Breaking News
September 22, 2018 - Finding epigenetic signature appears to predict inflammation risk in serious type of IBD
September 22, 2018 - Researchers develop light-based technique to measure very weak magnetic fields
September 22, 2018 - UAB researchers study dysfunction of the immune system associated with NSAID carprofen
September 22, 2018 - QIAGEN and DiaSorin launch automated, CE-marked workflow for high-throughput TB screening
September 22, 2018 - Cardiac MR With Contrast Feasible in Developing World
September 22, 2018 - Daily low-dose aspirin doesn’t reduce heart-attack risk in healthy people
September 21, 2018 - Children with asthma found to be disadvantaged in education and future occupation
September 21, 2018 - Interaction of chemical slurry and ancient shale in fracking wastewater causes radioactivity
September 21, 2018 - Researchers find that sample size is key factor determining accuracy of study results
September 21, 2018 - Study shows how the drive to eat overpowers the brain’s signal to stop
September 21, 2018 - 30 Million Americans Now Have Diabetes
September 21, 2018 - Thousands of breast cancer gene variants engineered and analyzed
September 21, 2018 - The current fellowship interview process is cumbersome — Stanford researchers have a better idea
September 21, 2018 - Progenitor cells for human bone and cartilage have been identified
September 21, 2018 - Study reveals new therapeutic target for pediatric tumor-associated intractable epilepsy
September 21, 2018 - SLU’s College professor receives NIH grant to develop I-TEST project
September 21, 2018 - DermTech completes enrollment in clinical study to assess DNA damage and reversal
September 21, 2018 - Grieving patients treated with talk therapy have lower risk of suicide and psychiatric illness
September 21, 2018 - NIH and FDA call for eliminating involvement of RAC in human gene therapy experiments
September 21, 2018 - New system uses algorithm to convert 2D videos into 3D printed ‘motion sculptures’
September 21, 2018 - Sea squirt model reveals key molecules in dopaminergic neuron differentiation
September 21, 2018 - Effective management of neonatal abstinence syndrome requires coordinated ‘cascade of care’
September 21, 2018 - Refugees seek care for wounds of war
September 21, 2018 - Under the sea, in an octopus’ garden on ecstacy
September 21, 2018 - Eating foods with low nutritional quality ratings linked to cancer risk in large European cohort
September 21, 2018 - Giving kids honest information about water consumption may help them make healthy choices
September 21, 2018 - Horwitz Prize Awarded for Work on Hormones
September 21, 2018 - CHMP issues positive opinion supporting use of Trelegy Ellipta in broader group of COPD patients
September 21, 2018 - Scientists discover new molecules that work together to remove unwanted DNA
September 21, 2018 - Dr. Fenella France to deliver 2019 Plenary Lecture
September 21, 2018 - New research finds that MHC-II molecules have more influence on tumors than MHC-I
September 21, 2018 - Researchers study effects of cardiac cycle in simple learning task
September 21, 2018 - FDA takes new steps to address opioid crisis by approving Opioid Analgesic Risk Evaluation and Mitigation Strategy
September 21, 2018 - Positive Barhemsys Phase 3 Treatment Data Published in Anesthesia & Analgesia
September 21, 2018 - Celiac Disease Screening: MedlinePlus Lab Test Information
September 21, 2018 - Autism linked to egg cells’ difficulty creating large proteins
September 21, 2018 - Tweaking nuclear pores could provide new avenue to battle against cancer
September 21, 2018 - Experts warn health care providers to slow down in allowing smart pill in patient care settings
September 21, 2018 - MoreGrasp reports breakthrough development of grasp neuroprosthetics activated by thought control
September 21, 2018 - Study reveals new way to target HER2-negative metastatic breast cancer
September 21, 2018 - CHMP grants positive opinion for VENCLYXTO plus rituximab for treating relapsed/refractory CLL
September 21, 2018 - Study offers solid link between visceral organs and brain’s reward, motivation system
September 21, 2018 - First U.S. patient treated with innovative gene therapy at Bascom Palmer Eye Institute
September 21, 2018 - New study shows how Ethiopia has managed to achieve extraordinary progress
September 21, 2018 - Choroidal Detachment – The American Society of Retina Specialists
September 21, 2018 - New clinical trial evaluates aesthetic results of conservative surgery in breast cancer
September 21, 2018 - Discovery of a key protein involved in the development of autism
September 21, 2018 - Air pollution appears to be linked to increased risk of developing dementia
September 21, 2018 - Henry Ford Health System receives $600k grant to study genetic makeup of gliomas
September 21, 2018 - Arthritis common in individuals with varying degrees of depression, finds study
September 21, 2018 - Scientist intends to fight pathogenic bacteria with viruses
September 21, 2018 - New research suggests link between PFAS chemicals and hyperthyroidism in pet cats
September 21, 2018 - Multi-year study data shows impact of new soft contact lens to slow myopia progression in children
September 21, 2018 - Neuroscientists identify circuit for brain’s statistical inference about motion
September 21, 2018 - MILabs’ VECTor6 system wins Commercial Innovation Award at WMIC 2018
September 21, 2018 - Scientists find wild African monkeys infected with bacterium that causes syphilis, yaws in humans
September 21, 2018 - 2006 to 2015 Saw Increase in Severe Maternal Morbidity
September 21, 2018 - Similar changes in the brains of patients with ADHD and emotional instability
September 21, 2018 - Cobalt mining in DR Congo takes a high toll on both creuseurs and environment
September 21, 2018 - Eating fatty fish during pregnancy may boost unborn child’s brain development
September 21, 2018 - Study reveals promising new drug candidate to treat acute renal failure
September 21, 2018 - Neural signal that urges to eat overpowers the one that says to stop
September 21, 2018 - Scientists achieve breakthrough in accelerated diagnosis of multi-resistant hospital pathogens
September 21, 2018 - Researchers simulate how different breast tissues respond to heat from MRIs
September 21, 2018 - Despite red flags at surgery centers, overseers award gold seals
September 21, 2018 - Zapping Airway Nerves May Help COPD Patients Breathe
September 21, 2018 - Researchers find answers as to why some people are at risk of gout
September 21, 2018 - Stars of Stanford Medicine: Genetic counseling and compassion
September 21, 2018 - Researchers use reinforcement learning to train gliders to soar like birds
September 21, 2018 - New federally-funded research project could lead to treatments that extend human lifespan
September 21, 2018 - Health insurance ads have shifted over time due to health plans offered via ACA
September 21, 2018 - Use of transcranial electrical stimulation to bolster creativity has far-reaching implications
September 21, 2018 - Scientists find way to boost efficacy of powerful antimalarial drug with anti-cancer medicines
September 21, 2018 - Weighing the risks and benefits of drug tapering—two patients, two perspectives
September 21, 2018 - The “exposome” revealed: a barrage of bacteria, chemicals, microscopic animals and more
September 21, 2018 - Top three immune boosting recommendations to ward off freshers’ flu
September 21, 2018 - Young children’s oral microbiota could serve as early indicator for obesity
September 21, 2018 - Older individuals with multiple sclerosis report higher quality of life than younger counterparts
September 21, 2018 - LineaRx signs agreement with Takis/Evvivax to develop linear-DNA based anti-cancer vaccines
September 21, 2018 - AbbVie Presents Upadacitinib Longer-Term (32-Week) and Patient-Reported Outcomes Data from Phase 2b Atopic Dermatitis Study at 27th European Academy of Dermatology and Venereology (EADV) Congress
Emergency services crews often unprepared for diabetic crises

Emergency services crews often unprepared for diabetic crises

image_pdfDownload PDFimage_print

(HealthDay)—If you call 911, you expect to get the medical services you need.

But new research suggests that when it comes to severe low blood sugar episodes in people with diabetes, first responders might not be able to administer a potentially lifesaving medication called glucagon.

Glucagon is an injectable medication that prompts the liver to release stored glucose. This quickly raises blood sugar.

“In most states, basic EMTs [emergency medical technicians] cannot administer glucagon,” said study senior author Dr. Robert Gabbay, chief medical officer at the Joslin Diabetes Center in Boston.

But paramedics can give the injections, said Dr. Craig Manifold, medical director of the National Association of Emergency Medical Technicians. That’s because paramedics get between 750 and 1,500 hours of education compared to about 100 to 150 hours of training for EMTs.

Low blood sugar levels (hypoglycemia) generally occur in people with type 1 or type 2 diabetes taking insulin or other blood sugar-lowering medications. Researchers said more than 100,000 serious hypoglycemia episodes occur each year.

Gabbay noted even U.S. Supreme Court justices aren’t immune to this problem. Earlier this month, Justice Sonia Sotomayor, who has type 1 diabetes, had to call emergency services for help with serious low blood sugar.

Early symptoms include shakiness, confusion and sweating. Left untreated, low blood sugar can cause seizures, unconsciousness and even death, according to the American Diabetes Association (ADA).

These episodes can usually be treated with a food or drink containing fast-acting carbohydrates, such as glucose tablets, juice or sugar-sweetened soda, the ADA said.

Sometimes the episodes are more serious and require glucagon. People with diabetes at risk of hypoglycemia may have their own emergency glucagon kit. But many don’t. The study found that of more than 11 million Medicare patients with diabetes, just 0.2 percent had a glucagon kit.

Ideally, family members are trained to use the kit. This involves mixing a dry powder with a sterile fluid. Then the proper dose needs to be drawn into a syringe and injected into muscle tissue. Everything that’s needed—including instructions—is in the kit.

Only eight states (Alaska, Illinois, Kansas, Minnesota, Montana, Rhode Island, Virginia and Wisconsin) and Washington, D.C., let EMTs give glucagon, the study found. Forty-one states don’t allow EMTs to give glucagon, and Texas doesn’t set specific standards.

Nationwide, there are 198,000 EMTs and about 61,000 paramedics. That means there’s a 75 percent chance that a responder won’t be able to give a potentially lifesaving treatment, researchers said.

Bryan Edwards, director of the Union EMS from Carolinas Healthcare, said those numbers don’t necessarily mean that only EMTs respond to an emergency call.

“In North Carolina, the state controls the ambulance services. When someone calls, they’re asked a series of questions and will send a paramedic when needed,” he explained.

But that doesn’t seem to happen in all states, the study found. Of nearly 90,000 cases where glucagon was given before the hospital, emergency dispatchers correctly coded the calls as a “diabetic problem” only about 45 percent of the time.

Almost 4,000 of those people had side effects from the glucagon injection. The most common reactions were nausea and vomiting, Gabbay said.

The cost of a glucagon kit is around $212. Gabbay noted that compared to an ER visit (average cost nearly $1,500) or a hospital admission (average cost of almost $19,000) for hypoglycemia, glucagon is quite cost-effective.

But in these days of tight government budgets, Manifold said the cost of the kits can sometimes limit their use.

Edwards said that in North Carolina, the decision on what medications to stock an ambulance with is made at the county level.

“Every county carries different medications that are usually chosen based on historical needs,” he said.

For example, in Charlotte, there are a lot of hospitals nearby, so those ambulances don’t need to carry as much medication. But in the surrounding areas, where ambulance transport times are longer, they may carry more medications, Edwards added.

Gabbay recommended that anyone at risk of hypoglycemia should have a glucagon kit. He said this is especially important for people who no longer feel the symptoms of low blood sugar—a condition known as hypoglycemia unawareness.

The study appeared recently in the Annals of Internal Medicine.


Explore further:
For diabetics, nasal powder fixed severe low blood sugar

More information:
Robert Gabbay, M.D., Ph.D, chief medical officer, Joslin Diabetes Center and associate professor, Harvard Medical School, Boston; Bryan Edwards, director, Union EMS, Carolinas Healthcare, Monroe, N.C.; Craig Manifold, D.O., medical director, National Association of Emergency Medical Technicians; Dec. 26, 2017, Annals of Internal Medicine.

Learn more about low blood sugar from the American Diabetes Association.

Journal reference:
Annals of Internal Medicine

Tagged with:

About author

Related Articles