Hypoglycemia in diabetes
Although diabetes mellitus is a chronic and also incurable disease, the restrictions in everyday life are minimal. After the disease has been diagnosed by a doctor and one has been adjusted to the disease with appropriate medication, one can go about one's life in the usual way. At least, the disease does not cause any chronic complaints that would impair one's life in such a lasting way that one would have to give up hobbies or profession. However, there are very few medical emergency situations that can be attributed to diabetes mellitus, including hypoglycemia.
Diabetes primarily means a deficiency of the body's own hormone insulin, which is a messenger responsible for supplying the cells with energy or transporting sugar from the blood into the cells. After the patient has been adjusted with various medications, this function will be balanced as far as possible. However, in extreme, strenuous situations, physical changes or simply negligent use of the medication, an insulin deficiency or surplus can affect the organism.
What happens during hypoglycemia?
One such case is the so-called hypoglycemia. In this situation, the blood glucose level drops to a value below 50 mg/dl. Every diabetes patient who is treated with insulin can get into this situation. Hypoglycemia is primarily triggered by an insulin dose that is too high, unusual physical stress, or insufficient food intake.
The signs
The diabetes patient will definitely notice such hypoglycemia. The symptoms are sweating, trembling, palpable palpitations, nervousness, headaches, ravenous appetite, dizziness or concentration and visual disturbances, as well as mild neurological deficits (reduction in fine motor skills).
The reaction of the body
The body reacts to such hypoglycemia by releasing the stress hormone adrenaline, which, among other things, mobilizes the storage sugar in the liver. If this body reaction is not sufficient, hypoglycemic shock with a complete loss of orientation and signs of paralysis can occur.
The measures
To prevent this condition from becoming life-threatening, the following measures should be taken:
- Immediately call the emergency physician (112).
- If unconscious, perform the recovery position.
- Do not give food or drink because of the risk of choking.
- If necessary, remove dentures.
It is possible for a diabetes patient to carry an emergency kit containing glucagon injections that are injected intramuscularly into the thigh. However, only the patient may do this; unless you have written permission to do so. Once the patient regains consciousness, immediate relief with dextrose may be attempted. After such a medical emergency, the diabetic patient should in any case discuss with his or her physician the medicinal adjustment of his or her diabetes.
It is important to be prepared!
Even if you are reluctant to think about such "worst-case scenarios", it is worth being prepared. It may be advisable to talk to a doctor who can give the patient some tips on which symptoms to expect in which situations and how best to react to them. Such conversations could possibly sharpen awareness and cause the patient to sit or lie down as a precaution when dizziness and sweating occur, rather than waiting to collapse unconscious and possibly inflict unnecessary injury by such a fall. Also, an emergency kit with glucagon shots, some glucose, and an instruction card for first responders might be useful. Such information can cause a first aider to give important information to the rescue control center already when making an emergency call. Likewise, it is certainly advisable to familiarize family members or life partners with the emergency aid in such a situation. Such clarifying conversations will certainly help to avoid panic or "unnecessary" worry.
How can such emergencies be avoided?
Even though hypoglycemia is certainly not fatal if emergency care is provided quickly and correctly, a medical emergency should never be underestimated or taken lightly. Especially in scenarios for which one can prepare, one should do so within one's means. This includes not only being sensitive to symptoms, but also and especially avoiding situations that favor or trigger such an emergency. In the case of hypoglycemia, for example, this would be vigorous physical exertion on an empty stomach or heat. Such things can be avoided. Insofar as other people are involved in possibly bringing about such situations, one can also tell these people why one considers this or that activity unfavorable. In case of doubt, one's own health is most certainly in the foreground and everyone will most certainly be able to sympathize with such prudence.
After the emergency always a visit to the doctor
If the emergency has occurred, you do not necessarily have to expect to end up in a hospital as an inpatient. In most cases, hypoglycemia can be treated on an outpatient basis. This means that the patient is discharged home after recovery and can continue his or her life in the usual way. However, since hypoglycemia also always suggests that the diabetes may not be completely properly controlled with medication, an emergency must always and absolutely be followed by a visit to the attending physician. Hypoglycemia remains an emergency and is by no means so "normal" that one must expect it at any time. A visit to the doctor will therefore also give the patient the feeling of security that such an emergency will not be repeated if possible.
Take symptoms seriously!
Even if a medical emergency does not make its way into the appointment calendar in the morning, in most cases a patient is not taken by surprise. The aforementioned symptoms are noticeable and, with a modicum of common sense, can be properly assessed. If a diabetes patient completely ignores such symptoms or pays no attention to them, no amount of fine words or helpful tips will help. Ultimately, therefore, this is also where personal responsibility for dealing with one's illness comes into play. This includes not only the speed of reaction to possible symptoms, but also the possible avoidance of situations that trigger such an emergency.
If you take all this to heart, you will certainly manage without such an emergency, because hypoglycemia is by no means part of the agenda of the course of the disease diabetes mellitus. Hypoglycemia is an exceptional situation that does not have to occur in every patient. And certainly not if the patient faces his disease with prudence and reason.
What to do in case of doubt?
In case of doubt, you can always have a conversation with your doctor to discuss which activities or "hikes" could possibly be dangerous. The doctor will be able to define his patient's physical resilience more reliably than the patient can with the help of the Internet and a healthy dose of overconfidence. Ultimately, diabetes mellitus remains a disease whose course can be controlled through constant communication with a treating physician. Depending on the patient's physical requirements or changes, the medication can then also be "readjusted" if necessary to avoid emergencies.
A diet, intense exercise, poor diet or alcohol consumption can cause hypoglycemia even in healthy people. Shivering, cold sweats, increased heartbeat and hunger are the symptoms. But the organism of the healthy person activates mechanisms that release glucose from the liver, causing blood glucose levels to rise again. </p>
Symptoms of impending hypoglycemia include profuse sweating, rapid heartbeat, weakness, hunger, dilated pupils, and tremors of the whole body. If the blood glucose level continues to drop, severe headaches, difficulty concentrating, and disturbances of speech and vision may occur. In advanced hypoglycemia, increased aggression, loss of consciousness, seizures, and coma may occur. </p>
If the symptoms of hypoglycemia are not responded to in time with the administration of sugar, the condition worsens; loss of consciousness, seizures and coma can occur. The diabetic can no longer help himself. If no help comes from outside in this case, the liver releases its sugar precursors and the patient wakes up again after several hours of unconsciousness. However, this protective function can be blocked by alcohol, since liver function is impaired by alcohol. In this case, and also in very severe hypoglycemia, death can occur without outside help. </p>
