Sweet as Sugar

posted 01/02/2009
Diabetes is a very misunderstood disease. When someone is said to be diabetic, it means that they no longer produce sufficient insulin to help to metabolize sugars which are eaten. Some people produce insulin but become resistant to their own insulin as well. Some women will develop "gestational" diabetes while they are pregnant, which usually resolves after the baby is born.

Some diabetes is controlled with diet and exercise alone. Some require the use of oral pills that help the body to produce more insulin. Severe diabetics require the self-injection of insulin with careful blood sugar monitoring several times per day. People who take insulin shots can go into Diabetic/Insulin Shock called hypoglycemia or low-sugar. This occurs when there is plenty of insulin but not enough sugar to metabolize.

The person may give themselves a shot, but then forget to eat enough afterwards. The blood sugar level drops rapidly, and the person can become unconscious quickly. Their skin in cool and clammy and the person may appear to be in shock. The treatment is SUGAR and NOT more insulin. Giving them an insulin shot will actually make them worse. Never give insulin to an unconscious person under any circumstances.

Call 9-1-1 immediately, because they will likely need an intravenous form of sugar which will immediately awaken them. Unless they are AWAKE and ABLE TO SWALLOW, do NOT put anything in their mouth. If they are able to sit and swallow, give them very concentrated forms of sugar to drink. Do not allow them to eat anything solid.

If unconscious or semi-conscious, roll them onto their side (coma position) to allow them to maintain their own airway. Some insulin dependent diabetics might carry a special “Glucagon pen” which requires training to administer into a large muscle. If you have been trained in the use of this pen, by the person, then administer the shot as directed.

Keep calm, keep them warm, and don't panic. Help is on the way.

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Chief Jim Cole from San Juan Island EMS has been a Nationally Registered Paramedic for more than 20 years and holds a Bachelor of Science Degree in Community Health and a Master of Art Degree in Higher Education. He is designated as a Chief Medical Officer by the Center for Public Safety Excellence and is a Senior Wilderness Medicine Instructor with the SOLO School of Wilderness and Emergency Medicine. Suggestions for future topics can be sent to chief@sanjuanems.org.