Diabetic Emergencies
Millions of workers have diabetes. Long shifts, skipped meals, heavy physical work and heat can push blood sugar too low or too high. Low blood sugar can come on fast and look like drunkenness or confusion, which is dangerous around equipment and heights.
- Everyone
Low blood sugar (hypoglycemia)
Signs: shaky, sweaty, pale, fast heartbeat, hungry, irritable, confused, slurred speech, clumsy; in severe cases, seizures or unconsciousness.
- Stop work and get them to a safe spot, away from equipment and edges.
- If they’re awake and can swallow, give about 15 grams of fast sugar: 4 ounces of regular juice or soda, glucose tablets or gel, or a few hard candies.
- Wait 15 minutes, then recheck their glucose if they have a meter. If still low or no better, give another 15 grams (the “15-15 rule”).
- Once better, have them eat a snack or meal.
Call 911 if the person is unconscious, having a seizure, or can’t safely swallow. Don’t put food or drink in their mouth. Put them on their side. If they carry glucagon and you’re trained, give it per the instructions.
High blood sugar (hyperglycemia)
Signs: very thirsty, peeing often, tired, blurry vision, headache. Severe cases can cause nausea, vomiting, fruity-smelling breath, fast breathing and confusion.
- Encourage water and let the person follow their own care plan (checking glucose, insulin).
- Call 911 for vomiting, confusion, trouble breathing or drowsiness.
Not sure which it is?
If a person with diabetes is awake but acting strangely and you can’t tell whether their sugar is high or low, give sugar. It can quickly help low blood sugar and won’t do much harm if their sugar is high.
Working with diabetes
- Keep fast sugar and snacks in your pocket, truck and lunchbox.
- Eat on schedule; take meal breaks even on busy days.
- Check glucose more often in heat, during heavy work and on long shifts.
- Tell a trusted coworker or supervisor what to do if you have a low.
- Wear a medical ID.
Rights: diabetes is usually covered by the Americans with Disabilities Act. Reasonable accommodations can include breaks to test and eat, a place to store supplies, and keeping snacks at your work area. Commercial drivers who use insulin must meet FMCSA’s insulin-treated diabetes standard.
Standards & references
- CDC: Low blood sugar
- See also: First Aid Basics · Heat Illness
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