Diabetes is a result of the pancreas not producing sufficient insulin, the chemical the body uses to regulate the blood sugar level. There are two main types, imaginatively named type 1 and type 2.
Type 1 diabetes is insulin dependent and is often diagnosed at an early age. People with type 1 don’t produce enough insulin in the body so require regular injections to top them up.
Type 2 diabetes normally develops later on in life and is often linked to obesity or just an unhealthy lifestyle. People with type 2 either don’t produce enough insulin or the body does not use the insulin it does produce effectively. In this case insulin injections may be required but in most cases it is controlled by having a healthy diet and taking regular exercise.
So diabetes is not about the body not being allowed sugar. You can let them eat cake, it’s just that the blood sugar level needs to be managed. The two consequences of not managing it properly are either hypoglycaemia or hyperglycaemia.
When the body’s blood sugar level gets too low this is known as hypoglycaemia and is usually something that occurs fairly rapidly and perhaps as a result of missing a meal, consuming too much alcohol, taking too much exercise or just the body starting to overheat.
When the body’s blood sugar level gets too high this is known as hyperglycaemia and this tends to occur over a period of time, even over a period of days. This condition is a lot more serious and requires urgent medical attention. Hyperglycaemia tends to be more acute so there are usually some warning signs - needing the wee more often (leading to dehydration), increased thirst (due to the fluid loss and dehydration) and weight loss. The symptoms that the first aider is likely to recognise in cases of hypoglycaemia and hyperglycaemia are:
Of course the biggest clue as to whether a patient is diabetic and therefore likely to be hypoglycaemic or hyperglycaemic is to talk to them. Patients are remarkably adept at knowing what illness they have and how to deal with it. There may be other clues such as a medic alert tag.
So how would you treat someone who is either hypoglycaemic or hyperglycaemic? If it is the latter then it is a medical emergency. Phone 999 and request an ambulance. Place the patient in a comfortable position and take some observations – pulse, resps etc. If it is the former then give them a sugary drink or perhaps a chocolate bar in order to get some sugar in them. If they start to improve then give them a bit more to eat or drink and encourage them to have a full meal as soon as they can, ideally something with plenty carbohydrates. Also encourage them to seek medical attention.
In either case if the patient has impaired consciousness then do not give them, anything to eat or drink as this could affect their treatment later on. If their condition worsens then be prepared to put them in the recovery position, maintain the airway and even perform CPR if things get really bad.
If you’re not sure whether it is hypoglycaemia or hyperglycaemia, merge both treatments. Phone 999 and give them something sugary to eat or drink.
Phoning 999 won’t be a problem even if you get it wrong. I’m sure ambulance crews would much rather be called to a non-emergency than not be called to an emergency.
As for giving them something sugary, it may sound odd giving sugar to someone whose blood sugar level is already too high but it won’t harm them. It will however help someone whose blood sugar level is too low. Remember that hypoglycaemia develops rapidly so can also be resolved fairly quickly. Hypoglycaemia on the other hand would have built up over time so won’t be resolved as quickly, topping the patient up with a bit more sugar won’t cause any more harm in the short term.
For more information on diabetes visit the St John Ambulance web site.
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