Diabetes emergencies can come on fast, and if you're not prepared can quickly turn into life-threatening situations. 

In general, diabetes is easily controlled with the proper diet and medication. However, there are some situations in which blood sugar can get out of control quickly. Understanding what you can do to treat and prevent a diabetes emergency can bring you peace of mind and just might save your life.

This article will discuss three types of diabetes emergencies, warning signs to watch out for, your immediate first steps, diabetes treatment guidelines, and how to prepare ahead, so you're always ready. 

What Happens During a Diabetic Emergency? 

A diabetic emergency happens when your blood sugar becomes severely dysregulated, resulting in either hyperglycemia or hypoglycemia. In either case, the dysregulation is typically due to issues with the hormone insulin.

While on a diabetes management protocol, your doctor will give you strict guidelines for managing your blood sugar. However, in some cases, either your medication may be off, causing issues with insulin, or your diet could be unsupportive, resulting in higher than normal blood sugar (hyperglycemia) or extremely low levels (hypoglycemia).


With hypoglycemia, your blood sugar levels plummet below 70 milligrams per deciliter (mg/dl). 

This is usually due to:[1]

  • Taking too much insulin medication, which results in too much blood glucose being shuttled into your cells.
  • Missing meals, which means that your body isn't getting the glucose it's expecting.
  • Exercising more thanusual without replenishing glucose in time. 
  • Consuming too much alcohol.


Hypoglycemia can be incredibly dangerous if left untreated, resulting in seizures, loss of consciousness, or even death. 

With hyperglycemia, your blood sugar levels are too high, reaching 180 to 200 milligrams per deciliter (mg/dL), typically due to:

  • For type 1 diabetics, not giving yourself enough insulin.
  • For type 2 diabetics, your body is not responding to your insulin medication.
  • For either, you consume too many simple sugars in one sitting, and due to dysregulated insulin, your body doesn't know what to do with it.

Hyperglycemia, much like hypoglycemia, can become a very dangerous condition when not treated promptly. High levels of sugar in your blood can have long-term implications such as nerve damage (neuropathy), kidney damage, damage to blood vessels, bone and joint problems, and cataracts.

In an acute situation, untreated hyperglycemia can turn into ketoacidosis. In ketoacidosis, your body is unable to use the glucose in your blood for fuel, so it starts to break down fat to make a new form of fuel called ketones. 

While ketones are a viable form of energy, in ketoacidosis, your body makes an excess of ketones which can build up in your blood (along with the glucose that can't get into your cells). Left unmanaged, ketoacidosis can turn into a diabetic coma and can be life-threatening.[2]

Another danger of hyperglycemia is a hyperglycemic hyperosmolar state. In this case, blood glucose levels can reach as high as 1,000 mg/dL, spilling over into your urine. This causes increased urination and can result in life-threatening dehydration or coma.[3]

What Are The Early Signs of a Diabetic Emergency? 

In either hyperglycemia or hypoglycemia, there are a handful of early signs to watch out for that can help you prevent your condition from turning into an emergency.  These include: 


Early signs of hypoglycemia include:

  • An irregular or fast heartbeat
  • Headache
  • Fatigue
  • Pale skin
  • Shakiness
  • Anxiety
  • Sweating
  • Hunger
  • Irritability
  • Tingling or numbness of the lips, tongue, or cheek


Early signs of hyperglycemia include:

  • Extreme thirst
  • Urinating a lot more than usual 

When left untreated, hyperglycemia can progress to ketoacidosis, hyperglycemic hyperosmolar state, or both. Signs to watch out for in these conditions include: 

Diabetic ketoacidosis:[3]

  • Quick breathing
  • Flushed face
  • Fruity smelling breath
  • Headache
  • Muscle stiffness
  • Stomach pain, nausea, and vomiting

Hyperglycemic hyperosmolar state:[4]

  • Blurred vision
  • Fever over 100.4 degrees F.
  • Drowsiness or passing out
  • Confusion or hallucinations  
  • Weakness or paralysis (often on one side of the body)

What Is The First Thing You Should Do When You or Someone You Know is Experiencing a Diabetic Emergency? 

In the case of hypoglycemia, you’ll need to get more sugar into your blood. Whatever you have around will do  — soda, candy, even sugar cubes. This is no time to worry about ingredients; it's all about getting more sugar into your body.

For hyperglycemia, you need to lower your blood sugar as fast as possible. Your regular insulin medication may not be doing its job, so it's best to call 911 in this situation to be safe. If you have hyperglycemia because you forgot to take your medication, then the first thing you should do is take your insulin. 

Also, because hyperglycemia can cause severe dehydration, replace fluids with water and electrolytes as soon as possible. 

In either case, be sure to call your doctor as soon as possible, even with hypoglycemia, to receive their guidance. 

What Should You Do During a Diabetic Emergency while Waiting for 911 or Your Doctor? 

While waiting to hear back from your doctor or for 911 to come:

  • Remain calm by slowing your breathing and keeping yourself distracted.
  • Allow yourself to sit or move around, depending on what feels best to you.
  • Drink plenty of fluids; if you have calming tea like chamomile or lemon balm, that's even better.
  • If you happen to be alone, call someone to keep you company and ensure that you're doing okay.

Where Can You Learn More Intensive Emergency Skills? 

If you or a loved one has diabetes, learning emergency skills can bring a lot of peace of mind. In some cases, these skills could even be life-saving.

An excellent resource for diabetes-related emergency skills is the Red Cross or their local hospitals.

Create a Diabetic Care Kit for Emergencies 

To make your life easier, put together a diabetic care kit so that you'll know that you have everything you need on hand in case of an emergency. You can buy diabetic care kits already stocked, but making your own is always a good idea so you can have specific items that fit your needs. 

Here are some key items to include in your kit:

  • Insulin and syringes 
  • Lancets and lancing devices
  • Glucose and ketone meter and test strips
  • Empty plastic bottle for lancets, needles, or syringes 
  • Extra batteries for glucose meter
  • Extra medication 
  • Glucose tablets (or raisins, juice boxes, candies)
  • If you use a pump: extra reservoirs and infusion sets
  • An info sheet detailing your diagnosis and any medications you're on
  • Thermometer
  • Glucagon pen
  • Electrolyte powder
  • Water 

Prevention Is The Best Medicine

The best way to prevent a diabetic emergency is to familiarize yourself with exactly what your body needs and how to stay on track. You'll continue to create a deeper intuitive knowledge of your body, but in the beginning, it can be very helpful to have some expert guidance on board. 

The BioCoach Program is specifically designed to help you navigate diabetes so that you don't end up in an emergency situation. BioCoach's mission is to make healthy living simple. 

When you join  BioCoach, you'll receive:

  • A starter kit that includes a state of the art bluetooth glucose and ketone meter, along with access to a powerful smartphone app.
  • A diet coach that can work with you on learning how to eat for diabetes (choose from keto, low-carb, carnivore, and more).
  • A modifiable grocery cart put together specifically for you by your health coach.
  • Rewards and discounts of dozens of health and wellness products.
  • A progress tracker for biomarkers like blood sugar, ketones, A1C, weight and more.

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