Recognizing symptoms early can save a life.
Diabetes management has become easier thanks to modern technology—insulin pens, pumps, CGMs, and temperature-controlled medication coolers like DISONCARE. Even so, diabetic emergencies still happen. Understanding the types, symptoms, and immediate actions is critical for staying safe at home, at work, or while traveling.
This guide breaks down the most common diabetic emergencies, how to manage them, and how to prevent them—especially when using insulin or other temperature-sensitive medications.
1. Severe Hypoglycemia (Very Low Blood Sugar)
What it is:
When blood glucose drops dangerously low (typically <70 mg/dL), the brain is deprived of glucose.
Common Causes:
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Too much insulin
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Skipped meals
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Intense exercise without carb intake
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Drinking alcohol on an empty stomach
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Medication dosing errors
Symptoms:
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Shaking, sweating
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Rapid heartbeat
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Confusion, irritability
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Slurred speech
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Loss of coordination
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Severe cases: seizures or unconsciousness
What to Do Immediately:
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Give 15g fast-acting carbs (glucose tablets, juice, regular soda)
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Recheck BG in 15 minutes
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If unconscious → administer glucagon (nasal or injectable) and call emergency services
Prevention:
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Eat consistent meals
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Frequent CGM checks
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Store insulin properly (heat-damaged insulin can act unpredictably—use a medication cooler when traveling)
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Review dosing with doctor if lows are frequent
Reference:
American Diabetes Association. “Hypoglycemia (Low Blood Glucose).” ADA Guidelines, 2024.
2. Hyperglycemia (Very High Blood Sugar)
What it is:
Blood sugar remains elevated (>250 mg/dL) due to insufficient insulin, illness, stress, or pump malfunctions.
Common Causes:
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Not enough insulin
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Illness or infection
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Expired or overheated insulin
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Pump infusion set failure
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Certain medications (steroids)
Symptoms:
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Excessive thirst
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Frequent urination
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Blurry vision
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Fatigue
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Headache
What to Do:
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Check ketones
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Hydrate
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Take correction insulin
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Contact doctor if ketones are moderate/high
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Replace pump site or check pen for storage damage
Prevention Tip:
Always store insulin in a temperature-safe range (2–8°C refrigerated) and never let it overheat. A portable cooler like DISONCARE can prevent insulin degradation during daily commutes or travel.
Reference:
American Diabetes Association. “Hyperglycemia.” ADA Standards of Care 2024.
3. Diabetic Ketoacidosis (DKA)
What it is:
A life-threatening condition where the body burns fat instead of glucose, producing dangerous acids called ketones.
Most common in:
People with Type 1 diabetes, but can occur in T2D during illness or severe insulin deficiency.
Causes:
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Missed insulin doses
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Illness or infection
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Pump catheter blockage
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Spoiled insulin (from heat exposure or freezing)
Symptoms:
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High blood sugar (>250 mg/dL)
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Moderate or high ketones
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Deep, rapid breathing
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Fruity-smelling breath
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Abdominal pain, nausea
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Confusion
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Extreme dehydration
What to Do:
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Test ketones
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Take rapid-acting insulin correction
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Drink water or electrolyte fluids
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Seek emergency medical care immediately
Prevention:
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Never skip insulin
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Use a temp-stable medical cooler when transporting insulin
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Replace pump infusion sets every 2–3 days
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Sick-day management plan
Reference:
Centers for Disease Control & Prevention. “Diabetic Ketoacidosis: Know the Signs.” CDC 2023.
4. Hyperosmolar Hyperglycemic State (HHS)
What it is:
A severe hyperglycemic emergency, mostly seen in Type 2 diabetes, where blood sugar becomes extremely high (>600 mg/dL) leading to dehydration and altered consciousness.
Symptoms:
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Extreme thirst
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Dry skin and mouth
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Weakness
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Confusion or hallucinations
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Seizures in advanced stages
What to Do:
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Seek emergency care immediately
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Hydrate if conscious
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Monitor BG on the way to hospital
Reference:
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “HHS in Diabetes.” 2023.
5. Insulin Pump Failure or Infusion Set Malfunction
Insulin pump issues can quickly lead to severe hyperglycemia or DKA.
Causes:
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Occlusion
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Kinking of infusion set
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Site infection
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Weak adhesive causing pump detachment
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Pump hardware/software failure
Warning Signs:
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Rapid BG rise
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Unexpected ketones
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“No delivery” alerts
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Wet infusion sites (leaking insulin)
What to Do:
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Replace infusion set immediately
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Inject correction insulin with a pen
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Check ketones
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Switch to backup syringes if pump remains faulty
Prevention:
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Rotate sites
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Inspect tubing
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Keep backup insulin in a cooler (DISONCARE recommended for heat protection)
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Always carry spare pump supplies while traveling
6. Severe Hypoglycemia Caused by GLP-1 Medications (Rare but Possible with Insulin)
GLP-1 drugs (Ozempic, Wegovy, Mounjaro) rarely cause hypoglycemia alone but can cause lows when combined with:
-
Insulin
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Sulfonylureas
Symptoms:
Same as hypoglycemia above.
What to Do:
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Treat with fast carbs
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Review dose adjustments with doctor
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Always store GLP-1 meds within required temperature ranges (never freeze; avoid heat)
Reference:
FDA Medication Guides for GLP-1 Agonists, 2024.
7. Lactic Acidosis (Rare, related to Metformin)
This is extremely rare but serious.
Symptoms:
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Nausea
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Rapid breathing
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Muscle pain
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Extreme fatigue
Emergency Action:
Seek immediate ER care.
Reference:
Drugs.com Metformin Monograph (FDA-Labeled Uses & Warnings), 2024.
Essential Emergency Kit for People with Diabetes
A well-prepared kit can prevent minor issues from becoming emergencies:
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Rapid-acting carbs
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Glucose tablets/gel
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Glucagon pen or nasal spray
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Meter, strips, and backup batteries
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Pump supplies
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Backup insulin pens
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Insulin stored in a temperature-controlled cooler (DISONCARE for travel or outdoor use)
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Medical ID tag
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Printout of emergency contacts
Final Thoughts
Most diabetic emergencies are preventable with education, preparation, and proper medication handling. Keeping your insulin, GLP-1 meds, or pump supplies stored at safe temperatures — especially during travel — is a crucial part of staying safe.