Diabetes in Emergency Situations

in Emergency Situations
Presented by
MaryAnn Nicolay, BA, DTR.
Health Educator
Program objective:
How to help people with diabetes in emergency
Learning objectives:
• Understand basic diabetes management
• Discuss emergency needs as related to basic
diabetes management
• Use tools for determining medication and
SBGM needs
What is diabetes?
Risk Factors
for developing diabetes
• Being over 45 years
• Having blood
relatives with
• Being over weight
• Being a person of
• Not exercising
• Having high
cholesterol or heart
• Having high blood
• Having diabetes
when pregnant
• Having a baby that
weighed over 9
Symptoms of Diabetes
• Increased hunger
• Being very thirsty
• Frequent urination
• Being very tired
• Slow healing wounds
• Changes in vision
• Tingling or numbness
in hands or feet
• Unexplained weight
Types of Diabetes
• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes
Diabetes Management Plan
Blood Sugar
Healthy Food Choices
• There is no “diabetes diet”
• General Guidelines
• Eat 3 meals each day
• Eat at about the same time each day
• Do not skip meals
• Watch the fat!
• Watch your portion size
• Learn to read and use food labels
Healthy Food Choices in
• Meals every 4-5 hours
• Between meal snacks
• Carbs at each meal
• Fruit, starches / grains, vegetables, milk /
• Serve sugar-free beverages
• Serve heart-healthy foods
Meal Ideas
Cold cereal/milk, toast, yogurt, fruit,
yogurt, bagel w/cream cheese,
Deli meat sandwich, soup, salad, fruit,
Grilled chicken salad w/low fat dressing,
roll or crackers, fruit
Baked chicken, mashed potatoes, green
beans, roll w/ margarine,
Fruit, 100 calorie snack packs, graham
crackers, peanut butter w/crackers,
yogurt, sandwich, ½ cup ice cream,
pudding, cheese and crackers, cottage
cheese w/fruit, pretzels
Beverage Ideas
Milk, sugar-free beverages like coffee or tea
w/sugar substitutes, water, crystal light,
sugar-free soda pop
Physical Activity
• Lowers
blood sugar
• Lowers blood
• Lowers cholesterol
• Helps you sleep
• Enhances your mood
• Helps burn fat
• Helps build muscle
• Strengthens bones
Physical Activity in
• Depending on the nature of the disaster, there may be a
change in regular activity
• Increase in activity due to repairing damage
• Hypoglycemia (low blood sugar)
• Decrease in activity due to being away from routine
• Hyperglycemia (high blood sugar)
• Excessive exercise when blood sugar is over
250mg/dl may cause blood sugar to elevate
Checking Blood Glucose
• Tells what your blood glucose number is NOW
• Is used to make changes in how you manage
• How food and activity affects your blood glucose
• How well diabetes medicines are working
• Effects of stress or illness
Blood Glucose Monitors &
Test Strips
Diabetes Medications
• People with diabetes may need to take pills
and/or insulin to help manage their diabetes
• Taking pills and/or insulin does not mean your
diabetes is worse than someone else.
• It means that this is the best way to
way to manage your diabetes.
Diabetes Medications in
• People with diabetes may or may not be taking
diabetes medications
• Oral medications do not require special storage
• Insulin or other injectable medications require
special storage and equipment
Pen needles
Alcohol swaps
Pump supplies
Sharps container
Insulin Pumps and Pens
Stress and Diabetes
• Coping skills may be inadequate for situation
• Decreased sleep
• Increased worry
• Damage to property
• “Where will I go?”
• Loss, grief, fear, anger, frustration
• Change in priorities
• Preoccupation with survival or clean up
Low Blood Sugar
Blood glucose of less then 70mg/dl
Feeling weak or tired
Being hungry
Feeling sweaty, having chills or cold hands
Feeling shaky, anxious or confused
Having a fast heart beat, dizziness, or headache
Having blurry vision or numb lips
Passing out or having seizures
Treating Low Blood Sugar
Follow the Rule of 15
15 grams of quick acting carbohydrate
Wait 15 minutes
Re-test blood glucose
If glucose still below 70mg/dl, retreat
15 grams of carbohydrate
½ cup of juice (any kind or REGULAR soda pop)
4 glucose tablets
2 teaspoons of jam or jelly
6-8 lifesaver candies, chewed up
1 tablespoon of sugar dissolved in water
Do not treat low blood sugar with diet soda pop.
This will not raise your blood sugar.
Do not treat low blood sugar with chocolate candy.
This will not raise your blood sugar quickly enough.
Other Things to Consider in
• Problems with feet
• Poly-pharmacy
• Where to get meds
• Other medical conditions
• Heart
• BP
• Vision
• Prosthetic devices
• Dialysis
When to call for help
Refer to a hospital, clinic or ER when:
• Hypoglycemia that does not respond to treatment
• Consecutive blood glucose readings greater than
250 mg/dl
• Blood glucose reading greater than 250 mg/dl along
with vomiting, rapid breathing, fruit breath, stomach
Emergency or Disaster

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