With 4.8 million people in the UK now having diabetes, do you and your staff know what to do in a diabetic emergency? Read our comprehensive guide on diabetes in the workplace.

As health and safety training specialists for workforces we come across the subject of diabetes a lot.

After all, there are now 4.8 million people in the UK with the disease – double the amount 20 years ago – so it is a subject employers should be clued up about.

Latest figures by Diabetes UK show that the upward surge of people being diagnosed with diabetes will likely continue, reaching 5.5 million by 2030. As one in 15 people now have diabetes and with a new diagnosis every two minutes, it’s no surprise that the NHS bill for this condition alone comes in at £19,000 a minute.

World Diabetes Day is held on November 14th, hosted by the International Diabetes Federation. We’d like to highlight this day by offering guidance about first aid and diabetes, along with some general education about the disease and how to look after yourself in order to manage or avoid diabetes. This is especially important in the time of Covid-19, when research has revealed that people with diabetes are at greater risk of dying from the virus.

Diabetes: A quick guide
Diabetes is a lifelong serious condition and involves having to control the blood glucose levels in the body to stop it getting too high, which can be dangerous. Among the different types of diabetes, type 1 and type 2 are the most common.

About 8% of people currently have type 1, while type 2 makes up about 90% of the overall number. Type 1 is an autoimmune disease and it is not known how it is caused. It is more likely to be diagnosed earlier in life and is not affected by lifestyle.

Type 2 diabetes risk factors are family history, ethnic background, age and an unhealthy lifestyle. Being overweight is a common factor.

Diabetes can have a knock-on effect to a person’s overall health, and there are a number of risks and side-effect ailments, including sight loss, kidney disease, foot ulcers, heart failure, strokes and depression.

Earlier this year the Diabetes Times reported that Bradford had the highest prevalence of the disease in the country, with 12,116 people recorded as having diabetes. This accounts for 10.81% of the population and is much higher than the UK average of 6.9%.

The Yorkshire city has three times the number than that of the lowest prevalence in the UK, which is Richmond in London. Harrow and Leicester follow close behind Bradford, with 9.79% and 9.37% of the population being diagnosed respectively.

When the figures were released, Chris Askew, Diabetes UK chief executive, called for the government to take action, calling diabetes ‘an urgent health crisis’ and said that over half of type 2 cases could be avoided if better lifestyle choices were encouraged.

World Diabetes Day
Huge efforts to raise awareness about the chronic condition are being made around the globe, and not without reason. The statistics on people who already have the disease are stark enough, however experts also believe there are more than 13 million people in the UK who are at risk or already have undiagnosed type 2 diabetes.

In addition, there are other reasons to highlight this serious disease. The latest figures show the NHS was spending a total of £27 million every day – 10% of its overall budget – on diabetes, which equates to £10 billion every year.

Out of that sum, 80% was spent on diabetes-related complications. One in six people occupying a hospital bed in the UK has diabetes, and people with the condition are twice as likely to be admitted to hospital.

Know how: Quick guide to giving first aid in a diabetic emergency
Because of the prevalence of diabetes in our society, it means workplaces are undoubtedly going to be affected by the disease. Many employers and their teams will either have diabetes or work with someone who does.

In fact, in most of our first aid training courses we usually come across at least one person who has had to administer first aid to a family member or colleague.

Very low or very high blood sugar affects the brain’s ability to function normally, so understanding how to help someone with diabetes is vital, and could be difference between life and death.

The most likely emergencies with a diabetic patient

There are three primary emergency situations that a person with diabetes is susceptible to:

• Low blood sugar levels: Hypoglycaemia (needs glucose/sugar)
• High blood sugar levels: Hyperglycaemia (may need insulin)
• Diabetic coma: Unconscious

How to spot the signs

A conscious person with low blood sugar will likely show these symptoms:

• Pale, clammy skin
• Change in behaviour, can appear drunk or confused, not themselves, can be aggressive or quiet
• Shaking, trembling
• Weak, tired, lethargic
• Fast but weak pulse

A conscious person with high blood sugar will likely show these symptoms:

• Change in behaviour, confusion
• Weak, tired, lethargic
• Thirsty
• May have acetone-like smell to their breath

It may be difficult for a first aider to recognise the difference between hypoglycaemia and hyperglycaemia.

How to treat a diabetic in an emergency

We like to teach our delegates the following rule-of-thumb when it comes to a diabetic emergency: While diabetes is a complex subject, the first aid it is very simple – give sugar.

Here is our diabetic emergency step-by-step guide:

1. A conscious diabetic needs sugar immediately. Try to persuade them to take it in liquid form such as a fizzy drink, sugary milk, fruit juice or water with sugar, as these act fast. Do not give them alcohol as this lowers blood sugar quickly, hot drinks because they could burn themselves, or diet drinks as they don’t contain enough sugar. Failing that, try sweets, biscuits or dextrose tablets.
2. You could see an improvement in minutes if the casualty has low blood sugar, however it could take up to 15 minutes so use a timer to help you. The person should regain brain function and become aware of their surroundings and begin to manage themselves.
3. If there is no improvement after 15 minutes, it is likely their blood sugar is high. At this point, call 999 for an ambulance.
4. If the casualty is unconscious, put them in the recovery position or begin CPR if they are not breathing. Tell the emergency operator that the casualty is diabetic as this changes the priority of the call – someone in this position is in a life threatening situation and needs immediate medical treatment.
5. A first aider should never administer insulin or encourage a person with diabetes in this position to do it themselves as it could lead to dangerously low blood sugar, diabetic coma or even death.

Training your staff for a diabetic emergency

As well as the first aid know-how, staff should understand other basics to help colleagues in a diabetic emergency.

• People will diabetes will usually carry a sugary snack or drink with them in case of an emergency. Know where they keep these, as well as any medication to give to paramedics should the need arise.
• Be aware when socialising as sometimes a diabetic emergency can look the same as being drunk. Alcohol can lower the blood sugar rapidly, so keep an eye out for your co-workers.
• Get talking within the team. Being open and honest about diabetes and its dangers can help ensure everyone is alert and aware when first aid intervention is needed. Greater understanding also helps to break down any stigmas that may exist

Diabetes in the workplace
According to Diabetes UK, 37% of people living with the condition said diabetes caused them a problem at work. In fact, as many as one in five people with type 1 diabetes reported discrimination in the workplace.

The Diabetes UK advocacy service said 30% of all of its issues were related to work-related problems in 2017 – a total of 1,593.

There are many ways in which a business can help its employees to feel supported and remain productive. Let’s look at some ways in which employers can make huge positive differences for their individual workers, their overall workforce – and even society as whole.

How to support employees with diabetes
Open up the conversation
Allowing the conversation to open up around diabetes can help in a variety of ways: improving the mental health and wellbeing of the employee; the eradication of discrimination; understanding of how staff are coping; and the ability to providing initiatives and measures which everyone gains from.

Educate yourself on the disease
There are alarming numbers of people out there who don’t even understand the disease they’re living with, so it’s unlikely that employers without diabetes will fully understand it. There are many resources out there so a quick read will give you a lot of insight. For example, did you know that there’s a link between diabetes and depression?

Be flexible
Understanding what your staff with diabetes need means you can then put measures in place to help them. Being accommodating for attending healthcare appointments for starters. Supporting them around working hours, any modified equipment they need or showing patience for when the disease becomes debilitating.

Provide privacy
Staff with diabetes may need to take injections of insulin or check blood sugar levels throughout the working day. Giving them a private and clean space to do this will provide peace of mind and inclusivity, and reduce stress.

Revisit working practices
Do your terms allow for assessing a worker on an individual basis? For example, some employees may benefit from flexible working patterns or a higher level of sick leave. Diabetes can cause short and long term complications, so factor this in to your policies.

Train your staff in first aid
Your workforce should know what to do in an emergency situation, but do they know what to do in a diabetic emergency? Pass on the information you have gathered.

Do a diagnostic diabetes risk assessment
Get the overall picture of your workforce. Understand the full health picture of your staff, then you can make steps towards pinning down your approach, ensuring the workplace is prepared, safe and supportive to those who need it.

Practical ways to target diabetes
Look at your company culture

As well as supporting people who already have diabetes, there are many improvements employers can make to do their bit in eradicating the disease. We know there is plenty that can be done to avoid getting type 2 diabetes. Promote healthier choices in available food and drink, encourage work-life balance and exercise, and have policies around mental wellbeing.

Stamp out ‘the sitting disease’

A study in the journal Diabetologia discovered that people who sit still for long periods of time double the risk of developing type 2 diabetes, even if they exercise too. The NHS says many adults in the UK sit for about nine hours a day, and that living a sedentary lifestyle is linked to obesity, type 2 diabetes, some types of cancer and early death. Because many people spend hours sitting at a desk while at work, employers should be finding ways to reverse this problem. For example, encourage people to take the stairs, set reminders to stand, create standing work stations, go for a walk while speaking on the phone or regular coffee breaks.

Covid-19 and the dangers
While people with diabetes are not at greater risk of catching Covid-19, they are at a higher risk of getting seriously ill or dying. As with coronavirus without diabetes, the symptoms will vary from person to person, however people with diabetes should be taking steps to looking after themselves to avoid complications, such as maintaining healthy blood sugar targets and being healthy.

Watch this video below, which explains Covid-19 and diabetes in more detail:

Let’s keep things simple:

• Eat well
• Make sure you’re eating a healthy, balanced diet without too much sugar.
• Stay active
• This is very important to avoiding type 2 diabetes. Find an activity you enjoy and aim to move for at least 30 minutes a day, five days a week.
• Lose weight
• Taking steps to losing weight has many health benefits, not just when avoiding type 2 diabetes. Making a concerted effort will help to boost your mood, lower your blood pressure, help you to sleep, help you to manage stress and you will be healthier overall.

Get support
You may need to look for help when it comes to making every day changes, setting goals and reaching them. There is so much help out there. Start with your GP if you don’t know where else to begin, or download the NHS Better Health app.

Look after your mental health
We know that depression and diabetes are linked. In fact 40% of people living with diabetes struggle with their mental health, and the NHS spends an extra 50% on the physical health of someone who has poor psychological wellbeing and diabetes, compared to someone with diabetes who does not have mental health issues. Here is a practical guide on how to cope.

https://cesafety.co.uk/diabetes-and-first-aid-how-to-help-in-a-workplace-emergency/