While we don’t want to go into what you do on a night out, these three symptoms together are the signs of diabetes and possibly a diabetic emergency. So how do you know when the good turns bad? How do you treat it? And why might it happen on a night out anyway?

What is diabetes?

Diabetes has so many names it can be confusing at first, so we’ll try to make it simple.

Diabetes is an imbalance of blood sugar and insulin.balance

Insulin is the hormone which normally controls blood sugar levels. From a first aid point of view, diabetes is simply low blood sugar. There are several other names for diabetes, depending on when it happens, what causes it, etc. Let’s look at a few:

  • Type 1 Diabetes (Juvenile onset diabetes, Insulin dependant diabetes)
  • Type 2 Diabetes (Adult onset or ‘late onset’ diabetes, non-insulin dependant diabetes)
  • Diabetes Mellitus
  • Diabetes Insipidus
  • Gestational Diabetes

Do they matter to us? If you’re treating someone for a diabetic emergency (from a first aid point of view) then you’re treating them for low blood sugar (hypoglycaemia). Call it what you will, there’s one condition we treat and one treatment we give (see below). So for first aid treatment of a diabetic emergency, no – it doesn’t matter what you or the casualty call this condition. You need to know how to recognize it and treat it. That’s all. So, shall we have a story?

insulin pen device

A Diabetic Story

Jo has had diabetes since birth. This has meant daily insulin injections, regular blood sugar checks and plenty of visits to doctors and clinics. Jo hit 19 today and decided to celebrate. There was going to be a big meal for the birthday so to keep things in balance Jo hadn’t eaten much, but still had today’s insulin knowing that the meal later would need it. Unfortunately like many good birthdays, plans changed and Jo’s friends decided the bar would be a better place to party and dance the night away. There wasn’t much food, plenty of alcohol and a good bit of dancing. At the end of the night Jo made it home before passing out in the bathroom. So, good night out or low blood sugar causing a diabetic emergency? Let’s see…..

Signs & Symptoms of Diabetes

These can easily be remembered as:

Wet, White & Wild

  • Wet: the person is often sweaty.
  • White: they will look pale and somehow ‘unwell’
  • Wild: there will be changes in mood. Often they will become aggressive or upset

So what’s happening? Well, the sugar which is normally in a person’s blood and providing them with energy is running critically low (that’s why we say they have low blood sugar or hypoglycaemia). As there isn’t enough energy reaching the brain, a person starts to become aggressive and agitated. The wet & white are there because the blood (and any last bits of sugar) are going to critical body organs – they aren’t needed in your skin when your brain is at risk.glass of beer
Remember that because of this, people suffering from a diabetic emergency can often appear drunk even with out alcohol.
Along with these, you may know the person is diabetic, or they tell you so. They may have a bracelet or necklace to tell you this. they might have insulin with them. They could be hungry, have a headache or feel dizzy. Eventually there’s the possibility of seizures and/or unconsciousness. There are other ways for medics to tell, but they involve a finger prick blood test and we don’t do that in basic first aid. Now, back to Jo…

Causes of a Diabetic Emergency

There are many, but you’ll see a few obvious ones in Jo’s story:
Too much insulin – it could be accidental, or in Jo’s case it could be the person expects a big meal but doesn’t get it. For whatever reason, if a person has more insulin injected than they need, they’re at risk.
Not enough sugar – We saw Jo didn’t eat when expected. It could also be that someone isn’t eating due to illness (but they still take the insulin) or perhaps they do eat, but then vomit. For whatever reason there isn’t enough sugar to balance the insulin they have.
Sugar gets used up – Maybe they’re late for work/school and run for the bus. Maybe there’s unexpected sports or other exertion. Maybe like Jo you spend the night on the dance-floor. For whatever reason, doing exercise is burning the sugar.
Alcohol – causes low blood sugar (hypoglycaemia). The more you drink, the lower the blood sugar.
So if Jo has passed out, what can you do? Really it depends on whether Jo can be woken….

First Aid Treatment for a Diabetic Emergency

First aid treatment really is as common sense as you’d expect. They have low blood sugar, so give them some sugar. Of course this can only safely work if they are conscious – if not then it’s time for an ambulance ride. Call for help.
Glucose tabletIf they are conscious, or can be roused enough to safely give them sugar, then do so. You might have to use your best persuasion skills to give them sugar, but any sugar will do. Pop/Soda, Candy/sweets, Fruit Juice, etc.
Once treated, they should be recovering within 5 minutes. If they don’t then it wasn’t simply low blood sugar and there might be something else. Assuming they do recover quickly, suggest they eat a meal with both sugar and carbohydrates in it (eg: jam or jelly sandwich).

When to get Help

If anyone is unconscious. Get the ambulance for them right away.
If they do not recover within 5 minutes of getting sugar, or get worse. Get the ambulance.
If they have never had this problem before, but they recover. They should see their own doctor as soon as they can.

Finally

Don’t worry about people having too much blood sugar (hyperglycaemia). They don’t often need first aid treatment (they need a doctor) and any small amount of sugar you do give them won’t cause any harm. Last of all, don’t forget to come to class for a review of everything and to ask any questions.

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