Emergency Preparedness

Planning ahead for diabetes emergencies and unexpected situations

In short: Being prepared for emergencies reduces stress and keeps your child safe. Most emergencies never happen, but having plans in place provides peace of mind for the whole family.

Hypoglycemia Emergencies

Recognizing and treating severe low blood sugar

Recognizing Severe Hypoglycemia

Severe hypoglycemia occurs when blood sugar drops so low the person cannot treat themselves. Warning signs include:

  • Unconsciousness or inability to wake up
  • Seizures or convulsions
  • Extreme confusion or combativeness
  • Unable to swallow safely

Glucagon Emergency Kit

Every child with T1D should have glucagon available at home, school, and anywhere they spend significant time. Options include:

  • Nasal glucagon (Baqsimi) - easiest to use, no mixing required
  • Injectable glucagon (Gvoke, Glucagon Emergency Kit)
  • Keep multiple kits - one at home, one at school, one for travel
  • Check expiration dates every 6 months and replace as needed

How to Use Glucagon

Train family members, babysitters, teachers, and coaches on glucagon use:

  • For nasal glucagon: Insert tip into nostril and press plunger
  • For injectable: Mix according to package directions and inject into thigh or arm
  • Turn person on their side (recovery position) in case of vomiting
  • Call 911 immediately after giving glucagon
  • Person should wake within 15 minutes - if not, call 911 again
  • Once awake, give sips of juice or regular soda, then a meal

When to Call 911

  • Always call after giving glucagon
  • If you don't have glucagon available
  • If person doesn't wake up within 15 minutes of glucagon
  • If person is having a seizure lasting more than 5 minutes

DKA (Diabetic Ketoacidosis)

Preventing and recognizing this serious complication

What is DKA?

DKA occurs when there's not enough insulin in the body, causing high blood sugar and ketone buildup. It's a medical emergency that requires immediate hospital treatment.

Warning Signs of DKA

  • Blood sugar consistently above 250 mg/dL despite correction doses
  • Moderate to large ketones in urine or blood
  • Nausea, vomiting, or stomach pain
  • Fruity-smelling breath
  • Rapid, deep breathing
  • Extreme thirst and frequent urination
  • Confusion or difficulty concentrating
  • Extreme fatigue or weakness

Prevention

  • Never skip insulin doses, even when sick
  • Check ketones whenever blood sugar is over 250 mg/dL
  • Have a sick day plan from your diabetes team
  • Ensure insulin pump sites are working properly (no kinks, infections)
  • Always have backup insulin (pens or vials) if using a pump

When to Go to the ER

  • Moderate or large ketones that don't come down with insulin and fluids
  • Vomiting more than twice in 4 hours
  • Unable to keep down fluids
  • Blood sugar over 400 mg/dL that won't come down
  • Signs of dehydration (no urination, dry mouth, dizziness)
  • Confusion, lethargy, or difficulty staying awake

Diabetes Emergency Kit

Essential supplies to have ready at all times

Home Emergency Kit

  • Glucagon emergency kit (check expiration)
  • Fast-acting glucose (tabs, gel, juice boxes)
  • Backup insulin (refrigerated and room temperature supply)
  • Extra pump supplies or pen needles
  • Blood glucose meter with extra batteries and test strips
  • Ketone strips or ketone meter
  • Contact information for diabetes team and pharmacy
  • Written emergency action plan

School/Daycare Emergency Kit

  • Glucagon emergency kit
  • Fast-acting glucose in multiple forms
  • Blood glucose meter and supplies
  • Back-up insulin and supplies
  • Emergency contact sheet with photos and instructions
  • Copy of 504 Plan or Diabetes Medical Management Plan

Travel Emergency Kit

  • Double all diabetes supplies
  • Glucagon that doesn't require refrigeration
  • Doctor's letter about diabetes supplies
  • Prescriptions for all medications
  • Medical alert information
  • List of nearby hospitals at your destination

Emergency Action Plans

Written plans for different scenarios

Hypoglycemia Action Plan

Post this in multiple locations (kitchen, school, babysitter instructions):

  • How to recognize low blood sugar symptoms
  • Step-by-step treatment (15g carbs, wait 15 minutes, recheck)
  • When to use glucagon
  • Emergency phone numbers

Sick Day Plan

Work with your diabetes team to create a written sick day plan that includes:

  • How often to check blood sugar and ketones
  • Insulin adjustments for high blood sugar and ketones
  • Foods and fluids to offer when sick
  • When to call the diabetes team vs. when to go to ER

School Emergency Plan

Include in your child's 504 Plan or keep with the school nurse:

  • Step-by-step instructions for treating lows and highs
  • Photos of your child to help identify symptoms
  • Parent/guardian contact information (home, work, cell)
  • Diabetes doctor contact information
  • Permission for emergency treatment

Emergency Contacts & Information

Who to call and what information to provide

Keep This Information Accessible

  • Endocrinologist name and 24/7 contact number
  • Diabetes educator phone number
  • Pharmacy name and phone number
  • Insurance information (policy number, member ID)
  • Medical alert membership information if applicable
  • List of all current medications and doses
  • Recent A1C results and typical blood sugar ranges

What to Tell 911 Operators

  • "My child has type 1 diabetes"
  • Current blood sugar level (if known)
  • Symptoms you're seeing
  • Whether glucagon was given and when
  • Your exact location and how to access your home

Medical Alert Identification

Your child should wear medical alert identification at all times (bracelet, necklace, or shoe tag). Include "Type 1 Diabetes" and emergency contact information.

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