Diabetic emergencies can lead to seizures, organ failure, coma, or even death if not treated properly. If you recognize the signs early like shaking hands, slurred speech, or excessive thirst, you can save a life.
More than 1 in 10 people in the U.S. have diabetes.1 You don’t know how many of your friends, coworkers, or family members are managing it on a daily basis.
So when you learn about diabetic emergencies, you’re protecting yourself and becoming someone others can count on. Let’s break down the most common diabetic emergencies, their causes, warning signs, and how to respond.
7 Most Common Diabetic Emergencies
Here are some of the most common diabetic emergencies to watch out for:
1. Hypoglycemia (Low Blood Sugar)
Hypoglycemia occurs when blood glucose levels fall below 70 mg/dL. It’s one of the most common diabetic emergencies, especially for people on insulin or certain oral medications.
Causes:
- Skipping or delaying meals
- Taking too much insulin or diabetes medication
- Exercising more than usual
- Drinking alcohol on an empty stomach
Warning signs:
- Shaking or trembling
- Sweating
- Dizziness or lightheadedness
- Irritability or confusion
- Blurred vision
- Headache
- Fast heartbeat
- Seizures or unconsciousness (in severe cases)
What to do:
- Take 15 grams of fast-acting carbs (like juice, glucose tablets, or regular soda).
- Recheck blood sugar after 15 minutes
- Repeat if still low
- Seek emergency help if the person is unconscious or having seizures
2. Hyperglycemia (High Blood Sugar)
This happens when blood glucose rises too high, typically over 180 mg/dL. Occasional spikes are common, but persistent hyperglycemia can lead to serious complications.
Causes:
- Missed insulin or medication doses
- High-carb meals
- Infection or illness
- Stress
- Hormonal changes
Warning signs:
- Frequent urination
- Extreme thirst
- Fatigue
- Blurry vision
- Headache
- Nausea
What to do:
- Make sure you haven’t missed a dose of insulin or oral medication.
- Check your blood sugar. If it’s over 300 mg/dL and rising, you’re at risk for complications like diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) both of which require urgent medical attention.
Note: Never take extra insulin without guidance unless it’s part of your treatment plan.
3. Diabetic Ketoacidosis (DKA)
DKA is a serious complication of type 1 diabetes (and occasionally type 2) where the body breaks down fat too fast, leading to the buildup of acidic ketones in the blood.
Causes:
- Missed insulin doses
- Illness or infection
- Undiagnosed type 1 diabetes
Warning signs:
- High blood sugar (usually >250 mg/dL)
- Nausea and vomiting
- Abdominal pain
- Fruity-smelling breath
- Rapid breathing
- Confusion or drowsiness
What to do:
- DKA requires immediate medical attention. Call emergency services or go to the ER. It’s life-threatening if untreated.
4. Hyperosmolar Hyperglycemic State (HHS)
HHS is a dangerous complication of type 2 diabetes that involves very high blood sugar levels, often over 600 mg/dL, without the presence of ketones. It is among the less common diabetic emergencies but potentially more dangerous.
Causes:
- Illness or infection
- Not drinking enough fluids
- Missed diabetes medication
Warning signs:
- Very high blood sugar
- Severe dehydration
- Weakness or confusion
- Seizures
- Coma (in extreme cases)
What to do:
- HHS is a medical emergency. The person needs IV fluids and insulin in a hospital setting right away.
5. Severe Hypoglycemia During Sleep
Also called nocturnal hypoglycemia, this occurs when blood sugar drops too low during sleep. It can be especially dangerous because symptoms may go unnoticed until severe.
Warning signs:
- Night sweats
- Nightmares or vivid dreams
- Waking up confused or feeling shaky
- Morning headache
- Unexplained fatigue during the day
What to do:
- Monitor blood sugar before bed, especially after exercise or alcohol
- Have a bedtime snack if needed
- Adjust medication with your doctor if episodes are frequent
6. Infections and Wounds
People with diabetes are more prone to infections due to weakened immune responses and slower wound healing, especially in the feet. Infections can worsen quickly and may lead to hospitalization or even amputation if untreated.
Warning signs:
- Redness, swelling, or warmth around a cut or sore
- Pus or drainage
- Fever or chills
- Numbness or tingling in the limbs (diabetic neuropathy)
What to do:
- Keep wounds clean and dry
- Check feet daily
- Seek prompt medical care for any infected area
7. Diabetic Neuropathy-Related Falls or Injuries
Loss of sensation in the feet or legs can lead to unrecognized injuries, balance issues, and falls, especially in older adults.
Prevention tips:
- Wear proper footwear
- Avoid walking barefoot
- Get regular foot exams
- Use assistive devices as recommended
When to Call Emergency Services
Seek immediate medical help if you or someone you know with diabetes experiences these diabetic crisis symptoms:
- Unconsciousness or seizures
- Difficulty breathing
- Severe vomiting or dehydration
- Blood sugar that doesn’t respond to treatment
- Sudden changes in mental status (confusion, drowsiness, delirium)
How to Prevent Diabetic Emergencies
You can take the following steps to prevent common diabetic emergencies:
- Regular Monitoring: Check your blood sugar as directed.
- Stick to Your Plan: Follow your diet, medication, and exercise routines.
- Stay Hydrated: Drink plenty of water, especially during illness.
- Stay Prepared: Always carry a source of fast-acting sugar. Have a plan for medication adjustments and when to call your doctor.
- Know Your Numbers: Learn your target blood sugar range and how to act on highs and lows.
- Educate Your Loved Ones: Make sure those around you know how to recognize and treat diabetic emergencies.
Final Thoughts
Understanding the common diabetic emergencies can mean the difference between a manageable situation and a life-threatening crisis.
If you notice the warning signs of diabetic emergency, head to the ER immediately. At ER Dallas, we’re equipped to treat these emergencies on the spot with IV fluids, insulin therapy, and close monitoring so you can recover safely and quickly.
FAQs
1. What is the most common diabetic emergency?
Hypoglycemia is the most frequent, especially in people using insulin.
2. How can I tell if it’s DKA or just high blood sugar?
DKA usually includes symptoms like nausea, vomiting, abdominal pain, and fruity-smelling breath along with high glucose and ketones.
3. Can HHS happen suddenly?
Yes. It can develop over several days, often during illness or dehydration, and requires urgent medical care.
4. How do I treat hypoglycemia at home?
Take 15 grams of quick carbs (e.g., juice), wait 15 minutes, and recheck blood sugar. Repeat if needed. Always follow your diabetes care plan.
5. Should I go to the hospital for high blood sugar?
If your blood sugar is very high and not responding to insulin or if you have signs of DKA or HHS, go to the emergency room immediately.
6. Can a diabetic emergency happen even if someone looks fine?
Yes. Symptoms can come on gradually or be masked until the diabetes complications are serious. That’s why regular blood sugar monitoring and recognizing subtle changes (like unusual fatigue or irritability) are important.
7. What should I do if I think someone is having a diabetic emergency?
If they’re conscious, give fast-acting sugar (like juice or glucose tablets) for low blood sugar. If they’re confused, vomiting, or unconscious, call 911 immediately. Don’t wait for symptoms to pass on their own.
