Diabetic Emergency First Aid: How to Respond to Hypoglycaemia and Hyperglycaemia (2026)

By SKLD Training - 2026-02-05

If a person with diabetes becomes confused, shaky, sweaty, or unresponsive - give them something sugary if they are conscious and can swallow safely. If they are unconscious, call 000 immediately and place them in the recovery position. This guide explains the difference between low and high blood sugar emergencies and what to do in each case.

What Happens in a Diabetic Emergency

Diabetes affects around 1.3 million Australians, according to Diabetes Australia. At any workplace, school, or public space on the Gold Coast, there is a real chance that someone nearby is managing their blood sugar - and that you may one day be the first person to recognise when something has gone wrong.

A diabetic emergency occurs when blood glucose levels fall dangerously low (hypoglycaemia) or rise dangerously high (hyperglycaemia). Both can become life-threatening. As a first aider, the most important distinction is this: if the person is conscious and you are not sure which type of emergency it is, give sugar. Giving sugar to someone with high blood sugar will not cause significant harm in the short term. Failing to give sugar to someone with low blood sugar can cause unconsciousness, seizures, and brain damage.

Knowing what to look for - and what to do - is part of HLTAID011 Provide First Aid. If you have not trained recently, the scenarios in this guide are exactly what you will practise in a course.

Book a first aid course on the Gold Coast: SKLD Training - check available dates

Hypoglycaemia vs Hyperglycaemia: The Core Difference

The two types of diabetic emergency present differently and require different responses. Understanding the distinction is the foundation of an effective first aid response.

Feature	Hypoglycaemia (Low Blood Sugar)	Hyperglycaemia (High Blood Sugar)
What it is	Blood glucose falls below normal levels	Blood glucose rises above normal levels
Onset speed	Fast - minutes to hours	Slow - hours to days
Common causes	Too much insulin, missed meal, unusual exercise	Missed insulin dose, illness, excessive carbohydrates
Key signs	Shaking, sweating, pale skin, confusion, aggression	Extreme thirst, frequent urination, fruity breath, fatigue
Level of urgency	Very high - can deteriorate rapidly	High - but typically more gradual
First aid response	Give sugar if conscious and can swallow	Keep calm, hydrate if conscious, call 000
If unconscious	Recovery position, call 000	Recovery position, call 000

The key practical rule: if in doubt, treat for hypoglycaemia first. A moderate sugar dose will not cause serious harm to a hyperglycaemic person in the short term, but leaving a hypoglycaemic person untreated can be fatal.

Recognising Hypoglycaemia: Signs and Symptoms

Hypoglycaemia - often called a "hypo" - develops quickly. A person can go from feeling mildly off to unconscious within minutes. The brain relies almost entirely on glucose for energy, so even a moderate drop in blood sugar affects behaviour and thinking rapidly.

Common signs of hypoglycaemia include:

Shakiness or trembling - hands or whole body, often the first physical sign.
Sweating - cold or clammy skin, often without obvious physical exertion.
Pale or grey skin colour - the opposite of the flushed appearance seen in heatstroke.
Confusion or disorientation - the person may not know where they are or what is happening.
Irritability or aggression - a normally calm person who suddenly becomes hostile or combative.
Hunger - an urgent, intense need to eat.
Headache and dizziness - particularly if the person skipped a meal.
Weakness or fatigue - legs may feel heavy or unsteady.
Seizures - if hypoglycaemia is severe and untreated.
Loss of consciousness - the most serious outcome; requires immediate 000 call.

One important point for workplaces: aggression or combative behaviour in a person with known diabetes should always trigger a diabetic emergency response. Colleagues who do not know about the person's condition may mistake a hypo for intoxication or a behavioural issue. This is a common, dangerous error.

Recognising Hyperglycaemia: Signs and Symptoms

Hyperglycaemia develops much more slowly than hypoglycaemia. It is typically the result of missing insulin doses, illness, or sustained high carbohydrate intake. At a workplace level, you are more likely to be called on to help someone whose hypo has already been building over hours or days.

Common signs of hyperglycaemia include:

Extreme thirst - the person cannot get enough water.
Frequent urination - the kidneys are trying to flush excess glucose.
Fruity or acetone-like breath - a distinctive sweet smell caused by ketones. This can indicate diabetic ketoacidosis (DKA), a serious complication.
Nausea or vomiting - especially in DKA.
Blurred vision - fluid shifts in the eye caused by high glucose.
Fatigue and weakness - despite the body having excess glucose, cells cannot use it effectively without insulin.
Deep, rapid breathing (Kussmaul breathing) - a sign of DKA, where the body is trying to compensate for acid build-up.
Confusion or drowsiness - in severe or prolonged cases.

First Aid Response: What to Do Step by Step

The response depends on whether the person is conscious and able to swallow. Follow this sequence whenever you suspect a diabetic emergency.

Check for danger. Ensure the area is safe before approaching. Apply DRSABCD.
Check for response. Call the person's name, tap their shoulder. If unresponsive, call 000 immediately and go to step 7.
If conscious - ask them. A person having a hypo may be able to tell you. Check if they carry a medical alert bracelet, emergency card, or glucose gel.
Give sugar if they are conscious and can swallow safely. Use any fast-acting carbohydrate: fruit juice (150-200ml), regular soft drink (not diet), glucose tablets, jelly beans, or sugar in water. Avoid anything that requires significant chewing if the person is confused.
Wait 10-15 minutes and reassess. If the person improves, give them a longer-acting snack (sandwich, crackers with cheese) to maintain blood sugar. Encourage them to contact their doctor or diabetes nurse.
If they do not improve or are worsening - call 000. Do not delay. If you gave sugar and there is no response within 15 minutes, paramedics are needed.
If unconscious - call 000 immediately. Do not give anything by mouth. Place the person in the recovery position (on their side, airway open). Monitor breathing. Be prepared to start CPR if breathing stops.
Stay with them until help arrives. Monitor and report any changes to emergency services when they arrive.

Person's State	First Aid Action	Do NOT
Conscious, can swallow	Give 15-20g fast-acting sugar (juice, glucose tablets, lollies)	Give diet drinks, give insulin, delay treatment
Conscious, confused or drowsy	Help them to a safe position, give small sips of juice if they can swallow, call 000	Leave them alone, give food that requires chewing
Unconscious but breathing	Recovery position, call 000, monitor breathing	Give anything by mouth, leave unattended
Unconscious, not breathing	Call 000, start CPR immediately, use AED if available	Delay CPR, wait for family or colleague to arrive first

Ready to practise these skills in a real scenario? SKLD Training - book a first aid course on the Gold Coast

What You Must Never Do in a Diabetic Emergency

Several common instincts are wrong in this situation. Being clear about what not to do is as important as knowing the correct response.

Never give insulin. As a first aider, you cannot know the correct dose, type, or timing. Giving insulin to someone who is already hypoglycaemic can be fatal. Insulin lowers blood sugar further. Only the person themselves (or a medical professional) should administer insulin.
Never give anything by mouth to an unconscious person. The risk of choking or aspiration is severe. Recovery position and 000 are the only appropriate actions.
Do not assume aggression or confusion is a behavioural issue. Irritability and aggression are classic signs of hypoglycaemia. If a colleague is behaving unusually, consider a medical cause before dismissing it.
Do not leave them alone. A person in a diabetic emergency can deteriorate rapidly. Stay with them, monitor, and be ready to call 000 or start CPR.
Do not wait too long to call 000. If the person does not respond to sugar within 15 minutes, or if they are deteriorating, call for paramedics immediately.

Workplace Context: Why This Matters on the Gold Coast

According to Diabetes Australia, approximately 1.3 million Australians have been diagnosed with diabetes. An additional estimated 500,000 are living with it undiagnosed. In any workplace of reasonable size, there is a strong likelihood that at least one employee is managing diabetes - and they may not have disclosed it to their employer.

Across Gold Coast workplaces from Southport and Surfers Paradise to Robina, Burleigh Heads, Helensvale, and Coomera, the range of environments creates different risk profiles:

Hospitality and shift workers: irregular meal times and physical activity can disrupt glucose management, making hypos more likely during long shifts.
Outdoor and construction sites: heat and physical exertion increase glucose use and sweat-related fluid loss, raising hypo risk.
Offices and sedentary roles: staff may not notice gradual onset hyperglycaemia symptoms and delay seeking help.
Schools and childcare: children with Type 1 diabetes require staff trained to recognise and respond quickly, as children can deteriorate faster than adults.
Retail and customer-facing roles: a customer or client may have a diabetic emergency on your premises - not just staff.

The Queensland Workplace Health and Safety Act requires employers to maintain first aid provisions appropriate to the workplace. Having a trained first aider who knows how to respond to a diabetic emergency is part of meeting that obligation. (WorkSafe QLD - First Aid in the Workplace Code of Practice)

Fast-Acting Sugar: What to Keep in Your First Aid Kit

Standard first aid kits do not always include glucose sources, but workplaces with known diabetic staff should consider stocking these items separately:

Glucose tablets or gel - purpose-made, fast-acting, easy to store. Glucose gels can be placed inside the cheek of a semi-conscious person (never a fully unconscious person).
Fruit juice cartons - 150-200ml of orange juice or apple juice provides a reliable 15-20g of fast-acting sugar.
Regular soft drink (not diet) - a 375ml can of regular cola or lemonade contains approximately 40g of sugar.
Jelly beans or glucose lollies - around 6-7 jelly beans provides approximately 15g of glucose.
Honey sachets - can be placed under the tongue or on the gum of a semi-conscious person who cannot swallow safely.

Label the location of these items clearly in your workplace. If a person carries their own glucose tablets or emergency kit, assist them to access it rather than reaching for something from the store room first.

Frequently Asked Questions

What are the signs of a diabetic emergency?

Signs of a diabetic emergency differ depending on whether blood sugar is low or high. For hypoglycaemia (low), look for shakiness, cold sweating, pale skin, confusion, aggression, dizziness, or loss of consciousness. These come on quickly - within minutes. For hyperglycaemia (high), signs develop more gradually and include extreme thirst, frequent urination, fruity or acetone-smelling breath, nausea, fatigue, and confusion. If you are unsure which type it is and the person is conscious and can swallow, give sugar - it is the safer default while you assess the situation further.

What should you give someone having a hypoglycaemic episode?

Give a fast-acting sugar source - approximately 15-20g of carbohydrate. Suitable options include 150-200ml of fruit juice, a small regular soft drink (not diet), 6-7 jelly beans, glucose tablets, or a teaspoon of sugar dissolved in water. After symptoms improve, follow up with a slower-acting snack such as a sandwich or crackers with cheese to help stabilise blood sugar. If the person does not recover within 10-15 minutes, or if they are deteriorating, call 000. Only give food or drink to a person who is conscious and can swallow safely.

What is the difference between hypoglycaemia and hyperglycaemia?

Hypoglycaemia means blood sugar is too low - the most common diabetic emergency in a first aid context. It comes on fast and can cause confusion, shakiness, sweating, aggression, and rapid loss of consciousness. Hyperglycaemia means blood sugar is too high. It develops more slowly, over hours to days, and presents with thirst, frequent urination, fruity breath, nausea, and fatigue. Severe hyperglycaemia can lead to diabetic ketoacidosis (DKA), which is a medical emergency requiring hospital treatment. Both conditions require a 000 call if the person is unresponsive, deteriorating, or you are uncertain how to help.

Should you give insulin to someone having a diabetic emergency?

No. As a first aider, you should never give insulin to someone having a diabetic emergency. Insulin lowers blood sugar. If the person is already hypoglycaemic (low blood sugar), giving insulin can cause a severe, potentially fatal drop in glucose. You cannot reliably determine the correct type, dose, or timing of insulin without medical training and a blood glucose reading. If a person manages their own insulin and is conscious enough to self-administer, assist them to access their kit and let them do it themselves. Your role as a first aider is to give sugar if conscious and call 000 if they cannot manage themselves.

When should you call 000 for a diabetic emergency?

Call 000 immediately if the person is unconscious or unresponsive. Also call 000 if the person is conscious but not improving after 10-15 minutes of sugar treatment, if they are deteriorating rapidly, if they are having a seizure, if you suspect diabetic ketoacidosis (fruity breath, vomiting, rapid breathing), or if you are uncertain what is happening and the person cannot help you understand. When in doubt, call. Paramedics can administer intravenous glucose and manage complications that are beyond the scope of first aid.

Can a diabetic emergency be life-threatening?

Yes. Severe hypoglycaemia can cause seizures, loss of consciousness, brain damage, and death if untreated. Diabetic ketoacidosis - a complication of severe hyperglycaemia - is also a medical emergency with a significant risk of death without hospital treatment. Even a moderate hypoglycaemic episode that is handled correctly can become dangerous if the person is alone, on elevated ground, operating machinery, or driving. Acting quickly and correctly as a first aider makes a real difference in outcomes. The skill is straightforward and taught as part of HLTAID011 Provide First Aid.

Train to respond with confidence: Book a first aid course with SKLD Training on the Gold Coast

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