The three most common causes of sudden death in diabetic patients are Hypoglycemia (Low Blood Sugar), MI (Heart attack) and DKA. All these are easily preventable with little education and awareness.
1) Hypoglycemia:
Hypoglycemia is low levels of blood sugar. If the sudden levels suddenly fall, or if hypoglycemia happens during night it can be fatal. Hypoglycemia usually happens when you are on glucose lowering drugs or insulin. The usual cause of hypoglycemia is overdose of medicine, skipping meals or excessive exercise. One should always monitor blood sugar levels in all such situations. The commonest presentation of hypoglycemia is excessive hunger, sweating, ghabarahat, palpitation. If any of these or any unusual symptoms appear, one must check the blood sugar instantly. If the glucose monitor is not available, one should not wait for checking blood sugar but should feed immediately with some carb containing diet like chapati, breads or biscuits. If the symptoms are severe sugar or some sweets can be given. If the patient is not fully conscious glucose paste should be prepared by adding water to glucose and the paste be applied inside mouth of the patient. If Glucagon injection is available, it can be given subcutaneously. Meanwhile preparations should be made to take the patient to hospital.
2) Myocardial Infarction:
Diabetic patients are at high risk of coronary artery disease. An annual cardiac check up can detect the disease in early stage. Symptoms of angina (which may sometimes confuse with those of hypoglycemia) should not be ignored. The commonest presentation is heaviness in chest, which can appear suddenly or while walking/exercising. It may be associated with sweating. Some patients get relieved with belching and usually attribute it to gastritis. Any of these symptoms should not be ignored specially in diabetic patients. Your diabetologist may advise you some medicines like Atorvastating, Aspirin for primary prevention.
Sorbitrate is a life saving drug and should be always with the patient. As an emergency keeping a tablet of sorbitrate beneath tongue may be life saving.
3) Diabetic Ketoacidosis:
Type 1 Diabetic patients are at high risk of DKA. The common triggers are missing of insulin dose or some kind of mental or physical stress. Type 1 diabetic patients should regularly monitor their blood sugars. If the sugars are high they should also test for urine ketones. During periods of stress they should follow sick day schedule. Monitor blood sugars more frequently, increase the dose of insulin if needed and have plenty of water.