Diabetes is a chronic, life long disease that has multiple safety concerns. The most severe complication of diabetes is hypoglycemia, which, if untreated can lead to seizures and death. Hypoglycemia can result from a variety of situations, including; too much insulin, not enough food, too much exercise or a mis-match between the timing of insulin dose and food consumption.
HYPOGLYCEMIA
As someone who has diabetes, it is recommended that at all times you have some sort of hypoglycemia correction on you. Examples of this would be a drink box, a pack of gummy fruit snacks, fun size pack of skittles, glucose tablets. A quick sugar that is around 15 grams of carbohydrates. Candy such as chocolates are not recommended because the fat in them will decrease the absorption of the sugar, making it longer to bring the blood glucose back up.
The normal recommendations for hypoglycemia treatment are as follows:
If your blood sugar is under 70 mg/dl
15 grams of quick sugar
Recheck blood glucose in about 15-20 minutes, it should be coming back up
If you are still below 70, another 15 grams of quick carbohydrates is recommended.
If you are now above 70, then it is recommended you eat food with some more complex carbs so you do not drop back down once the quick sugars are used up. An example of this would be a piece of bread with some peanut butter or a few crackers with peanut butter
If your sugar is under 40 mg/dl
30 grams of quick sugar
Recheck blood sugar in 15-20 minutes
If you are still below 70, repeat with another 15 grams of quick sugars
If you are now above 70, then as above it is recommended that you eat some complex carbs like crackers and peanut butter or a piece of bread with a protein or fat
HYPERGLYCEMIA
When you have a blood sugar reading over 250 mg/dl it is recommended that you do a urine check for ketones
If ketones are positive, you should drink a lot water to help flush the ketones out
You must take corrective insulin and repeat blood glucose readings until you are sure it is coming down
It i also very important to do your best to not eat a lot of carbohydrates while the sugar is elevated, this will only make you more resistant to the insulin and will make it more difficult to get the sugar back down. It is hard, having a high sugar will make you crave food and sweets.
If you develop nausea and begin vomiting or are unable to keep fluids down, you need to go to the ER for IV hydration. Having ketones and being dehydrated puts you at extreme risk for electrolyte imbalances, which could also be fatal.
Ketones can cause a very serious condition called diabetic keto-acidosis. This occurs when the blood glucose level is elevated for a period of time and the body begins to break down fat and muscle to use as a source of energy. The bi-product of this is ketones, which if left untreated can lead to an acidic blood pH. This can be come life threatening quickly.
DRIVER SAFETY
Many people with diabetes are unaware that before driving they are required to check their blood glucose level to ensure they are in a good range.
Low blood sugars have a neurological effect on people and can cause confusion, disorientation, decreased reaction time, much like someone under the influence of alcohol. If you are in an accident and it is discovered that your blood sugar was low, you are at risk of losing your license.
If you have checked before driving and your sugar is normal, it is also recommended that you repeat your blood glucose check every 1-2 hours while driving to ensure that you stay in the normal range.
It is recommended that you always have on you a blood glucose meter and something to treat hypoglycemia. (you should have something for hypoglycemia on you at all times)
SICK DAY MANAGEMENT
When you are not feeling well, it is very important to continue to take you insulin. Although you may not be eating, remember the body needs insulin even without food. Taking your basal insulin if you have type 1 diabetes is a must. Without it your chances of going in to DKA are very much increased.
In addition, it is very important that you stay hydrated, dehydration will increase your risk of going into DKA
It is also extremely important to keep a close eye on your blood sugars, remember, infections can cause blood sugars to go up even without food and sometimes, when you do it, you may need more insulin then normal to cover the food
Remember to contact your healthcare provider if you are steadily running over 400 and are having trouble getting your glucose to return to normal.