People who have diabetes may encounter three types of emergencies. Each comes with its own symptoms, treatments and preventions.
- Hypoglycemia. This occurs when blood glucose gets too low. It can happen with any type of diabetes.
- Hyperglycemia. This occurs when blood glucose gets too high. People who have either type 1 or type 2 diabetes may have this.
- Ketoacidosis. This occurs when there are too many ketones in the blood and urine. It is most common in type 1 diabetes, but does occur rarely in type 2 diabetes.
One of the best ways to prevent a diabetes emergency is to NEVER stop taking your diabetes medicine without your doctor's OK. Don't change how much or when you take it either, unless your doctor has told you to. Keep taking your medicine even if your symptoms go away. Neither insulin nor diabetes pills are a cure for diabetes. Your symptoms have gone away at least partially because of the medicine you take, so you need to keep taking it.
Diabetes emergencies can also happen even when you're doing your best to control your blood glucose. Knowing how to recognize, treat and prevent them is an important part of taking charge of your diabetes. Talk with your doctor or diabetes educator about how to handle these emergencies.
Know Your Healthy Blood Glucose Range
The usual range for healthy blood glucose when you have not eaten recently is about 70 mg/dL to 120 mg/dL. When you first learn you have diabetes and your blood glucose levels have been high, it might take a while to bring them down to these levels. So ask your doctor to tell you what range you should be aiming for.
The best way to keep your blood glucose in your healthy range is to maintain a balance in how much medicine you take, the amount of food you eat and drink, and how much exercise you get. When all of these factors are in balance, you are more likely to avoid the peaks and valleys of too high and too low blood glucose. This may be easy to do when life is going by routinely. There may be other times in your life when it is harder for you to keep your lifestyle factors and blood glucose levels in balance.
Increase Your Focus When Your Routine Changes
When life events cause your everyday routine to become less than routine, you may need to focus on controlling your glucose levels. Talk with your doctor about how to handle your diet and medicines when you are travelling, breastfeeding or sick, for instance.
Travel
Having diabetes doesn't mean you can't travel. It just means you need to plan. How you prepare depends on where you're going and how long you'll be gone. Visit your doctor and have a medical exam several weeks before travelling to make sure your diabetes is under good control. If it isn't, you'll still have a few weeks to get your glucose level in a healthy range before leaving. Refer to Travelling Diabetic in this guide for a few guidelines to make traveling safe and easy.
Breastfeeding
Insulin does not pass through into breast milk, so you do not need to worry about its effect on the baby. However, breastfeeding can change how much insulin a nursing mother may need. Be sure to talk with your doctor about how best to manage your insulin while you are breastfeeding.
Illness
Even if you are too sick to eat well, you may need to keep taking your usual dose of insulin or pills. But to be sure, call your doctor to get advice. Being sick is likely to increase the insulin needs of your body. Try to keep eating your standard diet. If you can't do that, at least try to drink small amounts of fruit juice, soda, clear soups and bland foods, such as crackers and bread. Test your blood glucose every four hours during the day. If you have type 1 diabetes, check your urine for ketones too. Call your doctor if your blood glucose goes past your healthy range and if you have ketones. Find out how your doctor wants you to adjust your diet and medicines while you are sick.
Being prepared for the unexpected can keep you from having a diabetes emergency.
Written by Bobbie Hasselbring
Reviewed by Beth Seltzer, MD
Last updated June 2008
