What your friends should know

This page is for the people around someone with type 1 — a partner, a roommate, a sibling, whoever is usually there. When drugs or alcohol are involved, a low blood sugar (a hypo) can look a lot like being drunk or high, and the person having it may not be able to help themselves. You don't need medical training. You need to know three things: how to spot it, how to fix it, and when to call 911.

If you have type 1: show this page to two people who are usually with you. A plan nobody else knows about is not a plan.

Spot it

Watch for:

• Confused or slurring
• Shaking, sweating, pale
• Suddenly angry or acting oddly
• Drowsy, hard to wake

Any of these can also just be the drink or the drug. You can't tell the difference by looking — and neither can they. If you're not sure, treat it as a hypo and call for help.

Fix it

Diet drinks do nothing for a hypo, and chocolate is too slow. If they have a sensor or meter, a reading helps, but don't hold back the sugar while you figure it out.

Call 911

Ambulances aren't police. Nobody gets charged for calling one.

Vomiting that won't stop can be a sign of DKA — a serious high-blood-sugar emergency that builds over hours — rather than just a bad night. It needs a hospital. Ketamine is another one to know about: at higher doses a person can stop responding altogether, which looks exactly like a severe hypo. In either case, the answer is the same — if in doubt, call for help.

Before the night, not during it

The most useful things you can do happen in advance:

• Know that your friend has type 1, and where they keep their fast sugar.
• If you're the sober one, know that's your job tonight.
• Know whether they wear a medical ID. Paramedics look for it first.

For the person with type 1, the full staying-safer checklist and the two emergencies go into more detail.