September is Sepsis Awareness Month. An emergency consultant shares what she wants people living with diabetes and the wider community to know about this condition.

Sepsis is a life-threatening response to infection that progresses quickly and needs immediate attention. When you or someone close to you is unwell, particularly if they also have diabetes, it’s always worth asking the question – could it be sepsis?

We caught up with emergency consultant Julie Dockerty to find out about sepsis prevention, early symptoms and when people should seek help.

As an emergency doctor, what would you like people to know about sepsis?

That sepsis can affect anyone, young or old, and it’s a medical emergency.

This is why it’s so important to do everything you can to prevent it. If you’re living with diabetes, this might mean good self-management of your diabetes, with the help of your diabetes educator and GP. This will help your white blood cells work better so you don’t develop the complications.

On top of that, general health is so important. A healthy diet, getting some exercise and enough sleep and reducing stress.

One thing we’ve really learned from Covid is prevention – so things like good hand hygiene and wearing a mask if you’re sick or around sick people. And stay up to date with your vaccinations!

Are people with diabetes at greater risk of sepsis, and is this something you see in the emergency room regularly?

People living with diabetes are at greater risk of infection, which is always the beginning of sepsis. This is something we see a lot in the emergency department. There are a few reasons for this increased risk.

The first is that higher blood glucose levels impair the white blood cells in your body. White blood cells are like the soldiers that defend you against infection. With diabetes, you don’t have black belt soldiers, more white or yellow belt.

Another reason is that reduced circulation is a complication of diabetes. This can mean you’re not getting defences to the areas you need to. Plus, if you have a wound or ulcer, it may be slower to heal, and wounds are where bacteria can enter the body.

You may also be less likely to feel any wounds or ulcers, which is why it’s so important to protect your feet and check them regularly.

What are the early signs of sepsis?

Sepsis is hidden because it looks like so many infections that are either self-limiting or benign. The early signs of sepsis, such as rapid breathing, rapid heart rate, confusion and muscle pain, for example, can be caused by a lot of things. So that is the difficulty that we’re facing.

It’s important to simply be aware of sepsis as a possibility.

Sepsis can be triggered by any infection, from a skin infection to a UTI, and it can be viral, and it can be bacterial. It can move slowly or very fast and cause rapid deterioration. So, it’s very hard to say there’s one single set of symptoms, like there might be with a heart attack or a stroke.

This makes it hard for people at home to work out is if it’s an emergency or not. That’s why it’s always good to seek help.

Call Health Direct on 1800 022 222 or use their online symptom checker.

What if someone is reluctant to seek help because emergency departments are so busy?

We do have problems with ambulance ramping right now, and we don’t want people to turn up in an emergency department with a common cold.

But we also don’t want them staying home when they are really sick.

So, what do we do? If you’re thinking “I’ve never felt this bad before,” you need to be calling an ambulance. You don’t always have to have fever for it to be sepsis.

Another big alert for me is that there’s some confusion. If a young person is delirious or confused, call an ambulance. Even for patients with dementia, ask yourself if they are more confused than usual. This is something that relatives may often pick up.

Many things can cause confusion but it’s definitely something you want to get a medical review for. Trust your intuition.

For the stoic types who are reluctant to seek help, again, reflect back and think, is this the worst I’ve ever felt?

Remember that delay that can make you end up with a worse outcome. The ultimate is dead versus alive, but delay might also mean a more severe illness and a longer stay in hospital.

Dr Julie Dockerty is an emergency consultant as well as a Medical Advisor for the Department of Health and has a wealth of knowledge and experience in the recognition, treatment and management of sepsis.

Learn more at Sepsis Australia

Getting timely help in an emergency

Health Direct has a symptom checker that will advise if you should seek medical help or stay at home.

When you call 000 or Health Direct on 1800 022 222, you can be connected to WAVED (WA Virtual Emergency Department) for expert assessment and advice from experienced emergency clinicians.

Your sick day plan will prompt when you need to seek emergency advice.

Do you want help with self-managing your diabetes?

Anyone in Western Australia can call our free helpline for advice and support from our health team.

Call 1300 001 880 or email info@diabeteswa.com.au