Diabetic Reaction

The rapid change in blood sugar leaves you feeling wiped out and shaky and searching for more sweets to regain that sugar "high." So that midday sugary treat has set you up for more bad eating.

• There are two main forms of diabetes:
  • Type 1 diabetes: Absent or low insulin levels prevent cells from taking up and using sugar for energy, thus requiring insulin injections
  • Type 2 diabetes: Cellular resistance to insulin reduces glucose uptake, often requiring medication to improve the sensitivity of cells to insulin
• Low blood sugar (hypoglycemia) is the most common form of diabetic reaction. A low blood sugar reaction is caused by increased exertion or increased demand for glucose. The body may "run out" of stored glucose more quickly, thus bringing on a hypoglycemic attack. Persistent intake of excessive alcohol may cause this reaction because alcohol decreases glucose stores in the liver.
• High blood sugar (hyperglycemia) is a common problem for people with diabetes. High blood sugar can be brought on by infections or other significant stresses that cause the body to decrease cell uptake of glucose. A decrease in cellular uptake of glucose leads to high blood sugar levels as well as the alternative use of fats by starving cells for energy. Fat breakdown increases the acidity of the blood and worsens symptoms of high blood sugar.

The diabetic reaction depends on the type of reaction such as hypoglycemia or hyperglycemia.

Symptoms of diabetic reaction depend on the type of reaction.

Low Blood Sugar (Hypoglycemia) Symptoms

• rapid onset of cool, pale, moist, and clammy skin;
• dizziness;
• headache;
• rapid pulse; and
• shallow breathing.

If untreated, symptoms may progress to confusion, nonsensical behavior, coma, and death.

High Blood Sugar (Hyperglycemia) Symptoms

• Symptoms occur gradually over several days.
• A person with high blood sugar develops increasing thirst and urination due to large amounts of unused glucose being lost in the urine.
• Skin feels warm and dry; respirations may be shallow; the pulse is rapid and weak, and breath may have a sweet odor (due to ketoacidosis from fat breakdown).
• A person with high blood sugar may become confused or comatose, and death may result.

Low Blood Sugar Treatment

• Provide the hypoglycemic person with low blood sugar with juice, candy, or any other sweet substance. If the person responds to treatment, further food will be required.
• Wilderness trips should be carefully planned. Blood sugar monitors and adequate medication supplies (including refrigeration for insulin) should always be available.

NOTE: When in doubt, any person with diabetes who appears to be having a reaction should be treated as if he or she has low blood sugar until blood sugar can be measured.

High Blood Sugar Treatment

• Encourage clear liquids with low or no sugar content.
• Administer IV fluids as soon as possible
• Check whether the patient has nausea or vomiting
• Check for the presence of ketoacidosis in the blood or urine.
• A person with high blood sugar may need extra insulin doses in a monitored medical setting.

Low Blood Sugar

• Seek medical treatment if the person with low blood sugar fails to respond quickly (within 15 minutes).
• Ensure appropriate food intake to prevent further attacks.

High Blood Sugar

• Consult your healthcare professional about extra doses of insulin.
• Seek medical treatment as soon as possible for loss of consciousness, presence of ketoacids in blood, urine, or vomiting.