1. Hypo and Hyperglycemia
Diabetic Emergencies
Hypo and Hyperglycemia

2. What Affects Your Blood Sugar?
What is hypoglycemia & hyperglycemia?

3. Learning Points Know signs of high blood sugar (hyperglycemia)
Know the signs of low blood sugar (hypoglycemia)
Know what to do when sugars are too high or too low

4. Your Blood Sugar: Hyperglycemia or High Blood Sugar
Symptoms
Extreme thirst
Frequent urination
Dry skin
Hunger
Blurred vision
Drowsiness - may progress to coma

5. Your Blood Sugar: Hyperglycemia or High Blood Sugar
Causes
Too much food
Too little insulin or diabetes medicine
Illness
Stress
Onset
Gradual
If extremely high or you have type 1 diabetes it may progress to diabetic coma

6. Your Blood Sugar: Hyperglycemia or High Blood Sugar
What can you do when you have symptoms?
Test blood glucose more often**
Don’t wait, call your doctor if your blood sugar is over 240mg/dL for several tests or for 2 days
**If your meter reads HI or your reading is higher than your usual – wash your hands and retest.

7. Hyperglycemia
Type 1 –If blood glucose over 240 mg/dl check for ketones (urine). (Possible Diabetic Ketoacidosis (DKA) If ketonuria - call your health care provider or seek emergency care – call 911
Type 2 Blood glucose can go very high (.600) without ketones in the urine:
Altered mental status/confusion to
Hyperosmolar, Hyperglycemic Syndrome (HHS) – Seek Emergency Care (911)

8. Your Blood Sugar: Symptoms of Hypoglycemia
Shaking
Fast heartbeat
Sweating
Dizziness
Anxiety
Hunger
Impaired vision
Weakness/fatigue
Headache
Irritability

9. Your Blood Sugar: Hypoglycemia or Low Blood Sugar
Causes
Too little food
Too much insulin or diabetes medicine
Extra activity or exercise
Onset
Sudden
May progress to unconsciousness, confusion, or insulin shock

10. Your Blood Sugar: Treatment of Hypoglycemia
4 Steps to treating your blood sugar:
Quick sugar, 10 to 15 grams carbohydrate
Recheck blood glucose in 15 to 20 minutes and repeat treatment if necessary
If your glucose is normal, eat a protein meal or snack
If you have symptoms, but BG is over 70, have snack
*Treat all sugars under 70 mg/dl (with or without symptoms)
*If you have symptoms, but no meter, treat and try to be prepared and have meter with you the next time.

11. Hypoglycemia or Low Sugar: Step 1- 10 to 15 Grams of Carbs Pick One of these
5 to 8 Life Savers®
1/4 to 1/3 cup raisins
4 oz. orange juice
8 oz. milk
Choose one.
Raises glucose 30 to 45 mg/dl
Do not keep eating until symptoms disappear
2 to 3 Glucose Tablets
½ can of regular soda
3 to 5 peppermint candies

12. Hypoglycemia or Low Sugar: Step 2- Recheck Blood Sugar

13. Hypoglycemia or Low Sugar: Step 3- Eat a protein snack Pick One
½ meat sandwich
peanut butter sandwich or crackers
crackers & cheese

14. Hypoglycemia or Low Sugar: Foods to avoid for lows
Potato Chips
Doughnuts
Chocolate
Pizza
Cookies
Nuts
Ice Cream
Cake

15. This is a medical emergency
Severe Hypoglycemia
Elderly people, those that take oral medicines such as sulfonylureas that stimulate the Beta cells to release more insulin or those people who are on insulin are more likely to develop severe hypoglycemia ,
If symptoms of low blood sugar go unnoticed, your brain deprived of glucose, you can become confused, incoherent and may lose consciousness.
This is a medical emergency

16. Severe Hypoglycemia Have an emergency plan in place
Wear identification such as a medical alert braclet stating you have diabetes and the med you take.
Carry your meter with you and test
If you don’t have a mete with you, treat the symptoms
Carry glucose tablets with you
Tell a friend, instruct your family about the signs of hypoglycemia and what to do.-First - call 911.
If you are prone to hypoglycemia you will need to teach someone how to inject Glucagon.
Glucagon is a hormone produced by the alpha cells of the pancreas. Glucagon raises blood sugar. Available by prescription and must be injected.