monitor their blood glucose or who do not know that they have diabetes. It can also be precipitated by steroids and infections.

Signs and symptoms:

• Excessive thirst
• Dry mouth
• Frequent urination
• Dehydration
• Leg cramps
• Rapid pulse
• Seizures
• Coma

What to do?

Check your blood glucose levels. If it is more than 350mg/dL consult your doctor. Level of more than 500mg/dL is a medical emergency. Treatment consists of administration of intravenous fluids and short acting insulin.

Diabetic ketoacidosis (DKA)

When enough insulin is not present in the body, the cells get deprived of glucose and energy. If this continues for sometime, the cells try to get energy from fat. During this process substances called ketones are formed. An excess accumulation of ketones is called diabetic ketoacidosis and it is fatal if not treated promptly. This medical emergency is more common in people with Type I diabetes. It s usually precipitated by infections.

Signs and symptoms:

• Dry mouth
• Excess thirst
• Frequent urination
• Vomiting
• Abdominal pain
• Shallow breathing
• Sweet fruity odor on your breath
• Confusion
• Drowsiness

What to do?

Check your ketone levels if your blood glucose level is persistently above 250 mg/dL. Diabetic ketoacidosis is a medical emergency in diabetes which has to be treated with intravenous fluids and insulin.  Rapid correction can cause swelling of the brain and so it has to be corrected slowly over a period of 24-48 hours.