WHEN SHOULD A PERSON WITH DIABETES GO TO THE HOSPITAL


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Keeping your blood sugar levels under control can be tough. There are so many factors that can affect blood sugar, like exercise, food, illness, exhaustion, and stress. Any of these can cause your careful control to go right out the window. So how do you know if your loss of control is an emergency?


Hypoglycemia is the condition of having too little glucose in the blood, usually below 70 mg/dl. It can result from taking too much insulin, not eating, illness or exercise. Hypoglycemia sometimes called insulin shock or insulin reaction can cause serious physical and mental changes. Physical changes include shakiness, sweating, chills and feeling clammy, increased heart rate, dizziness, blurred vision, headache, weakness or excessive fatigue, tingling and numbness in the lips or tongue, lack of coordination, nausea and, in worst cases, seizures and unconsciousness.


Mental changes include confusion and delirium, anger, stubbornness, and sadness. On occasion, someone who is suffering from an episode of hypoglycemia might be mistaken for being extremely drunk. All of the symptoms above are preliminary to passing out and/or entering a coma state if left untreated. Unreversed hypoglycemia is a medical emergency. The brain relies upon glucose to operate, and a reduced level of available glucose can lead to neuronal damage.


Like hypoglycemia, hyperglycemia can be triggered by stress, illness, exercise, diet or exhaustion. It can also result from insufficient insulin in the blood cells, whether because of insufficient production, insufficient injections, or because of insulin resistance by the cells. Hyperglycemic emergency occurs when the patient develops either diabetic ketoacidosis (DKA) – more common in type 1 diabetics – or hyperosmolar hyperglycemic syndrome (HHS) – more common in, but not exclusive to, type 2 diabetics. Both are the result of insulin deficiency, which causes other hormones to be released to compensate. With not enough insulin to permit access of glucose to the cells in the bloodstream, the cells starve. Both of these situations require immediate medical intervention, as successful treatment of each is complex. Contacting emergency services is an appropriate first step.


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