Diabetes First Aid Work Instruction

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TOPIC Diabetes First Aid
Domain Governance TYPE Procedure

Causes of hypoglycaemia

Hypoglycaemia can be caused by one or a number of events, such as:

  • Too much insulin or other glucose lowering diabetes tablets

  • Delaying or missing a meal

  • Not eating enough carbohydrate

  • Unplanned physical activity*

  • More strenuous exercise than usual*

  • Drinking alcohol – the risk of hypoglycaemia increases, the more alcohol drunk.

*Hypoglycaemia may be delayed for 12 hours or more after exercise.

Symptoms

Symptoms of hypoglycaemia vary from person to person. Early signs and symptoms may include:

  • Shaking, trembling or weakness

  • Sweating

  • Paleness

  • Hunger

  • Light headedness

  • Headache

  • Dizziness

  • Pins and needles around mouth

  • Mood change

If the BGL continues to drop, more serious signs and symptoms may occur.

Later signs and symptoms of hypoglycaemia may include:

  • Lack of concentration/ behaviour change

  • Confusion

  • Slurred speech

  • Not able to treat own hypo

  • Not able to drink or swallow

  • Not able to follow instructions

  • Loss of consciousness

  • Fitting/seizures

Hypoglycaemia can be classified as mild or severe. A mild hypo occurs when a person can treat their own hypo. A severe hypo occurs when a person needs help from someone else to treat their hypo.

Treating hypoglycaemia

If possible, confirm that the symptoms are due to hypoglycaemia by performing a finger-prick blood glucose level (BGL). If you can’t check the BGL, treat it as a hypo, just in case.

If the BGL is below 4 mmol/L:

Step 1:

Have 15 grams of fast acting carbohydrate such as:

  • 6-7 jellybeans OR

  • 1/2 can of regular soft drink (not ‘diet’) OR

  • 1/2 glass of fruit juice OR

  • 3 teaspoons of sugar or honey OR Glucose tablets equivalent to 15 grams carbohydrate.

Step 2:

Wait 15 minutes, re-check the blood glucose levels to see if the BGL has risen above 4mmol/L:

  • If the BGL has risen above 4mmol/L go to Step 3.

  • If the BGL is still below 4mmol/L, repeat Step 1.

Step 3:

Eat a snack or meal with longer acting carbohydrate such as:

  • A slice of bread OR

  • 1 glass of milk OR

  • 1 piece of fruit OR

  • 2-3 pieces of dried apricots, figs, or other dried fruit OR

  • 1 tub of natural low fat yoghurt OR

  • Pasta OR

  • Rice.

What happens if I don’t treat hypoglycaemia?

If not treated quickly, the BGL can continue to drop, which may result in the brain not getting enough glucose. This can cause unconsciousness or fitting.

What to do if the person is unconscious, drowsy, or unable to swallow

If a person with diabetes is unconscious, drowsy, or unable to swallow THIS IS AN EMERGENCY call 000.

Do not give them any food or drink by mouth, treat as follows:

  1. Place them on their side making sure their airway is clear.

  2. Give an injection of Glucagon if available and only if you are trained to give it.

  3. Phone for an ambulance (dial 000) stating the person is unconscious AND that the person has diabetes.

  4. Wait with them until the ambulance arrives.

What is glucagon?

Glucagon is a hormone which raises the BGL. It is injected into a muscle to reverse severe hypoglycaemia in people with diabetes. The consumer may have this on hand in case of a severe ‘hypo’, their GP for diabetes Educator should have shown them or their family, carer how to give the injection.

Diabetes Australia; https://www.diabetesaustralia.com.au/living-with-diabetes/managing-your-diabetes/hypoglycaemia/

Hyperglycaemia means high blood sugar level, this can develop over many hours or days.

Many people do not experience the symptoms of hyperglycaemia until their blood sugar levels are extremely high. Although their blood contains too much sugar, they cannot tell unless they do a finger prick test.

Symptoms

  • Feeling excessively thirsty

  • Dehydration

  • Abdominal pain, nausea, and vomiting

  • Frequently passing large volumes of urine

  • Feeling tired

  • Blurred vision

  • Infections (e.g., thrush, cystitis, wound infections)

  • Weight loss.

Common Causes

  • Sickness

  • Infection

  • Stress

  • Too much carbohydrate food at once

  • Not enough insulin or diabetes tablets

  • Other tablets or medicines.

Treatment

For people with type 1 diabetes

  1. Contact the consumers authorised representative or advise the consumer to contact their GP or Diabetes Educator (for advice about increasing the dose of short acting insulin. The consumer may also need extra doses of this insulin (e.g., 2-4 units every 2 hours).

  2. Test blood glucose levels: they need to be checked frequently, as well as urine for ketones every time they pass urine.

  3. Get the consumer to drink extra water or low-calorie fluids to keep up with fluid lost by passing more urine.

Contact the consumers GP (with consent) or call 000 if:

  • Vomiting stops the consumer from drinking and makes eating difficult

  • Blood glucose levels remain high

  • Moderate to large ketones are present in the urine.

In type 1 diabetes, high blood glucose levels can progress to a serious condition called Ketoacidosis.

For people with type 2 diabetes

It is normal for blood glucose levels to go up and down throughout the day. An occasional high blood glucose level is not a problem. But if the consumers blood glucose level remains high for a few days or if they are sick, contact the consumers GP or Diabetes Educator (with their consent) or authorised representative and inform mobility.

If not treated, high blood glucose levels can be dangerous and lead to Diabetic Ketoacidosis. Find out more here: https://www.diabetesaustralia.com.au/living-with-diabetes/managing-your-diabetes/ketoacidosis.

 

Document History

Reviewed by:          Clinical and Risk Specialist

Authorised by:         CEO

Date Adopted:

Next Review Due:

 

Version Control

Version Date Change
1 10/4/22 New

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