It's Saturday morning. The Unit is building a pioneering project in the hot sun when a Pathfinder stops, turns pale, starts breaking into a cold sweat and says they feel dizzy. They have type 1 diabetes. What you do in the next few minutes matters a lot.
The good news: a hypoglycemia crisis (low blood sugar) has clear signs and a simple step-by-step that any Counselor can learn. You don't need to be a doctor. You need to recognize what is happening, act calmly and know when to call for help.
This guide explains the difference between low sugar and high sugar, teaches the famous 15/15 rule and shows the clear line between what you can do and what requires emergency services. This is awareness, not a first-responder course. But it can help you take good care of a Pathfinder.
What hypoglycemia is and why it happens at the club
Hypoglycemia is when blood sugar (glucose) drops too low, usually below 70 mg/dL. Glucose is the brain's fuel. When it runs short, the body sets off alarms: trembling, cold sweat, racing heart. If no one acts, the brain starts shutting down functions, and confusion sets in.
In a Pathfinder with type 1 diabetes, the body does not produce insulin, so they inject it every day. The problem is the imbalance. They took their lunch insulin, but the hike was longer, the game harder, or they ate less than expected. The insulin keeps working and the sugar plummets.
That is why the club is a risky setting. Intense physical activity, heat, messed-up meal schedules at camp, excitement that makes you forget to eat. All of this can bring down the glucose of a Pathfinder who was perfectly fine half an hour earlier. It is not carelessness on their part; it is how diabetes works.
The signs: how to know it's low sugar
Hypoglycemia usually arrives fast, within minutes. Watch for this set of signs in the diabetic Pathfinder:
Trembling hands, cold sweat (even on a cold day), pale skin, sudden and strong hunger, a fast-beating heart. And as it worsens: confusion, slurred speech, unexplained irritability, difficulty paying attention. A Pathfinder who was cheerful and suddenly becomes aggressive or 'dazed' may have low sugar, not a bad mood.
Here is something important: mental confusion clouds their own judgment. They may insist they are fine when they are not. Trust the signs you see. If the Pathfinder has a glucose meter or sensor, help them measure. But when in doubt, and if they are conscious and able to swallow, treat it as hypoglycemia. Giving sugar to someone who mistakenly already has high sugar is far less dangerous than leaving hypoglycemia untreated.
The 15/15 rule: the step-by-step (only if they are conscious)
This is the standard response recommended by the Brazilian Diabetes Society. The rule applies only if the Pathfinder is conscious, alert and able to swallow safely. Keep the two numbers in mind: 15 grams of fast sugar, reassess in 15 minutes.
Step 1 — Give 15g of fast-absorbing carbohydrate. That equals: 1 tablespoon of sugar dissolved in water, 150 ml of regular soda (not diet) or whole orange juice, 3 to 4 chewable candies, or glucose tablets if they have them. No chocolate or cereal bar at this moment: the fat slows down absorption.
Step 2 — Wait 15 minutes. Stay by their side, seated, calm, no physical effort. Do not send them back to the activity.
Step 3 — Reassess. If they have a meter, measure again. If the signs persist or the glucose is still low, repeat: another 15g and another 15 minutes. When they improve, and if the next meal is more than an hour away, offer a real snack (a sandwich, a fruit with a carbohydrate) so the sugar does not drop again. Then, notify the family and the Director.
Read alsoBurns: first aid every Pathfinder should knowWhen it's serious: fainting, seizures and emergency services
There is a line you never cross. If the Pathfinder faints, stops responding or starts having a seizure, do NOT give anything by mouth. No water, no sugar, no gel, and don't put anything between their teeth. An unconscious person does not swallow properly, and food can go into the lungs and choke them. This is the most dangerous and most common mistake.
What to do: lay the Pathfinder on their side (recovery position), so that saliva drains and they don't choke. Move objects away if they are having a seizure, but do not forcibly hold their body down or restrain their tongue. Note the time. And call your local emergency number immediately (in Brazil, SAMU 192), stating that it is a diabetic person who is unconscious or seizing.
Some diabetic Pathfinders carry glucagon, an injectable medication for emergencies, and the family may have trained in its use. If there is a written medical instruction on the form and someone trained, follow it. If not, just keep the Pathfinder on their side, safe, and wait for emergency services. Calling the emergency service is never an overreaction in a crisis like this. It is also worth knowing CPR, although it is for another situation: cardiorespiratory arrest, not hypoglycemia.
The opposite: what if it's HIGH sugar (hyperglycemia)?
Not every diabetes crisis is low sugar. Hyperglycemia (high sugar) has different signs and develops more slowly, over hours. Knowing how to tell them apart keeps you from treating the wrong thing.
Signs of high sugar: intense and constant thirst, needing to urinate a lot, tiredness and drowsiness, blurred vision, and in cases that progress to ketoacidosis, breath with a sweet smell (similar to fruit or 'rotten apple'), nausea, stomach pain and rapid breathing. Note the contrast: hypoglycemia is 'fast, trembling and cold sweat'; hyperglycemia is 'slow, thirst and too much urination'.
Severe hyperglycemia is also an emergency, but the treatment is medical, not giving sugar. You do not correct high sugar at camp. If a diabetic Pathfinder shows these signs, with intense thirst, drowsiness and sweet breath, notify the family and seek medical care. If they are very lethargic, vomiting or hard to wake, call your local emergency number (in Brazil, SAMU 192). When in doubt between high and low, with the Pathfinder conscious, measuring the glucose settles the matter in seconds.
Prevention: the work you do BEFORE the crisis
The best emergency is the one that does not happen. And that is solved in the office, weeks in advance, not in the middle of the trail. The starting point is each Pathfinder's medical form. It needs to clearly record: whether they have diabetes, which type, which medications they use, the schedules, the guardians' contact and what to do in a crisis. The Director and the Unit Counselors must know this information, discreetly.
Arrange with the family that the Pathfinder always carries their own glucose source: candies, tablets or a sachet of sugar in a pocket or backpack, at hand during every activity. If they use a meter or sensor, they should bring that too. And talk to the Pathfinder without drama: ask them to speak up as soon as they feel the first signs, even in the middle of a game. Make it clear that stopping to take care of themselves is not 'being fussy' nor a reason for shame.
On camps and long hikes, adjust meals and snacks, and keep an eye on the diabetic Pathfinder during moments of greater effort. None of this excludes them from activities; on the contrary, good preparation lets them take part in everything safely. Caring for the health of the troop is part of the leadership routine, just as much as teaching a lashing or leading a meeting.
Each body is a work carefully made
For the Pathfinder Club, caring for the body is part of faith. The Bible says, in Psalm 139:14: 'I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well' (NIV). Each Pathfinder, with or without diabetes, is a work carefully made by God.
Having diabetes makes no one less able to climb a mountain, earn an Honor or lead a Unit. It only makes the troop learn to take better care of one another. And that is one of the most beautiful lessons of the club: no one is left behind, and the strength of the group appears precisely in the care for whoever is most vulnerable at that moment.
Adventists place special value on the health of the body, understood as a gift from God to be well cared for. You do not need to share this belief to apply everything you have read here. Recognizing the signs, applying the 15/15 rule and knowing when to call emergency services is care that serves any person, of any faith. And it is, in the end, a practical way of loving your neighbor.