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Diabetic emergencies: first aid

Emergency numbers differ by country. This page uses 911, the number for the United States and Canada. Many other countries use 112, 999, or another number. Find the number for your country.

Diabetic emergencies occur when blood sugar levels drop too low (hypoglycemia) or rise too high (hyperglycemia). Low blood sugar is a fast-acting emergency that requires rapid response.

Do this now

  1. If the person is conscious, awake, and able to swallow, give them fast-acting sugar right away (fruit juice, soda, candy, or glucose tablets).
  2. If the person is unconscious, confused, or unable to swallow safely, do not put food or liquid in their mouth.
  3. Call your local emergency number (911 in the United States, 112 in Europe, 999 in the United Kingdom) immediately if they lose consciousness or do not recover within 10 minutes after sugar.
  4. Keep an unconscious person lying on their side in the recovery position to keep their airway clear.

Low blood sugar (Hypoglycemia)

Low blood sugar can happen rapidly in minutes. It occurs when a person with diabetes takes insulin or medication but skips a meal or exercises heavily.

Symptoms: - Shakiness, sweating, and pale, cold skin. - Irritability, anxiety, or sudden mood changes. - Confusion, dizziness, and difficulty speaking. - Rapid heartbeat and hunger.

Treatment: Give 15 to 20 grams of fast-acting sugar, such as: - 120 milliliters (4 ounces or half a cup) of fruit juice or regular (non-diet) soda. - 3 to 4 glucose tablets. - 5 to 6 jelly candies or 1 tablespoon of sugar dissolved in water.

Wait 15 minutes. If they still feel shaky or confused, give another 15 grams of sugar. Follow up with a meal or snack like bread, cheese, or milk once they recover.

High blood sugar (Hyperglycemia)

High blood sugar develops slowly over hours or days. It happens when insulin is missed or during illness.

Symptoms: - Extreme thirst and frequent urination. - Fruity or sweet-smelling breath odor. - Dry mouth and flushed, warm skin. - Drowsiness, shortness of breath, or nausea.

Treatment: Encourage the person to check their blood sugar using their meter. If levels are dangerously high, help them locate their prescribed insulin or medical plan, and seek prompt medical attention.

When to call emergency services

Call 911 or your local emergency number if:

  • The person becomes unresponsive or faints.
  • The person has a seizure.
  • Blood sugar levels remain low after two rounds of fast-acting sugar.
  • You are unsure whether blood sugar is high or low and the person cannot answer questions clearly.

... note "The rule of safety" If you cannot tell whether a conscious diabetic person has high or low blood sugar, medical guidelines recommend giving fast-acting sugar. Low blood sugar is immediately dangerous, and a small amount of sugar will not harm high blood sugar temporarily.