Emma Hammett A qualified nurse, author and first aid trainer with over 30 years’ healthcare and teaching experience The facts One in 15 people in the UK have diabetes. This includes one million people who have Type 2 but haven’t yet been diagnosed. In the UK, someone is diagnosed with diabetes every two minutes. Worldwide
One in 15 people in the UK have diabetes. This includes one
million people who have Type 2 but
haven’t yet been diagnosed. In the UK, someone is diagnosed with diabetes
every two minutes.
According to the
World Health Organization (WHO), there are around 422 million people are living
with diabetes worldwide. Between 1980 and 2016 the number of people with
The rise is partly attributed to increases in the number of
people who are overweight – including an increase in obesity – and in a lack of
The largest numbers of people with diabetes were estimated
for the South East Asia and Western Pacific Regions, accounting for
approximately half the diabetics in the world.
Diabetes is one of the leading causes of diabetes in the
world. There are 1.6 million deaths directly attributed to diabetes each year.
The majority of these deaths happen in low and middle-income countries.
What is it?
Diabetes is a chronic condition where someone is unable to
adequately regulate their blood glucose levels. The body produces the hormone
insulin which helps the body burn off sugars. If someone’s body has problems
with insulin production, they will develop diabetes. If glucose can’t get into
your cells, it begins to build up in your blood.
Having too much glucose in your blood causes many different
Diabetes is caused by insufficient insulin or ineffective
insulin. There are two main types – Type 1 and Type 2.
Type 1 Diabetes
Type 1 can occur in any age group but is most commonly
diagnosed in children. It is not generally linked to lifestyle or weight but affects
insulin production. Type 1 diabetics usually control their diabetes with
injections of insulin
Type 2 Diabetes
This is the more widespread type. It tends to develop later
in life, and is often linked to obesity. Type 2 diabetes develops when the body
is unable to make enough insulin, or when the insulin that is produced does not
work properly (known as insulin resistance). Type 2 Diabetes is controlled by
diet, exercise or oral medication – or a combination of all 3.
In fact, it has been suggested that it is possible that Type
2 diabetes can be prevented: by 30
minutes of moderate-intensity physical activity on most days and a healthy diet
can seriously reduce your risk of developing type 2 diabetes.
Some patients are diagnosed as being pre-diabetic, or having
insulin resistance. Often this diagnosis can be reversed with lifestyle
changes, modifying the diet, exercising and losing weight.
Diabetes can also occur in pregnant ladies – gestational
diabetes. This usually resolves post birth.
In the short term this build-up of glucose leads to diabetes
symptoms, like having to wee a lot.
In fact, the term ‘diabetes’ which was coined by The Greek
physician Aretaeus of Cappodocia (81-133 A.D) translates as “flowing
through” in Greek. In ancient times, doctors would test for diabetes by
tasting urine to see if it was sweet.
Other symptoms include being really thirsty, and feeling
extremely tired. You can also lose weight, be more prone to infections like thrush
or suffer from slow healing wounds.
Over a longer time and left untreated the high glucose
levels in your blood can seriously damage your heart, eyes, feet and kidneys.
Diabetes is an important cause of blindess, amputation, kidney failure, vision
loss, nerve damage, heart attack and stroke.
With diabetes, early detection, diagnosis and intervention
is key. The longer a person lives with undiagnosed diabetes the more serious
their health outcomes are likely to be. Happily, with the right treatment and
care, many people with diabetes live a healthy life.
First aid treatment
for diabetes is more likely to be necessary for low blood sugar levels than
high. This is because high blood sugar levels usually build over a few days or
weeks, whereas low levels can come on very fast. Blood sugar can drop very
quickly if the person has missed a meal or done any strenuous exercise.
Blood glucose levels can drop very fast if someone who is
diabetic has skipped a meal, taken a lot of exercise, if they are ill, or have
given themselves too much insulin. If this is not treated quickly they can
rapidly start to lose consciousness and fall into a diabetic coma. This can be
Signs and symptoms
- Behaving unusually
- May be aggressive
- Could appear slightly confused or drunk
- They are pale, cold, shaky and sweaty
- They have shallow, rapid breathing and a fast,
- They could have seizures.
- Sit them down and give them a sugary drink, or glucose
sweets (not a diet drink).
- If they begin to feel better, give more drinks
and some food, particularly biscuits or bread to sustain their blood sugar – a
jam sandwich is great.
- If they don’t feel better within 10 minutes or
they begin to get worse phone the emergency services.
- If they lose consciousness but are breathing,
put into the recovery position and phone the emergency services.
- If they stop breathing, prepare to give CPR.
Do not attempt to give an unconscious casualty anything to
eat or drink.
Never give them insulin as this will further lower their
blood sugar and could kill them.
If hypoglycaemia was
not the problem and you gave a sugary drink, you are highly unlikely to have
made anything worse. If you had misdiagnosed and their levels were high not low
(extremely unlikely), the glucose you have given them is tiny compared with
that in their blood. If they do not feel better once you have given the sugary
drink – always contact their diabetes nurse specialist or doctor for advice and
encourage them to get checked.
Even if someone appears to have recovered, ensure they
receive urgent medical advice. This is particularly important at night, as
insulin will still be active in the blood stream while they are asleep and the
blood sugar levels will therefore drop again and they could drift from sleeping
High Blood Sugar
if you are looking after someone who develops weight loss, excessive urination,
thirst and tiredness, these could be symptoms of hyperglycaemia or an
indication of Diabetes and they should visit their family doctor as a matter of
Phone for an
ambulance: if they deteriorate quickly and begin to get drowsy, their
breath smells of pear drops, and they start to lose consciousness.
Hyperglycaemic State (HHS) is a serious condition that can occur in people
with diagnosed Type 2 diabetes who
experience very high blood glucose levels (often over 40mmol/l). It can develop
over a course of weeks through a combination of illness (such as infection) and
Stopping diabetes medication during illness (such as
swallowing difficulties or nausea) can contribute, but blood glucose often
rises despite the usual diabetes medication, due to the effect of other
hormones the body produces during illness.
- dry skin
- disorientation and, in later stages, drowsiness
and a gradual loss of consciousness
HHS is a potentially
Hospital treatment for HHS aims to correct dehydration and
bring blood glucose down to an acceptable level by giving replacement fluid and
insulin by an intravenous drip.
It does not usually lead to the presence of ketones in the
urine, as occurs in diabetic ketoacidosis(DKA), which is why it was previously
referred to as HONK (hyperglycaemic hyperosmolar non-ketotic coma).
Ketones develop when the blood glucose level is high due to
lack of insulin which is needed to allow glucose to enter the cells for energy.
Because people with Type 2 diabetes may still be producing
some insulin, ketones may not be created.
How you can help:
- Encourage the diabetic person to take their
diabetes medication, even if they feel unwell and can’t eat
- If they monitor their blood glucose, they may
need to test more frequently
- They should contact their healthcare team if
their blood glucose levels remain high (>15mmol/l)
- They should drink plenty of unsweetened fluids
- If they can’t eat, replace meals with snacks and
drinks, containing carbohydrate
- Suggest they contact their Diabetes Nurse
Specialist for advice if they are unwell
Read our article on diabetes here: https://firstaidforlife.org.uk/diabetes/
Read our article on vital information friends and family
need to know about diabetes here: https://firstaidforlife.org.uk/diabetes-2/
We include diabetes on most of our courses and run
specialist courses covering this subject too. Please join one of our practical
or online first aid courses and learn more about this and so many other life
It is strongly advised that you attend a fully regulated
Practical or Online First Aid course to understand what to do in a medical
emergency. Please visit https://firstaidforlife.org.uk or call 0208 675 4036
for more information about our courses.
Written by Emma Hammett for First Aid for Life
It is highly recommended that you attend a practical or
online first aid course to learn how to help in a medical emergency.
First Aid for Life and onlinefirstaid.com provides this
information for guidance and it is not in any way a substitute for medical
advice. First Aid for Life is not responsible or liable for any diagnosis made,
or actions taken based on this information. The best way to be prepared for
action in an emergency is to attend a practical first aid course.
For more information please visit: www.firstaidforlife.org.uk or contact
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