Emergency First Aid Training - Diabetes
September 22, 2015

How Should First Aiders Respond to a Diabetic Emergency?

As a paramedic, I am not an expert in all the complexities of diabetes.

However, I am frequently called to manage patients experiencing hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar).

In most cases of hypoglycaemia, there is already someone present helping the patient — often a friend, family member, or workplace first aider.

But sometimes, it is a member of the public who is suddenly faced with a confused, sweaty, and deteriorating person who needs urgent help.

So what should you actually do?

What Does a Diabetic Emergency Look Like?

Let’s look at a typical situation.

Darryl is an insulin-dependent diabetic. He has had a cold for several days and is feeling increasingly unwell.

Although he normally manages his condition well, illness can disrupt blood sugar control. Sometimes blood sugar rises due to stress on the body, and other times it drops due to reduced food intake.

In this case, Darryl has not been eating properly, but he has continued taking his insulin.

He begins to feel:

  • Sweaty
  • Confused
  • Agitated
  • Weak

Eventually, his condition deteriorates and he becomes unconscious.

This is a classic presentation of hypoglycaemia.

What Are the Signs of Hypoglycaemia?

How Can You Recognise Low Blood Sugar?

Common signs include:

  • Sweating
  • Confusion
  • Irritability or aggression
  • Shaking or tremors
  • Dizziness
  • Slurred speech
  • Loss of consciousness

A diabetic emergency can develop quickly and may not always have warning signs.

What Should First Aiders Do First?

Do You Follow Basic First Aid Principles?

Yes. Always start with DRSABCD:

  • Danger
  • Response
  • Send for help (000 in Australia)
  • Airway
  • Breathing
  • CPR if required
  • Defibrillation if available

If the person is conscious, reassure them and keep them safe while awaiting help.

Should You Put Sugar in an Unconscious Person’s Mouth?

Can You Give Food or Drink to Someone Unconscious?

No.

This is one of the most important rules in first aid.

Even if hypoglycaemia is suspected, nothing should be placed in the mouth of an unconscious person because:

  • It can block the airway
  • It increases the risk of choking
  • The person cannot swallow safely

Even though the intention is good, it can cause serious harm.

Can You Inject the Person’s Insulin?

Should First Aiders Give Insulin in an Emergency?

No.

First aiders are not trained or authorised to administer insulin or any prescription medication.

Doing so is outside the first aider’s scope of practice and may cause serious harm.

In a hypoglycaemic emergency, giving insulin would actually make the condition worse.

Why Is Sweating Important in Diabetic Emergencies?

What Does Sweating Indicate in Hypoglycaemia?

Sweating is a key sign of low blood sugar.

When someone is sweaty and confused, it may indicate the body is under metabolic stress.

In first aid, this often helps distinguish hypoglycaemia from other causes of collapse.

Keeping the person warm (without overheating) can help maintain body stability while awaiting emergency care.

What Should First Aiders Actually Do Instead?

How Do You Manage a Suspected Hypoglycaemic Patient?

Appropriate actions include:

  • Place the person in a safe position
  • Reassure them if conscious
  • Call 000 immediately
  • Check for medical ID (bracelet, phone medical info)
  • Monitor breathing and responsiveness
  • Place in recovery position if unconscious and breathing normally

If the person is conscious and able to swallow safely, emergency services may advise oral glucose administration — but this should only be done if trained and appropriate.

Why Is Overstepping First Aid Training Dangerous?

What Happens If You Treat Outside Your Scope?

First aiders must always act within their level of training.

Attempting advanced medical interventions such as:

  • Injecting insulin
  • Administering prescription medication
  • Forcing oral intake in unconscious patients

can lead to serious harm and potential legal consequences.

What Is the Key Lesson in Diabetic First Aid?

Why Is Thinking Clearly in a Diabetes Emergency So Important?

First aiders often show excellent problem-solving instincts during training scenarios.

Many correctly identify:

  • Recovery position
  • Calling emergency services
  • Checking medical ID

But the key principle remains:

Do not do anything that compromises the airway or goes beyond first aid training.

Good first aid is not about doing everything — it is about doing the right things safely.

Final First Aid Reminder for Diabetic Emergencies

If you suspect hypoglycaemia:

  • Act quickly
  • Follow DRSABCD
  • Do not put anything in the mouth of an unconscious person
  • Do not administer insulin
  • Call 000 early
  • Monitor closely until help arrives

Early recognition and correct first aid response can make a significant difference in outcomes.