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How To Spot A Hypo Diabetic As Opposed To A Drunk.


Poppy

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Do not make assumptions.  It is a serious life threatening situation:

DIFFERENTIATING THE PATIENT WITH "INTOXICATED" SYMPTOMS

It should be obvious that the distinction between the patient who is intoxicated and the patient experiencing a diabetic emergency can be blurred.

When the conditions are ripe, it can become very easy to mistake one for the other.

When faced with a situation like the one described in the opening scenario, take a minute to think. The patient's combativeness may be the result of hypo- or hyperglycemia, so restrain the patient as necessary and perform a thorough assessment.

One simple thing - ask them if they are diabetic.  You may be  unlikely to get a clear cut response..... but it's still the first thing you should do.

Look carefully for medical alert jewelry, especially around the wrist and neck. If personal identification is available, such as a wallet or purse, check for any information that might point to a medical condition, such as prescriptions, a medical card or, especially, for the insulin-dependent diabetic, small tuberculin syringes.

Establish baseline vital signs. Evaluate BGL using glucometry if available. Check for scarring on the anterior abdomen from repeated insulin injections, and the presence of an insulin pump strapped to a pants belt.

Most importantly, smelling alcohol on the breath is NOT a "rule out" finding!

While this article centers on the diabetic patient, there are other causes of altered mental status, including seizure, brain injury, stroke, drug overdose and psychological conditions.
In other words, if your initial impression is that the patient is intoxicated, pause for a few minutes and completely assess for other possible conditions.
If you can't be absolutely certain about the underlying cause, don't make a risky decision — transport to an appropriate medical facility.

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DO NOT GIVE THEM INSULIN. You could kill them.   If in doubt, try to get some juice or a bit of honey inside 'em. If they sober up almost miraculously, you got it right. If they don't you won't have done any harm, even if they were hypoglycemic already.

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