Diabetic Emergency: Symptoms, Consequences, and Remedies
In the complex world of diabetes management, one potentially life-threatening complication is diabetic shock, also known as insulin shock or hypoglycemic shock. This condition occurs when a person's blood sugar drops extremely low.
Doctors may prescribe a hormone called glucagon to people at risk of diabetic shock. In an emergency, glucagon can be used to help blood glucose levels return to normal. However, it is crucial to remember that prompt medical attention is still required after the administration of glucagon.
Complications from diabetic shock can be severe, including loss of consciousness, seizures, and, in rare cases, death. If a person experiencing hypoglycemia becomes unconscious, immediate action is necessary. Call 911 and turn the affected person on their side before delivering a glucagon shot.
High glucose levels are also a problem and can lead to potentially serious complications, such as hyperglycemia, diabetic hyperosmolar syndrome, and diabetic ketoacidosis. Symptoms of high blood glucose levels can include dry mouth, vision issues, increased thirst, and frequent need to urinate.
Potential causes of diabetic shock include taking too much insulin, ignoring mild hypoglycemia, excessive, unusual activity or exercise without adequate changes to carbohydrate intake, missed meals, using too much diabetes medication, changing exercise routines, eating too little (fasting), advanced age, living with diabetes for a longer time, taking more insulin than needed, illness, and excessive alcohol consumption.
Repeated episodes of diabetic shock, particularly diabetic ketoacidosis (DKA) or severe hypoglycemia, have significant long-term health effects. These can include organ damage, cognitive decline, increased risk of complications, higher hospital readmission rates, and microvascular and macrovascular damage.
Organ damage from recurrent DKA can increase the risk of long-term damage to vital organs including the kidneys, heart, and nervous system, contributing to chronic kidney disease, cardiovascular complications, and neuropathies. Frequent hypoglycemic or hyperglycemic crises can lower the glycemic threshold for symptom awareness, leading to unnoticed episodes that accelerate cognitive deterioration. Diabetes itself increases the risk of cognitive decline and dementia, and repeated severe episodes may exacerbate this risk.
Recurrent DKA is associated with elevated morbidity including dehydration, electrolyte imbalances, and in severe cases, cerebral edema (though rare). Such repeated metabolic derangements further strain body systems. Studies show a significant proportion of individuals hospitalized with DKA experience recurrent episodes within weeks or months, suggesting persistent instability in glycemic control that worsens long-term outcomes.
To prevent complications, people can carry a medical alert bracelet or another form of identification to inform emergency personnel that they have diabetes. If a person's blood sugar levels are less than 70 milligrams per deciliter (mg/dl), they can follow the 15-15 rule: consume a sugary snack or drink containing 15 grams (g) of carbohydrates, then recheck blood sugar levels after about 15 minutes. If the levels are still low, repeat the process and consume another sugary food or drink. Once the levels have returned to normal, a person can return to their regular meal and snack schedule.
A continuous glucose monitoring system (CGM) with alerts may be a good solution for some. These devices regularly monitor a person's blood sugar levels, which can help determine if levels drop too low or go too high. A person can make general lifestyle changes to help avoid diabetic shock and hypoglycemia, including monitoring their blood sugar levels closely, avoiding skipping meals or snacks, taking medication as prescribed, keeping a log of any low blood sugar reactions or symptoms, and adjusting medication and calorie intake when increasing physical activity levels.
Symptoms of diabetic shock or severe hypoglycemia include blurry or double vision, seizures, convulsions, drowsiness, losing consciousness, slurred speech, trouble speaking, confusion, jerky movements, clumsiness, and impaired movement and ability to think clearly.
In essence, repeated diabetic shock episodes can compound the risk of progressive organ damage, neurocognitive decline, and vascular complications, ultimately worsening a person's overall prognosis and quality of life. Preventive strategies include close monitoring, early treatment of precipitating factors, and education to reduce recurrence.
- Diabetic shock, also known as hypoglycemic shock, is a potentially life-threatening complication in diabetes management.
- Glucagon, a hormone prescribed to people at risk, can help manage diabetic shock by elevating blood glucose levels.
- Prompt medical attention is necessary after the administration of glucagon to avoid further complications.
- High blood glucose levels, leading to conditions like hyperglycemia, diabetic hyperosmolar syndrome, and diabetic ketoacidosis, are equally dangerous.
- Causes of diabetic shock include excessive insulin intake, physical activity without adjusting carbohydrate intake, missed meals, illness, and excessive alcohol consumption.
- Repeated diabetic shock episodes have long-term health effects, including organ damage, cognitive decline, increased risk of complications, and microvascular and macrovascular damage.
- Damage to vital organs such as the kidneys, heart, and nervous system is a risk with recurrent diabetic ketoacidosis.
- Frequent hypoglycemic or hyperglycemic crises can lower glycemic awareness, leading to unnoticed episodes that hasten cognitive deterioration.
- A medical alert bracelet can inform emergency personnel about a person's diabetes, helping in case of an emergency.
- The 15-15 rule (consume 15g of carbohydrates when blood sugar levels drop below 70mg/dl) helps manage hypoglycemia.
- A continuous glucose monitoring system (CGM) with alerts can help determine if blood sugar levels drop too low or go too high.
- To prevent diabetic shock and hypoglycemia, people should closely monitor their blood sugar levels, avoid skipping meals or snacks, take medication as prescribed, and adjust medication and calorie intake when increasing physical activity levels.
