Diabetes 911. Larry A. Fox

      

Director, Book Publishing, Robert Anthony; Managing Editor, Book Publishing, Abe Ogden; Editor, Greg Guthrie; Production Manager, Melissa Sprott; Composition, ADA; Illustrations, Pam Little, CMI; Cover Design, pixiedesign, llc; Printer, United Graphics, Inc.

      ©2009 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

      Printed in the United States of America

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      The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

       _{The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).}

      ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at the address below, at [email protected], or by calling 703-299-2046.

      American Diabetes Association

      1701 North Beauregard Street

      Alexandria, Virginia 22311

       Library of Congress Cataloging-in-Publication Data

      Fox, Larry A.

      Diabetes 911 : how to handle everyday emergencies / by Larry A. Fox and Sandra L. Weber.

      p. cm.

      Includes index.

      ISBN 978-1-58040-300-9 (alk. paper)

      eISBN 978-1-58040-378-8

      1. Diabetes—Complications. 2. Medical emergencies. I. Weber, Sandra L. II. Title.

      RC660.F688 2008

      616.4’62025—dc22

      2008024026

       This book is dedicated to all of the patients and families who have taught me so much about diabetes.

       —Larry A. Fox

      To my family, with love.

       —Sandra L. Weber

      CONTENTS

       Title Page

       Copyright Page

Acknowledgments

Introduction

1: Preparation and Prevention

2: Hypoglycemia

       3: Sick Day Care

       4: Insulin Pump Emergencies

       5: Depression and Coping

       6: Traveling with Diabetes

       7: Miscellaneous Emergencies

       8: Severe Weather and Natural Disasters

       Index

Acknowledgments

      I would like to graciously acknowledge the members of the diabetes team and my colleagues and the endocrine staff at Nemours in Jacksonville, all of whom have made immeasurable contributions to the care of children with diabetes. I am especially indebted to Dr. Nelly Mauras, a wonderful friend, colleague, and mentor, whose support over the years has been invaluable.

      I am grateful to the American Diabetes Association and its editorial staff for the opportunity to enhance the education and care of patients with diabetes and their families.

      Last, but certainly not least, I am forever thankful to my wife, Mary Louise, and my daughters, Erin and Megan, for the endless support and love they have given me.

       —Larry A. Fox, M.D.

      I wish to thank all who have contributed to a lifetime of learning: my patients, who have shared their joys, frustrations, successes, and struggles; my colleagues, who have provided an environment in which to think and grow; my students, who have kept the desire to learn fresh; and my family, who have always been there, encouraging me to grow and explore and reach.

      I am grateful to the American Diabetes Association for their commitment to those with diabetes and to Greg Guthrie for his guidance in preparing this manuscript.

       —Sandra L. Weber, M.D.

Introduction

      People with diabetes have to deal with the same day-to-day emergencies in life as those that occur for people without diabetes. Unfortunately, they also have to deal with a number of diabetes-related emergencies—ones that are not experienced by most people. These include potentially life-threatening events, such as reactions to low blood glucose levels (hypoglycemia) or insulin pump failure, but also include less severe emergencies, such as travel-related diabetes issues. It goes without saying that the best way to deal with any emergency, diabetes-related or not, is to be prepared. That’s why we wrote this book.

      Diabetes 911 will help you prepare for the emergencies that creep up if you have diabetes. It is a valuable reference for children and adults with diabetes (regardless of whether you have type 1 or type 2). People who are friends or family