Diabetes mellitus
Diabetic emergencies
Václav Vafek
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Learning objectives
̶ Student will learn to recognize acute life-threatening conditions of
diabetes.
̶ Student will learn the basic principles of first aid for diabetic
emergencies.
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Diabetes mellitus
̶ “diabetes“
̶ a group of chronic, metabolic disorders characterized by a
disorder of carbohydrate metabolism and the associated high
blood sugar level
̶ 1 million patients in Czechia, more than 30 millions in EU
̶ the treatment prevents long-term complications
̶ in addition to a medication, the treatment includes a strict diet and
a regular regimen
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How does carbohydrate metabolism work in a
healthy person?
̶ blood sugar and insulin levels fluctuate depending on food intake
̶ food  increase of the blood sugar level  insulin is released
from the pancreas  muscles and liver can process sugar thanks
to insulin  decrease of the blood sugar level
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How does carbohydrate metabolism work in a
diabetic?
̶ in diabetics, the physiological mechanism does not work
1. the pancreas does not produce insulin at all
2. the pancreas makes insulin, but the tissues don’t respond to its
releasing
̶ the body cannot utilize the sugar from food  high blood sugar
level (hyperglycaemia)
̶ high sugar levels can cause long-term complications (chronic
kidney disease, foot ulcer, cardiovascular disease,…)
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Diabetes types, therapy
̶ type 1 diabetes
̶ the pancreas does not produce insulin at all
̶ early onset in children
̶ therapy: strict diet + INSULIN (insulin pen, insulin pump)
̶ type 2 diabetes
̶ the pancreas produces insulin, but the tissues don’t respond to its releasing
̶ insulin production in the pancreas decreases progressively
̶ adult-onset, often obese
̶ therapy: strict diet+ drug treatment, in later stages INSULIN
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Hyperglycaemia - high blood sugar level
̶ unrecognized diabetic or severe diabetes management mistake
̶ frequent urination
̶ increased thirst
̶ fatigue, weakness, blurred vision
̶ several days lasting condition
̶ severe dehydration may occur after a few days  disorder of
consciousness  life threatening condition
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Hypoglycaemia - low blood sugar level
̶ commonly in diabetics treated with insulin
• repeated dose of insulin
• physical activity
• insulin taken on an empty stomach
̶ a person with hypoglycaemia looks like an inebriated person
̶ increased appetite, weakness, fatigue
̶ behavioural changes - aggression, nervousness, lack of concentration
̶ pale skin, sweating, palpitation
̶ after that progressive loss of consciousness and seizures life threatening
condition
̶ the quick reaction of the rescuer is crucial, the condition may worsen
very quickly in a few minutes!
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First aid
̶ the diabetic begins to behave strangely  give him sugar
• conscious (holds the mug): sugar in a liquid form (sweet tea,
lemonade, sugar in water)
• unconscious - SSSABC, call an ambulance
̶ if a diabetic has hyperglycemia, the sugar will not significantly
harm him
̶ if he has hypoglycemia, his condition improves after taking sugar
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First aid
Caution!
̶ never give insulin to the patient (it should only be given by a
doctor or diabetic in full consciousness)
̶ if a person has a disorder of consciousness, don’t put a sugar
cube under his tongue or pour sugar into his mouth - there is a risk
of suffocation!
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Diabetic equipment
̶ Glucagen kit
̶ Insulin pen
https://www.glucagenhypokit.com
https://www.diastyl.cz/pomucky-aplikaci-inzulinu/
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Take home message
Always save diabetics with sugar
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Learning outcomes
̶ Student is able to recognize acute life-threatening conditions of
diabetes.
̶ Student understands the basic principles of first aid for diabetic
emergencies.
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Resources
̶ https://www.cprguidelines.eu
̶ https://www.erc.edu
̶ AUSTIN, Margaret, Rudy CRAWFORD a Barry KLAASSEN. First
aid manual : the Authorised Manual of St John Ambulance, St
Andrew's First Aid and the British Red Cross. Revised 10th
edition. London: DK, 2016. 288 stran. ISBN 9780241241233
Simulation Centre, Faculty of Medicine, Masaryk University
2020