Food turns into glucose, which fuels the body through the blood. Insulin is what lets that glucose move into the body's cells. In diabetes, that system doesn't work properly, so glucose stays in the blood instead. Too much of it causes damage slowly, over years. Too little of it causes a problem within minutes. That's the whole shape of the two emergencies a worker needs to recognise: highs harm slowly, lows harm fast, and the fast one is the one most likely to turn up on an ordinary shift.
What's the difference between type 1 and type 2 diabetes?
In type 1, the body has stopped making insulin altogether. It isn't caused by diet or lifestyle and can't be reversed, and the person needs insulin every day for life. In type 2, the body still makes insulin but can't use it well, and it's managed with food, activity, tablets and sometimes insulin, changing over time. Gestational diabetes appears during pregnancy and usually goes after birth, though it raises the chance of type 2 later. The emergency response to a hypo is the same whatever the type, so a worker doesn't need to check someone's diagnosis before acting.
What does a hypo actually look like?
A hypo is blood glucose that's fallen too low, usually under 4, and the brain is affected first because it runs on glucose. That's why it shows up as confusion and odd behaviour, not just shakiness. The signs, coming on quickly, include being shaky or weak, sweaty and pale, suddenly hungry, irritable or tearful with a mood change from nowhere, confused or vague, slurred speech or stumbling that's often mistaken for drunkenness, and headache or blurred vision. Some people lose their early warning signs over time, and for them confusion may be the first thing anyone notices. If a worker isn't sure whether it's a hypo, the rule is to treat it as one. Treating a hypo that wasn't there does no harm.
Can a hypo be mistaken for behaviour rather than a medical problem?
Yes, and it's the part support workers most need to understand. A hypo can be mistaken for being drunk, being difficult with sudden irritability or snapping, being tired and wanting to lie down, a behaviour of concern that seems to come from nowhere, or in an older person, worsening confusion read as dementia. The rule is simple: if someone with diabetes is suddenly not themselves, think hypo first, and rule it out before reaching for any other explanation.
How do you treat a hypo in someone who is awake?
This applies only when the person is awake and can swallow safely. Give fast sugar now, around 15 grams, which is about 150ml of regular soft drink, 125ml of fruit juice, six to seven regular jellybeans or four large glucose jellybeans, three teaspoons of sugar or honey, or glucose tablets or gel adding up to 15 grams. Wait 15 minutes, sitting with them rather than leaving them alone. Check again, and repeat the fast sugar if they're still low or unwell. Then give a longer-lasting snack, a sandwich, fruit, or their next meal if it's due. Call 000 if they don't improve after the second lot of fast sugar, or get worse at any point, rather than continuing to wait. Diet soft drink doesn't work, since it has no sugar in it. Chocolate is slower than wanted here, because the fat slows absorption.
The hard stop: when nothing goes in the mouth
If the person is drowsy, unconscious, having a seizure, or can't swallow safely, give nothing by mouth at all, no food, drink or gel, since it can go into the lungs. Call 000 straight away and say it's a diabetic emergency. Roll them onto their side and check breathing; if they're not breathing normally, start CPR. Glucagon is only given if a worker is specifically trained, authorised, and it's in the person's current plan, and that's said out loud when calling 000. Stay with the person until the ambulance arrives, and tell paramedics the person has diabetes and what was seen.
What are the signs of a high, and when does it become an emergency?
A high builds over hours or days and is easy to put down to a bad night or a virus: being very thirsty, weeing a lot including at night, tired and flat, blurred vision, and slow-healing cuts or grazes. Usually a high is a report-and-record situation, not a 000 call. The exception is diabetic ketoacidosis, which can develop within hours and is life-threatening. Call 000 for vomiting, especially with a high reading or illness; new, unexplained stomach pain; deep, fast breathing; sweet or fruity-smelling breath; or being drowsy or hard to rouse.
Where does insulin sit in a support worker's role?
Giving insulin needs three things all to be true: specific training for it, not general medication training; the provider's authorisation; and a current plan with the dose and timing. If any one is missing, it isn't given, and the worker escalates instead. Insulin lowers blood glucose, and too much of it is what causes the hypo this course spends most of its time on, which is why the sign-off exists and isn't a paperwork formality.
What does supporting someone with diabetes look like day to day?
Supporting the choice, not policing it. People with diabetes get plenty of unwanted advice, and an adult's food choices are their own. The role is to offer rather than withhold, make no comment on what's on someone's plate, support the plan they already have with timing, shopping or cooking where that's the worker's role, and raise a genuine concern properly with a supervisor rather than as a running commentary. Beyond day-to-day choices, feet, skin and eyes are where slow damage shows first, so a cut or blister that isn't healing, redness or swelling, a colour change, new numbness or tingling, or new trouble seeing all get reported, since a small foot wound is a serious thing in diabetes. Illness usually pushes glucose up even when someone isn't eating, and most plans have sick day instructions for exactly that reason. Insulin is often still needed when someone is unwell, so it's never skipped on a worker's own judgement.
How CORA's course fits into this
CORA's course Diabetes Awareness & Support, part of the Disability Understanding & Daily Life stream in the course library, covers what diabetes is, spotting and treating a hypo, recognising a high that's heading toward an emergency, and supporting someone without policing their choices. It is knowledge-only and does not replace accredited first aid training.
To map this alongside the rest of the Disability Understanding stream for a team, try the Free tools, free and no sign-up required, or enquire.
See how CORA covers diabetes awareness and the rest of Disability Understanding
CORA includes the provider portal behind the library: pathways with per-course due dates, automatic due, overdue and renewal reminders, a credential and evidence register, and exportable audit records, a training register by name, a completion summary and the credential register. Browse the full library, or get in touch to talk through what your team's coverage looks like right now.
Try the Pathway Builder Book a demo Browse the course libraryCommon questions
How do you treat a hypo in someone who is awake?
Give fast sugar straight away, around 15 grams, such as 150ml of regular soft drink, 125ml of fruit juice, or glucose tablets or gel adding up to 15 grams. Wait 15 minutes, sitting with them. Check again, and repeat the fast sugar if they're still low or unwell. Then give a longer-lasting snack. Call 000 if they don't improve after the second lot of fast sugar, or get worse at any point.
What do you do if someone having a hypo can't swallow safely?
Give nothing by mouth, no food, drink or gel, because it can go into the lungs. Call 000 straight away and say it's a diabetic emergency. Roll them onto their side and check breathing. Only give glucagon if you're specifically trained, authorised, and it's in their current plan. Stay with them until the ambulance arrives.
Can a hypo look like bad behaviour rather than a medical problem?
Yes, and this is the part workers most need to know. A hypo affects the brain first, so it can look like being drunk, being difficult, sudden irritability, agitation, or worsening confusion mistaken for something else entirely. If someone with diabetes suddenly isn't themselves, think hypo first and rule it out before reaching for any other explanation.
What are the signs that a high blood sugar is becoming an emergency?
Vomiting, especially with a high reading or illness; new, unexplained stomach pain; deep, fast breathing; sweet or fruity-smelling breath; and being drowsy or hard to rouse. Any of these means calling 000. This can develop within hours and is life-threatening.
Sources and further reading
- Guideline 9.2.9, First Aid Management of a Diabetic Emergency, Australian and New Zealand Committee on Resuscitation
- Medication Awareness for Support Workers, CORA Workforce
This page is general knowledge for support workers and providers, not clinical guidance. It does not qualify a worker to administer insulin or glucagon beyond what their organisation has specifically authorised and trained them for, and it is not a first aid qualification. Always follow the person's diabetes management plan and your organisation's policies.
← Back to the course library