How to Manage a Diabetic Emergency without a Blood Glucometer

If you don’t have a blood glucometer then follow the patients management plan or the accepted general management of a diabetic emergency:

Conscious – 4-5 x 4gm glucose tablets or sugar sweetened drink

Unconscious – manage as per unconscious patient and give no food or drink

The Australian and New Zealand Resuscitation Committee on Resuscitation (ANZCOR) make the following recommendations:

When available, and trained to do so, use a blood glucometer to check the victim’s blood glucose level

When available, glucose tablets are preferred over other sugars for the first aid management of suspected hypoglycaemia in conscious victims

When available, and trained to do so, family members and carers use a GlucaGen® HypoKit® glucagon injection to manage suspected hypoglycaemia in an unconscious or seizing victim

If a person with diabetes has a diabetes management plan then that plan should be followed. If a person with diabetes reports low blood glucose or exhibits symptoms or signs of hypoglycaemia:

Stop any exercise, rest and reassure;
If the victim is able to follow simple commands and swallow safely, we recommend that first aid providers administer 15-20 grams glucose tablets (4 – 5 x 4 gram glucose tablets) for treatment of symptomatic hypoglycemia
If glucose tablets are not available, we suggest administering confectionary including:
- Jelly beans (5-20 beans depending on the brand)Skittles® (20-25 candies)
- Mentos® (5-10 mints),
- Sugary drinks or sugar-sweetened beverages (approx. 200 mL), but DO NOT administer ‘diet’ or ‘Low-cal’ or ‘zero’ or ‘sugar free’ beverages;
- Fruit juices (approx. 200 mL);
- Honey or sugar (3 teaspoons);
- Glucose gels (15 g of glucose gel); and
- Monitor for improvement – resolution of symptoms would be expected within 15 minutes.

If symptoms or signs of hypoglycemia persist after 10-15 minutes, and the victim is still able to follow simple commands and swallow safely, administer a further 4 x 4g glucose tablets or alternatives as listed above. Once recovered, give a snack with longer acting carbohydrate, for example: 1 slice of bread OR 1 glass of milk OR 1 piece of fruit OR 2-3 pieces of dried fruit OR 1 snack size tub of yoghurt (not diet or ‘sugar free’ yogurt). If it is a usual meal time, then eat that meal.

If the victim deteriorates, does not improve with treatment, is seizing or is unconscious, call for an ambulance.

- If the victim is unresponsive and not breathing normally, commence resuscitation
- If the victim is unconscious but breathing, lie the victim on their side and ensure the airway is clear