MEDICAL PROBLEMS - Diabetes
 
Diabetes Mellitus is a condition in which the body fails to regulate the concentration of sugar (glucose) in the blood. There are two main types of diabetes: Type 1, or insulin-dependent, is the more severe form of the disease. Type 2, or adult onset, is the more common form and accounts for more than 85% of all cases. Diabetes cannot be cured, but it can be controlled. Control requires carefully regulating one's diet, regular exercise, and, if necessary, insulin. Blood-sugar levels are normally controlled by a hormone (insulin) produced by the pancreas. Without insulin, sugar accumulates in the blood, and can cause hyperglycaemia. Diabetics must carefully balance the amount of sugar in their diet and regulate their blood sugar with insulin injections or tablets; too little sugar or too much insulin can cause hypoglycaemia.

Most diabetics are aware of the risk of hypoglycaemia if, for example, they miss a, meal or over-exert themselves, and may carry sugar lumps or glucose tablets to raise their blood-sugar level quickly.
 

Hyperglycaemia
Prolonged high blood sugar can result in unconsciousness and then diabetic coma, although a diabetic often drifts into this state over a few days. The condition requires urgent medical treatment with insulin and intravenous infusion of fluids.
 
Signs & Symptoms
  • Dry skin and rapid pulse
  • Deep laboured breathing
  • A faint smell of acetone (as in nail varnish remover) on the casualty's breath
Treatment
Call 999 - the casualty should be removed to hospital urgently.
For a conscious casualty:
  • Keep calm and reassure the casualty
  • Let the casualty adopt the position that's most comfortable
  • Ask him to breath slowly and deeply
For an unconscious casualty:
  • Open the airway and check breathing - see right
  • If the casualty starts to vomit place him in the recovery position
  • Constantly monitor the situation: record breathing and pulse every 10 minutes
  • Be prepared to resuscitate if necessary

Hypoglycaemia
During hypoglycaemia, when the blood-sugar level falls below normal, brain function is affected rapidly. This can occur in sufferers of diabetes mellitus and, more rarely, accompany an epileptic fit or follow an episode of binge drinking. Hypoglycaemia can also complicate heat exhaustion or hypothermia.

Diabetics may carry their own blood testing kits with which to check their blood sugar-levels, and are usually well prepared for emergencies. If the "hypo" attack is advanced however, consciousness may be impaired or lost.
 
Signs & Symptoms
  • A history of diabetes; the casualty will sometimes, but not always, recognise the onset of a "hypo" attack
  • Weakness, faintness or hunger
  • Palpitations and muscle tremors
  • Strange actions or behaviour; the casualty may seem confused, belligerent or may even be violent
  • Sweating
  • Pallor
  • Cold, clammy skin
  • A strong, bounding pulse
  • A deteriorating level of response
  • Shallow breathing
  • A diabetic's warning card (medic-alert) or bracelet, sugar lumps, tablets, or an insulin syringe (which may look like a pen) among the casualty's possessions
Treatment
For a conscious casualty:
  • Help the casualty to sit or lie down and give him a sugary drink, sugar lumps, chocolate or other sweet food
  • If he responds quickly, give more food or drink and let him rest until he feels better. Advise him to see a doctor - even if he feels fully recovered
For an unconscious casualty:
  • Open the airway and check breathing - see above
  • If the casualty starts to vomit place him in the recovery position
  • Constantly monitor the situation: record breathing and pulse every 10 minutes
  • Be prepared to resuscitate if necessary

 
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