Diabetes-Related Emergencies Toolbox Talk

Diabetes-related emergencies can happen when a worker’s blood sugar gets too low or too high. On a jobsite, heat, heavy work, missed meals, long shifts, dehydration, illness, or changes in routine can make symptoms worse and can lead to confusion, weakness, collapse, or loss of consciousness.

This talk focuses on recognizing warning signs, getting help quickly, keeping the worker safe, and knowing when emergency services are needed.

Why This Matters

• Low blood sugar can become serious fast and may affect speech, balance, thinking, and consciousness.
• High blood sugar can also become dangerous, especially with dehydration, illness, heat, or long work periods.
• Symptoms may look like fatigue, heat stress, intoxication, anger, confusion, or a minor illness.
• Workers may not want to speak up about diabetes or may try to keep working through symptoms.
• Fast response helps prevent falls, equipment incidents, vehicle crashes, and serious medical emergencies.

Common Hazards

• A worker becoming shaky, sweaty, weak, dizzy, confused, irritable, pale, or unusually tired.
• Slurred speech, poor coordination, headache, blurred vision, trouble focusing, or acting out of character.
• Missed meals, skipped breaks, heavy exertion, heat exposure, dehydration, or working overtime.
• Workers operating lifts, vehicles, tools, or equipment while blood sugar symptoms are developing.
• Workers eating alone, working alone, or being assigned to remote areas where symptoms may go unnoticed.
• Assuming a confused or unsteady worker is under the influence instead of checking for a medical issue.
• A worker improving after a short break but symptoms returning later during heat, heavy work, or delayed meals.

Safety Checklist

Before Work Begins

• Know who on the crew is trained in first aid, CPR, and AED use.
• Locate the nearest first aid kit, AED, phone, radio, emergency contact list, and site address.
• Confirm the best gate or access point for emergency responders.
• Make sure workers have access to drinking water, meal breaks, shade, and a place to safely manage personal medical needs.
• Encourage workers with medical conditions to share emergency instructions with supervision or a trusted coworker as required by company policy.

During Work

• Stop work if a worker shows confusion, weakness, shakiness, sweating, dizziness, slurred speech, poor coordination, or unusual behavior.
• Move the worker away from equipment, traffic, heights, edges, ladders, trenches, and other hazards if it can be done safely.
• If the worker is awake, able to swallow, and says they need sugar, help them access their approved quick sugar source.
• Do not give food, drink, or medication to a worker who is unconscious, confused to the point they cannot swallow safely, or having a seizure.
• Call emergency services if the worker is unconscious, has a seizure, cannot swallow, does not improve quickly, or symptoms return.
• Do not let the worker drive, operate equipment, climb, or return to high-risk work until they are fully recovered and cleared by supervision or medical direction.
• Give responders clear details about symptoms, time started, work conditions, heat exposure, food or drink given, and any known medical information.

Crew Talking Points

• What symptoms could show a worker is having a diabetes-related emergency?
• Who on this crew is trained in first aid, CPR, and AED use?
• Where are the first aid kit, AED, phone, radio, and emergency contact list?
• How will we make sure workers get water, breaks, and meals during heavy work or hot weather?
• What should workers do if a coworker becomes confused, shaky, weak, or starts acting out of character?
• Speak up if you are unsure how to report a medical emergency, where emergency supplies are located, or how responders will reach the work area.

Stop Work If

• A worker becomes confused, shaky, weak, dizzy, sweaty, pale, unsteady, or unable to focus.
• A worker has slurred speech, unusual behavior, blurred vision, poor coordination, seizure, or loss of consciousness.
• The worker cannot safely swallow, cannot answer simple questions, or does not improve quickly.
• The worker is near equipment, traffic, heights, ladders, open edges, trenches, energized areas, or other hazards.
• The crew is unsure whether the condition is diabetes-related, heat-related, intoxication-related, or another emergency.

Final Reminder

Diabetes-related emergencies can look like other problems. Stop work, protect the worker from hazards, get trained help, and call emergency services when symptoms are serious or do not improve.