Continuing Professional Development: Diabetes and associated diabetic emergencies

Diabetes is a group of metabolic diseases characterised by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic complications of diabetes include accelerated development of cardiovascular disease, end-stage renal disease, loss of visual acuity, and limb amputations. However, in the acute situation, diabetes can result in conditions such as diabetic ketoacidosis and hyperosmolar hyperglycemic state, both of which have the same cause: insufficient insulin. This article explores the physiology of glucose control, the pathophysiology of diabetes and the role of the paramedic in the prehospital treatment of the diabetic emergencies, diabetic ketoacidosis and hyperosmolar hyperglycemic state.