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    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Aug. 28, 2009

    Dealing with diabetes emergencies

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

30 comments posted

Ever forget your insulin? Or did your snacks get all eaten and then you had a severe low? A couple of summers ago we had a family vacation in Florida. Our son, who lived in South Carolina and has type 1 diabetes, mentioned that he forgot his insulin and these were his exact words: "Oh well, I guess I just won't eat."

Of course, I was horrified and told him that that wasn't an option. We went to the nearest pharmacy that was able to call and get his prescription. This was a good learning experience for him. No matter how well you may be prepared, diabetes emergencies happen. Here are a few tips that our family has learned along the way:

  • Have a backup plan in case you forget to bring your insulin or something happens to your insulin and you're not able to use it. In the United States, you can go to a pharmacy and they can call your doctor for a new prescription. U.S. insulin strengths are U-100 strength, while in foreign countries insulin may come in U-40 or U-80 strength. Check with a local healthcare provider for adjusted dose. If you need to use a different insulin, you'll need to buy new syringes to match the new insulin to avoid a mistake in your dose.
  • Snacks — When out with family or friends, snacks tend to disappear. To avoid a hypoglycemic emergency, it's a good idea to carry sugar tablets. My son has found that if he carries lifesavers or other candy, those tend to be eaten (by him). He finds it less tempting to snack on sugar tablets.
  • Always wear a diabetes medical ID bracelet or necklace — Information on the ID is invaluable to emergency medical personnel. If you are having a low and not able to communicate well, you can point to your ID. There are many attractive styles available.
  • Carry a bag/backpack with your diabetes supplies and keep it close to the door when leaving. My son calls his backpack his "man purse." Gotta have a sense of humor!
  • Did you get to work and realized that you forgot your insulin? — Ask your employer whether you can store an extra insulin vial/pen in a refrigerator.

Do you have a close call story? A frightening low? A time where you were caught unprepared? Please share your experiences and what you have learned.

Peggy

30 comments posted

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  • February 1, 2012 11:46 p.m.

    I forgot to add what I learned from my scary low this morning. I have learned that I need to start testing when I get up at 5 A.M. even if I feel ok, just to make sure!

    - Nicole

  • February 1, 2012 11:42 p.m.

    I have had some scary lows. I have been as low as 24 when I was pregnant with my daughter, I was home alone that day. I was able to quickly raise my blood sugar by drinking two glasses of orange juice. I usually always feel my lows when I start getting into the 60's/50's. I first get real shakey in my hands and legs, usually I can barely even write my hands shake so much, and my legs feel like they will give out on me and I will fall. But this morning I had a severe low that I didn't really feel my typical symptoms. Of course I was home alone again with my three year old. I take Lantus in the morning at 5 a.m. I get up take it and go back to bed for a couple hours before work. I didn't feel any symptoms of a low when I came down to take the Lantus this morning. I took it went back up to bed. When I laid down my heart was racing and I felt like I couldn't quite catch my breath. I figured it was because of going up the stairs. Finally because it did not stop at 5:15 I went in and checked and I was 34. Terrified I went downstairs and drank a huge glass of orange juice and ate four glucose tabs. I was sweating like I do when I get done with a run! I also was seeing this round circle of light, which has never happened before. I waited 10 min and checked again and it was 30, so I called 911 and could barely talk. I got enough out to say my name address and that I am diabetic, take insulin and I am 30. Then I hung up and called my mom. It was so scary, this was my first 911 call.

    - Nicole

  • January 16, 2012 7:54 a.m.

    We went to Jamaica for 30th anniversy. Later that evening we discovered my husband's Lantus insulin vials broke! We had an open vial that had enough for the night and next day. The resort had a medial office staffed with a nurse and had an oncall doctor. The doctor was able to locate the needed replacement vial by that eventing, and our trip went on as planned. We did take medical emergency insurance, due to my husbands medical issues. So, if needed he could have been evacuated back to the US. We were very happy that we did not need to use that extreme meaure. In planning our trip, we did not check if this resort had medical services, and were very happy that they did. In the future, this is another preparation that we will include in planning to travel.

    - Deb

  • October 20, 2011 11:04 a.m.

    Linda: Check with your endocrinologist. It is not uncommon for those with diabetes to have other endocrine disorders such as thyroid disease, etc, that can cause hair loss.

    - Nancy and Peggy

  • September 27, 2011 1:39 p.m.

    What about hair loss with type 2? I am looking balder by the day and it's miserable! After several years of not facing reality and avoiding treatment, I have brought my A1C down from 15.9 to 9.2!! Yahoo! The effort is paying off. I'm working hard to get it down more -- working with a great endocrinologist & his team. Thank God for good insurance! I just found out how much my test strips really cost. Any help on the hair loss? Mine is really BAD! Help!

    - Linda

  • July 26, 2011 2:07 a.m.

    recently my fiance and i had a huge scare. for four days he was having a hard time eating, he was tired, weak, and he wasnt stable at all. his eye sight kept going in and out and he was scared he was going blind. after the fourth day he woke me up and i called the ambulance. when we arrived at the hospital they took a blood test, came back in the room and hooked him to an insulin bag, his blood sugar level was 657. the doctors said he was on the verge of going into a diabetic coma. neither of us knew he had diabetes. he's active, leads a healthy life style eats well, and is all around healthy. his sugar levels were just checked 5 months ago and all was fine. i have diabetes in my family and i never thought he would be the one to get the news. i rarely hear about someone that leads a good lifestyle that gets diabetes. its horrible to think that it would take something like almost going into a coma to make us realize that it could have been diabetes.

    - Brianna

  • July 19, 2011 4:02 p.m.

    i was taking a bath and i got really sleepy and weak . when i got out i could hardly get to the bed. . when i did i took my sugar level it was 45 . when my husband came in i was very angry and irritated. and he wanted to give me someorange juice to bring it up . i actually tried to stop him by pushing it away. i was not expecting this reaction of so much anger and different personality. when i finally did take it i felt better right away. i fear that your mind does not think at all right during a extreme low . and is a very dangerous thing and i am glad i did get out of the bath and my husband did return home at the right time.

    - leslie

  • January 9, 2011 9:29 p.m.

    I'm a Type 2 diabetic, fairly well controlled if I behave myself. I just wanted to post an excellent suggestion for those of us who tend to go "hypo" with little or no warning ... carry a small tube of the icing they sell to write on cakes. I have them all over the house; they are much less expensive than the products you buy at the pharmacy. I asked my nurse practitioner about this, and she approved. It might not work for everyone, but there it is!

    - Diane

  • December 31, 2010 1:11 a.m.

    Has anyone experienced the following eating disorder in type 1 diabetes: Won't eat any food due to its color, smell, consistency, texture and prefers only carbs such as dry cereal, bread, crackers at times, chicken nuggets, pancakes, anything sweet, lots of water, stopped drinking anything but water. We've tried everything to get this child to eat nutritious foods but it's like something is not clicking in his brain that vegetables, fruits, meat tastes good. He won't even smell the food. His eating habits changed dramatically before age 2, and always very hyperactive, would never sit longer than a minute if that much. Therapy is definitely needed. Would medicaid insurance cover therapy? Diagnosed almost 3 yrs ago. I would be very interested in hearing from anyone with this problem.

    - Corine

  • November 13, 2010 10:46 a.m.

    Lisa- To my surprise when i went to Publix recently to pick up my RX for Metformin recently it was free

    - Kris

  • November 8, 2010 8:50 p.m.

    Yes, I thought I will share my experience as well. We were 25 mile away from where we stay and were house hunting.My husband who is a diabetic suddenly started to sweat a lot, I askem him to check and upon checking he was 38 and he said he had n sugar n no more strips, I quickly went to next house n explained the situation and asked the lady if i could get soda or orange juice. I fed him two can of soda and i small tetra pack of oj n there was no way of finding out the effects as he had no strips. We reached home after a hour ( wch seemmed like the longest hour i have spent in the car) We checken n found out that he was 190 ...it was high ...n it was the first time i didn mind him being at 190... i said 190 one day isnt going to kill u! This incident proved two things to us : Always double check n keep a box of strips n box of candies in the car n yes we cant live 25 miles away frm wrk....itz not an option for us

    - stuti

  • October 19, 2010 11:45 a.m.

    Lisa: First of all, talk with your healthcare provider. There may be another insulin that is much more affordable than the insulin you are using. Also, you might check with your county's public health service..they can help you to find the right resources for financial help.

    - Nancy and Peggy

  • October 12, 2010 11:59 p.m.

    I'm 53, a type 2 diabetic for 10 years now. I use insulin and the metformin pill. I also have neuropathy in my feet due to diabetes. Can someone please give me some advice? I have not taken my insulin or my diabetic pills (metformin) for a year now because I don't have insurance. I've been so terrified that something will happen to me, so I haven't been taking my readings. I took a reading last night and it was almost 400. I am so terrified of going into a diabetic coma. I do not qualify for medicaid. Please can someone please give me some advice?

    - lisa

  • September 29, 2010 4:17 p.m.

    My son is 40 (type 1 for just over 38 years). His symptoms of low blood sugar have changed over the years. When he was younger, he had pretty typical symptoms. He lived away from me for a number of years and is now back living with me. He has always been brittle and his blood glucose is quite low before symptoms appear. I had had to learn a whole new set of symptoms and behaviors when he move back with me. First one is not thinking clearly, then getting silly (like being drunk) then he gets muscle seizing which is quite painful and uncontrollable. I have learned to call 911 at the first sign of incoherence or silliness, since he is already beyond being able to cooperate and allow liquids or glucose to be administered to him. His threshold is quite low, so once any symptoms appear, the levels drop rapidly. He is usually down in the 30s before there is any noticable symptom, and by the time seizing occurs he is in the low teens. Be prepared has always been our motto and don't wait to call 911 for help if you are getting no cooperation from him.

    - Sara

  • September 28, 2010 2:08 p.m.

    My husband is an Insulin dependent type 2. I am a nurse (retired) and would like to share some toughts.Its never a problem if the sugar level goes up (temporarily) but NEVER let it go to a hypo.Its life threatening. When in doubt, mix 2 teaspoons of sugar in a half glass of water.ALWAYS carry sugar cubes in your pockets, purse, any way you can store. DONT PANICK!! If you are in an ofice and you see the patient sweating, lips and ear lobes becamimg pale, may or may not be confused, ask immediately for the sugar/water from anyone in the office, store, private home, etc..you will always get it.REMEBER, however, after the sugary drink, to eat some protein (cheese) and a carb (bread, crackers) in order to balance the sugar level which went up due to the sugar. TEACH the patient how to behave if he is alone and the symptoms of hypo appear. Some times, I use honey by the tablespoon (I give him the jar) it absorbs fast, not only it raises his sugar (momentarily) but it also provides the pleasure of eating something he never eats.Same for sugary ice cream, jam etc.. IMPORTANT to remember: a diabetic is not an invalid.He can live normal life (with proper medications) all it takes is LEARNING how to live with the disease. My very best to all, Rena (Israel)

    - Rena

  • August 16, 2010 3:50 p.m.

    I have an A1C of less than seven. I have recently stopped taking avandia - where's there smoke there's fire - and I'm trying to get a better handle on my diet. I am a half active (I work 50 hours a week, but walking is my only real exercise) 66 year old male. I can get exchange lists at a hundred web sites, but I have yet to find even one that gives some sensible advice on how many of which exchanges I should eat to lose weight and control my blood sugar. There must be a rule of thumb...

    - Bob

  • May 18, 2010 7:19 a.m.

    i was diagnosed with type 2 over 3 years ago, have been fine until recently, now i seem to have hypos in the morning, and just today had one in my college class, I am 45 and wondering if this is the start of menopause and this is affecting my glucose levels. Anyone else had this.

    - shirley(uk)

  • May 17, 2010 2:50 p.m.

    I was driving home from picking up my daughter and her friend. My blood sugar dropped. I felt like I was going to faint. I made it home and immediately had some juice and some watermelon. I later contacted my doctor, and he suggested I get some sugar tablets to have on hand in case it happens again. I am not on insulin, but I do take medication to manage my glucose levels.

    - Vicky

  • May 14, 2010 2:37 a.m.

    I've been a Type 1 diabetic for 28 years and have had many emergency situations (the most spectacular one was probably collapsing in the departure lounge at Changi Airport in Singapore, missing the flight and staying in the clinic there for 24 hours!). I have three pieces of advice for what they are worth: 1. Know yourself. Know your symptoms (mine are sweating and confusion at the moment). If you think you might be having a hypo, you probably are. 2. Keep liquid glucose to hand. You can buy tubes with a top you can snap off (useful in a bad situation) which delivers a perfect 15g. In Australia they are called 'Glutose 15'. Family can easily administer this without worrying about the right amount, and it works almost instantly. 3. It is a good idea to wear an SOS necklace or bracelet with (at least) your type of diabetes. This is the first thing they looked for in Singapore given I was fitting. It speeded things up. I am in perfect health despite these dramas which are extremely rare! Just sharing what I've learned.

    - Katie

  • March 16, 2010 6:32 p.m.

    I am terrified..... I have been having problems for a few years now, all indicates diabetes but because I do not have health insurance, doctors wont do the testing and when I have had to go through ER they send me right back out. I have developed severe rash over my entire body, have liver, thyroid, numbness in hands and feet, cold all the time, etc., I can no longer leave my house and most days can not even get out of bed. So scared and worried that it is going to come down to an emergency situation and that it will be too late. I am suffering and my family is suffering, I am only 42. I have already told my family that if I die, they are to do what ever testing to figure out the cause. Doctors have let me slip through the crack and have left me to suffer in the worst way.

    - LeeAnn

  • February 5, 2010 8:49 a.m.

    My husband is Type 2 and had a frightening low. He was on 30/70 insulin & his numbers were all over the map. His worst low was 1.9 (Canadian) & although I knew how to treat him I was doing so with the phone in 1 hand to call 911. It took about 1/2 an hour to get him back to normal but it was very scary. His mood changes when he's low and he's very cranky. I know not to react to that mood as it's caused by his low. We keep glucose tabs everywhere & I know how to use his meter as well as when to test during a low. It's hard to believe a person can sweat from every pore in their body and the extreme exhaustion of the low. Now switched to NovoRapid & Lantus and control much better. Next time he hits a low like that we now have glucagon to inject and I WILL call 911. We have the education & tools to do it ourselves but better to have the pros there just in case!

    - Lorna

  • February 3, 2010 6:09 p.m.

    I have type 2 and take 1--1000MG tablet daily Once had some kind of reaction. It seemed I was debating deep in my mind unaware of anything or anybody. The person i was talking to got angry, I don't know why. Help.

    - Dolly

  • January 26, 2010 2:02 p.m.

    No name given, I would see your doctor as soon as possible. Over medicating is a concern and so is the hair loss.

    - Nancy and Peggy

  • January 23, 2010 1:20 a.m.

    I am a fairly new type 3 diabetic. I must admit that I have not had much education on diabetes but have been having issues that I am researching. I can always tell when my sugar gets too low because I get light headed and sick to my stomach fairly guickly. Recently I experience a real low while sitting in christmas traffic and woke 3 times at the same stop light. Luckly I had eaten a breath ment or two but not soon enough. I made it to the parking lot whereby I woke up in my care a little bit later( approx 25 min). I have had two more similar situations, one being tonight where I didn't get the sick feeling first just felt my brain stop for a few seconds. I guickly took my sugar 113 and within a few minutes it was in the lower 70's. I got out the warning but was gone by the time my husband showed up with help. So..because I have not had blood sugar over 141, even after a meal sense I started my pills, I am now concerned that I am on too much medicine and it is knocking me out from my second dose in the evening. Also I am experiencing a tremendous amount of hair loss. and I mean alot alot. In the last 3-4 months I have probably lost half my hair, but I have (had) thick thick hair prior. Now I am worried becasue it is not slowing down. Suggestions? I started omega' 3 fishoil and sea kelp to help slow it down but my understanding is it will take a few months to turn the hair loss around. Also my insurance company will not cover diabetic classes..where do I go now?

    - No name given

  • January 9, 2010 9:40 a.m.

    My father has type 2 diabetes and my mother and I are still learning how to take care of him. He also has other health issuse such as severe nerve damage, and cronic pain syndrome. I was told these also could affect his sugar level, but I also learned he was not checking his count every day. I need more information on how to help my parents. Diet, counting intake and so forth would be helpful. He runs a low blood level from what I saw, it was 66 last night.

    - Olivia

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