Seizures and Diabetic Emergencies

Seizures and hypoglycaemia can look similar and may occur together. Low blood sugar can cause confusion, aggression, sweating, shaking, drowsiness, fitting, or loss of consciousness. Seizures may be due to epilepsy, hypoglycaemia, fainting, medication, illness, or an unknown cause.

Safe immediate actions

• Protect the patient from injury and note the time.
• Do not restrain convulsive movements.
• Do not put anything in the mouth during a seizure.
• Bring oxygen, suction, AED, glucose meter, oral glucose, and glucagon.
• Call 999 for prolonged, repeated, first-time, atypical, injured, or poorly recovering seizures.

For hypoglycaemia, SDCEP guidance recommends oral glucose if the patient is conscious and cooperative, repeating if needed. If the patient is unconscious or uncooperative, use glucagon according to protocol and give oral glucose once the patient can swallow. Dental nurses can help by recognising risk, checking whether the patient has eaten, bringing the emergency kit, recording timings, and escalating if the response is poor.

Midazolam and glucagon

Do not assume all fitting is epilepsy. In dental practice, hypoglycaemia, fainting, medication effects, illness, and delayed recovery all require assessment and escalation.