What to do if someone has a diabetic emergency (low or high blood sugar)?

What to Do if Someone Has a Diabetic Emergency

Diabetic emergencies usually involve either low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia/diabetic ketoacidosis). Both require quick recognition and appropriate action.

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Low Blood Sugar (Hypoglycemia)

Typical signs: sweating, shakiness, hunger, pale skin, confusion, irritability, drowsiness, or seizures in severe cases.

What to do:

1. Check responsiveness – see if the person can swallow safely.

2. Give fast-acting sugar if they are conscious and able to swallow:

   • Glucose tablets (about 15–20 g)

   • Half a cup of fruit juice or regular (non-diet) soda

   • 1 tablespoon of honey or sugar

3. Wait 10–15 minutes, then recheck their condition. If still low, repeat with another 15 g of sugar.

4. Give a snack with complex carbohydrates (like bread or crackers) once blood sugar stabilizes, to prevent another drop.

5. If unconscious or unable to swallow:

   • Do not give anything by mouth.

   • Call emergency services immediately.

   • If available, someone trained can administer glucagon injection or nasal spray.

6. Stay with the person until help arrives or they recover fully.

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High Blood Sugar (Hyperglycemia)

Typical signs: extreme thirst, frequent urination, dry mouth, blurred vision, headache, nausea, vomiting, abdominal pain, fruity-smelling breath, confusion, or rapid breathing (may indicate diabetic ketoacidosis, DKA).

What to do:

1. Encourage fluids – preferably water – to prevent dehydration.

2. Check for insulin or medication – if the person uses insulin or diabetes medication and is alert, help them take it as prescribed.

3. Do not give food or sugar unless instructed by the person’s care plan.

4. Seek urgent medical help if:

   • They are vomiting and cannot keep fluids down

   • They show confusion, drowsiness, or unconsciousness

   • They have rapid breathing or fruity-smelling breath (signs of DKA)

5. Monitor their breathing and consciousness until help arrives.

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General Principles

• Always call emergency services if the person becomes unconscious, has seizures, or you are unsure whether it’s low or high blood sugar.

• If you don’t know which emergency it is, treat for low blood sugar first, as hypoglycemia is more immediately life-threatening.

• Stay calm, reassure the person, and keep them safe from injury.