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Be Prepared for Diabetes Emergencies

Here, with the help of Sandra Weber, MD, co-author of Diabetes 911: How to Handle Everyday Emergencies (American Diabetes Association, 2009) and the chief of endocrinology at Greenville Hospital System University Medical Center in Greenville, SC, we offer contingency plans to all-too-common diabetes problems.

The crisis:

You're on vacation, but your insulin has been left behind, lost or destroyed.

Fast fix: If you are away from home, call your home pharmacy and have your prescription transferred to any national pharmacy chain. You can also call your doctor and have your prescription emailed to or called in to a local pharmacy.

Plan ahead: When packing, keep a travel checklist that includes your diabetes supplies by your suitcase, and place those supplies in your carry-on luggage, not in a checked suitcase.

The crisis:

You are caught off-guard by a hypo- or hyperglycemic attack.

Fast fix: Since a hypoglycemic attack—when your blood sugar levels drop severely—can lead to loss of consciousness, you must act quickly. Eat a piece of candy or a tablespoon of sugar.

For a hyperglycemic attack—when your blood sugar levels spike—give yourself a correction dosage of insulin and monitor your blood sugar closely for the next two to three hours. In both cases, call your doctor as soon as possible.

Plan ahead: Test blood glucose levels on the schedule prescribed by your doctor. If you notice that your numbers are higher or lower than your target range for several days, let your healthcare provider know. A change in your medication may be needed, as well as a review of possible changes in diet, exercise routine or factors such as an illness.

The crisis:

You accidentally inject fast-acting insulin instead of long-acting insulin and start to feel sick.

Fast fix: If someone is with you, tell him or her what you did. If alone, call a friend or family member and ask that person to be on standby alert. Next, figure out how much carbohydrate you'll need to eat to counteract the dosage, or call your doctor to find out. Know how long your insulin will last and how often to monitor your glucose during this time frame. For most fast-acting insulin, the full effect will be complete in four to five hours.

Plan ahead: Try not to be alone when administering insulin, and always double-check your medication before using it.
Most pens and bottles are color coded, so check for both color and medication name. Know what the insulin looks like: Is it clear or cloudy? If you are still unsure, ask the person with you to also look to confirm your selection.

The crisis:

You have the flu and your blood sugar is out of control.

Fast fix: Check your blood sugar, but keep taking basal insulin even if you're sick and not eating. "It's important not to withhold all insulin," says Dr. Weber. "But only withhold mealtime insulin if you aren't eating." If you can't keep fluids down, you may have to go to the emergency room. Call your doctor to determine if you need immediate medical attention.

Plan ahead: Ask your diabetes-care team about a sick-day scenario. Be clear as to when you should continue treatment as usual, call your doctor or go to the hospital.

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