Headaches, fatigue, difficulty concentrating – what looks like the harbingers of a cold can often be a serious indication of hypoglycemia in people with diabetes. If a “hypo” is not recognized and treated in time by the person affected, it can lead to severe hypoglycemia with unconsciousness or even seizures. The patient is then absolutely dependent on outside help.
Diabetics should have glucagon emergency kit
Insulin-dependent people with type 1 diabetes are at greatest risk for severe hypoglycemia. But people with type 2 diabetes are also at risk – whether they are treated with insulin or blood sugar-lowering tablets. Every diabetic prone to severe hypoglycemia should therefore be informed about what to do in an emergency and have at least one emergency glucagon kit. “To be well prepared for severe hypoglycemia, every insulin-dependent diabetic should have at least one glucagon emergency kit,” explains Prof. Dr. Thomas Haak of the Diabetes Center Mergentheim. “It is even more advisable to store several emergency sets in a cool place, for example at home, at work, or in kindergarten or school – then the patient is fully prepared.”
What is glucagon and how is it administered?
Glucagon is a hormone that, when blood glucose is extremely low, causes the body to release sugar reserves and allow blood glucose levels to rise again within a short time. In the event of severe hypoglycemia, it is injected so that blood glucose levels rise again quickly. Relatives, work colleagues and acquaintances can then administer the necessary glucagon injection themselves if the worst comes to the worst. Important: They must always know where the emergency kit is kept and should be trained in its use. Then fast and correct action is possible in an emergency.
Many patients often inadequately prepared for severe hypoglycemia
Injecting too much insulin, skipping meals, exercising an unusual amount, or drinking alcohol excessively – these are all reasons that can lead to hypoglycemia in diabetics. Hypoglycemia is still the most common “side effect” of diabetes therapy with insulin or blood glucose-lowering tablets and is characterized by a drop in blood glucose levels below normal. But “hypo” is not just “hypo”. Depending on the symptoms that become apparent, a distinction is made between mild and severe hypoglycemia. Not all “hypo warning signs” have to occur at the same time. They can vary greatly from person to person and are often perceived differently. Thus, with frequent hypoglycemia, the body adapts to the low blood glucose levels, and timely perception may become worse.
What to do in mild and severe hypoglycemia?
In principle, the following applies: in the case of mild hypoglycemia with symptoms such as sweating, racing pulse or ravenous hunger, the patient can help himself: In most cases, just a few tablets of glucose or a glass of a sweetened drink (no “light products”) are enough to raise blood glucose levels again. Slight hypoglycemia is unpleasant but harmless. It only becomes critical when the first signs of hypoglycemia are not noticed or heeded and the blood glucose drops below 50 mg/dl or 2.8 mmol/l. Then a severe sugar deficiency develops in the brain, which can lead to symptoms of paralysis, cramps or even unconsciousness – and in the worst case is even life-threatening. In this phase, the person with diabetes is absolutely dependent on outside help, for example in the form of a glucagon injection.
Glucagon emergency kit to be used correctly in case of emergency
The emergency kit should be stored in a cool place at +2 ºC to +8 ºC. It is advisable to take it with you on hikes, bicycle tours or on vacation. In an emergency, the glucagon powder is dissolved in water and then injected either under the skin or into the muscle. Regardless of whether it’s relatives, friends, work colleagues or teachers – everyone in the immediate vicinity of a person with diabetes should always know where they keep their emergency kit, when it’s needed and how to handle it.The prerequisite is that the doctor or diabetes team provide comprehensive information and training to those affected in advance: they explain the causes and symptoms of hypoglycemia, teach the correct handling of the emergency kit and provide appropriate information materials. “Because only those who are well informed and trained can act quickly and correctly in an emergency,” says Haak. As soon as the patient regains consciousness, he should take “fast energy” in the form of glucose and “slower energy” in the form of bread. “If the patient still does not regain consciousness, an emergency physician must be alerted immediately,” Haak explains. “This also applies if the situation is not clear or you are unsure.”
