Diabetic Shock and Insulin Reactions: Causes, Symptoms, and Treatments

Written by Joseph Saling

• What Is Hypoglycemia?
• What Causes Hypoglycemia?
• Are There Symptoms of Hypoglycemia or Warning Signs of Insulin Shock?
• How Is Hypoglycemia Treated?

Hypoglycemia, or insulin shock, occurs anytime there is an imbalance of insulin in your system.

Severe hypoglycemia, or insulin shock, is a serious health risk for anyone with diabetes. Also called insulin reaction, because of too much insulin, it can occur anytime there is an imbalance between the insulin in your system and the amount of food you eat, or your level of physical activity. It can even happen while you are doing all you think you can do to manage your diabetes.

The symptoms of insulin shock may seem mild at first, but they should not be ignored. If it isn’t treated quickly, hypoglycemia can become a very serious condition that causes you to faint, requiring immediate medical attention. Insulin shock can also lead to a coma and death. It’s important that not only you but also your family and others around you learn to recognize the signs of hypoglycemia and know what to do about them. It could save your life.

Hypoglycemia refers to a low level of blood sugar. The cells in your body use sugar from carbohydrates for energy. Insulin, which normally is made in the pancreas, is necessary for sugar to enter the cells. It helps keep the levels of sugar in the blood from getting too high.

It’s important to maintain the proper level of sugar in your blood. Levels that are too high can cause severe dehydration, which can be life-threatening. Over time, excess sugar in the body does serious damage to organs such as your heart, eyes, and nervous system.

Ordinarily, the production of insulin is regulated inside your body so that you naturally have the amount of insulin you need to help control the level of sugar. But if your body doesn’t make its own insulin or if it can’t effectively use the insulin it does produce, you need to inject insulin as a medicine or take another medication that will increase the amount of insulin your body does make. So, if you need to medicate with insulin, it becomes your responsibility to see that you have the amount of insulin you need.

When to take insulin or another medication and how much to use depends on when, what, and how much food you eat. It also depends on your level of physical activity since the cells in your body use more sugar when you are active. Hypoglycemia is a reaction to too much insulin in your system. The insulin speeds up the lowering of the blood glucose level. Then without eating or with your body burning sugar faster because of physical activity, the level of sugar becomes dangerously low.

Several things can cause hypoglycemia. Your blood sugar level could be low if you:

• Become more physically active than usual.
• Miss a meal.
• Change when or how much you normally eat.
• Take your insulin or medication in a different amount or at a different time than usual.
• Drink alcohol excessively without eating.

The symptoms of hypoglycemia can be classified as mild or early, moderate, and severe.

Mild Symptoms of Hypoglycemia

Mild symptoms include:

• Dizziness
• Irritability
• Moodiness or sudden changes in behavior
• Hunger
• Shakiness
• Sweating
• Rapid heartbeat

Severe Symptoms of Hypoglycemia

When hypoglycemia becomes severe, symptoms may include:

• Fainting and unconsciousness
• Seizures
• Coma
• Confusion
• Headache
• Poor coordination

Nighttime Symptoms of Hypoglycemia

Hypoglycemia can also occur overnight while you sleep. Symptoms may include:

• Crying out in your sleep
• Nightmares
• Damp pajamas or sheets resulting from perspiration
• Waking up tired, irritable, or confused

If you experience any possible signs of mild hypoglycemia, it’s important to check your blood sugar if you can to make sure it isn’t low. If it is, you should treat it quickly or seek emergency care. However, if you notice symptoms and can’t check your blood sugar level for some reason, you should go ahead and treat yourself for low blood sugar or seek emergency care. If symptoms are severe or you are unable to help yourself, seek emergency medical attention.

If your hypoglycemia is mild or moderate, the best way to raise your blood sugar level quickly is to eat or drink something that contains 15-20 grams of glucose or other sugar. You might take three to four glucose tablets or one-third to one-half tube of glucose in gel form, which you can buy at the drugstore. Or you may want to drink a half cup of fruit juice (orange juice or apple juice).

Other snacks you can use to raise your sugar level include:

• 1/2 cup of regular soda (not diet soda)
• 1 cup of milk
• 1 tablespoon of sugar
• 1 tablespoon of honey, molasses, or corn syrup
• 1/4 cup raisins
• 2 large or 6 small sugar cubes dissolved in water

You can also ask your doctor or dietitian for recommendations for other snack items that can help raise your blood sugar level when you need to.

After you’ve taken a snack, wait 15 minutes and check your blood sugar level again. If it is still low, eat another snack, then wait 15 minutes and check it again. Repeat the process until your blood sugar level is in its normal target range. Following that, eat another small snack if your regular meal is more than an hour away, such as half a sandwich, 1 ounce of cheese with 4-6 crackers, or 1 tablespoon of peanut butter with 4-6 crackers.

If you lose consciousness, you will need immediate medical attention. It’s important that you educate the people in your family and the people you work with about insulin shock and about what to do if it happens. Someone should call 911 or arrange to get you to an emergency room if that’s not possible. If you go to the hospital, doctors may give sugar through a vein (intravenously).

You can ask your doctor to prescribe a glucagon rescue kit and then teach others how to use it. Glucagon is a natural hormone that rapidly causes the level of sugar in your blood to rise. If you are unconscious, someone injecting you with glucagon even before emergency help arrives can prevent further complications and help you recover.

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Warning Signs and Treatment Options

Warning signs of insulin shock can include dizziness, shaking, clamminess, a rapid pulse, and other symptoms. If not treated, it can become an emergency.

Insulin shock occurs when you have too much insulin in your blood. This can lead to hypoglycemia, also called low blood sugar.

Insulin shock may occur if someone:

• ignores mild hypoglycemia
• takes too much insulin by mistake
• misses a meal completely
• does excessive unusual exercise without changing their carbohydrate intake

Insulin shock is a diabetic emergency. If left untreated, it can lead to diabetic coma, brain damage, and even death.

Having too much insulin in your blood can lead to having too little glucose. If your blood sugar falls too low, your body no longer has enough fuel to carry out its regular functions. In insulin shock, your body becomes so starved for fuel that it begins to shut down.

If you have diabetes and use insulin to help control your blood sugar, you can end up with excess amounts in your blood if you inject too much insulin or miss a meal after injecting insulin.

Other possible causes include:

• not eating enough
• exercising more than usual
• drinking alcohol without eating any or enough food

If your blood sugar drops a bit below normal, you may experience mild to moderate symptoms, including:

• dizziness
• shaking
• sweating/clamminess
• hunger
• nervousness or anxiety
• irritability
• rapid pulse

At this stage, you can usually take immediate steps to recover. Eating 15 grams of quick-acting carbohydrates — such as glucose tablets or high-sugar options like fruit juice, raisins, honey, or candy — can help stabilize your blood sugar and reduce symptoms.

After 15 minutes, test your blood sugar. If your blood sugar has improved, you’ll want to eat a small smack to help your body fully recover — but otherwise you should be fine.

If your blood sugar isn’t increasing, try eating another 15 grams of carbohydrates, followed by a meal. If you blood sugar is not increasing after repeating this step again, contact your doctor or visit the emergency room.

Plummeting blood sugar can also cause:

• headaches
• confusion
• fainting
• poor coordination, tripping, and falling
• muscle tremors
• seizures
• coma

Insulin shock can also happen in the middle of the night. In that case, the symptoms may include:

• nightmares
• crying out in your sleep
• waking up confused or very irritable
• very heavy sweating
• aggressive behavior

When we consume food or beverages that contain carbohydrates, your body converts them into glucose. Glucose is a type of sugar that fuels the body, giving it the energy it needs to perform everyday functions. Insulin is a hormone that works like a key. It opens the door in the body’s cells so they can absorb glucose and use it as fuel.

People with diabetes may lack enough insulin or have cells that aren’t able to use insulin as they should. If the cells of the body aren’t able to absorb the glucose properly, it causes excess glucose in blood. This is called high blood glucose, which is linked with a number of health issues. High blood glucose can cause eye and foot problems, heart disease, stroke, kidney problems, and nerve damage.

Insulin shots help people with diabetes use glucose more efficiently. Taking an insulin shot before eating helps the body absorb and use glucose from the food. The result is a more balanced and healthy blood sugar level.

Mild to moderate hypoglycemia can normally be treated as described above. If you start experiencing the symptoms of severe hypoglycemia, however, it’s time for more aggressive treatments. If you or someone near you begins to experience insulin shock, take these steps:

1. Call 911, particularly if the person is unconscious.
2. Treat as outlined above unless the person is unconscious. Don’t give an unconscious person something to swallow as they may choke on it.
3. Administer an injection of glucagon if the person is unconscious. If you don’t have glucagon, emergency personnel will have some.

Insulin shock is not a pleasant experience. But there are things you can do to prevent it from happening.

Follow these tips to reduce your risk of experiencing severe hypoglycemia and related problems:

• Keep glucose tablets or hard candy for times when your blood sugar dips too low.
• Eat after taking your insulin shot.
• Always ask your doctor how to use a new medication.
• Eat a snack if your blood sugar is under 100 milligrams per deciliter before exercise or if you’re planning on doing more exercise than normal. Keep a carbohydrate snack with you when exercising. Talk to your dietitian about the best things to eat before exercise.
• Be cautious when drinking alcohol. Talk to your doctor about safe levels of consumption.
• Be cautious after vigorous exercise, as it can lower blood sugar for hours after the workout.
• Test your blood sugar often.
• If you experience symptoms while driving, pull over immediately.
• Inform family and friends of the symptoms of hypoglycemia so they can help you if you start experiencing it.
• Ask your doctor for glucagon, since all people on insulin should always have glucagon available.
• Wear a medical ID so emergency technicians can treat you quickly.

With the proper precautions, you can manage your diabetes and your insulin medications to keep your blood sugar levels steady.

Insulin reaction (hypoglycemia) – Medical center “Lіko-Med”

Publication date
October 3, 2018

Rubric
Diseases

What is an insulin response (hypoglycemia)?

Insulin response – a decrease in blood sugar to below normal levels (70 mg / dl, 3. 5 mmol / l) in patients with diabetes mellitus as a result of skipping meals, increased physical activity or the use of a large dose of insulin. Hypoglycemia causes confusion, excessive sweating, hunger, headache, and fatigue. If left untreated, low blood sugar can cause blackouts, seizures, or coma. Therefore, it is important to recognize the insulin reaction in time and return the sugar level to normal. To do this, it is enough to drink fruit juice, eat a lollipop or take glucose tablets.

Ambulance.

Seek emergency help immediately if your symptoms do not improve with glucose, convulsions, and faintness.

What to expect?

The first signs of low blood sugar are hunger and feeling warm. This is followed by confusion, fatigue, sweating, restlessness and headache. The symptoms differ from person to person. Critically low blood sugar levels can lead to fainting, seizures, and coma. To avoid severe symptoms of hypoglycemia, follow your prescribed diabetes management plan and control your blood sugar. Taking action to raise blood sugar as soon as symptoms appear is the main treatment for hypoglycemia.

What makes it worse?

Lack of measures to increase the amount of sugar in the blood at the time of the onset of symptoms. Drinking alcohol, skipping meals, increased physical activity, and high doses of insulin lower your blood sugar levels.

Treatment.

Foods or drinks that are high in glucose will usually help to eliminate the insulin response. In severe cases, glucose injections may be required.

What should I do myself?

You can prevent hypoglycemia on your own by eating about 15 grams of carbohydrates. To do this:

— take three glucose tablets;

– drink half a cup of fruit juice or one glass of milk;

– Eat 5-6 caramels or a tablespoon of sugar.

Wait 15 minutes. Then re-measure the sugar level. If it is still below normal, take another 15 grams of carbohydrates. Repeat the steps until the sugar level returns to normal. If long-acting insulin or oral anti-diabetic drugs are used, the blood sugar test should be repeated after a few hours to ensure there is no insulin response.

When to see a doctor?

Seek medical attention if your blood sugar levels are low frequently.

What to ask the doctor?

1. Could the insulin reaction be caused by taking a large dose of insulin or a high sugar diet?

2. Do I need to change my medication dose?

3. What should I do if the insulin reaction happens again?

4. How often should blood sugar be measured?

5. Is it possible that my symptoms are caused by a condition other than low blood sugar?

Diagnosis.

Patients with diabetes should regularly measure the amount of sugar in the blood. If you have frequent episodes of hypoglycemia, see your doctor to find out if you need to make dietary changes, exercise, or medication.

treatment and diagnostics in Moscow

What is it

Diabetes mellitus is an extremely common chronic disease, ranking third among the leading causes of death: after cardiovascular disease and cancer.

Sugar (it is more correct to call it “glucose”) is necessary for our body as a source of energy. Glucose enters the body with food and is absorbed in the intestines, and is also produced by the liver on an empty stomach. Insulin is an important hormone produced by the pancreas and is responsible for transporting glucose from the blood into cells. Cells, in turn, convert glucose into energy. Insulin also regulates the production of glucose by the liver.

The disease is divided into the first and second types.

In type 2 diabetes mellitus the cells of the body are less sensitive to insulin, so they do not take in the glucose they can tolerate, and it remains in the blood in excess. Or, due to some reason, insulin ceases to effectively regulate the production of glucose by the liver, so blood sugar levels increase.

In insulin dependent type 1 diabetes own immunity destroys the cells of the pancreas responsible for the production of insulin. Thus, insulin does not enter the bloodstream and does not transfer glucose into the cells, which remains in the blood. This condition requires the introduction of insulin into the body by injection, which is why the first type is called insulin-dependent diabetes mellitus.

Causes of type 1 diabetes

Insulin-dependent type 1 diabetes refers to autoimmune diseases, i.e. to those caused by an aggressive reaction of the immune system in relation to the body’s own cells. Unfortunately, the reasons for this reaction are still unknown.

Most scientists tend to genetic predisposition and transmission of the disease by inheritance. There is also an assumption about the viral component: at risk are people who have had serious viral infections against the background of a genetic predisposition to diabetes.

Most often, insulin-dependent type 1 diabetes manifests itself already in childhood or adolescence, less often in adulthood. Diabetic coma is an extreme manifestation of an untreated disease, because about half of patients do not know about their disease until the first serious complications appear.

Type 1 diabetes symptoms

Late diagnoses and complications are a consequence of the fact that the first symptoms are often overlooked.

Among the main first symptoms can be listed:

• feeling of dry mouth,
• constant thirst,
• frequent urination,
• sleep disorders due to frequent urge to urinate,
• general weakness, lethargy, fatigue,
• weight loss,
• blurred vision.

One of the frequent complications of insulin-dependent type 1 diabetes – ketoacytosis – is an attempt by the body to make up for the lack of energy (after all, glucose is not absorbed) by burning fat, which releases ketone bodies.

The presence of a large number of ketone bodies in the blood is toxic and manifests itself with the following symptoms:

• smell of acetone from the mouth,
• dizziness,
• vomiting,
• abdominal pain,
• palpitations,
• loss of consciousness,
• coma.

Often, a doctor is consulted only after the first symptoms of ketoacytosis appear, and this complication is life-threatening. Therefore, it is important to know and monitor the appearance of the primary symptoms of type 1 diabetes in yourself or your loved ones, especially children.

Diagnostics

To make a diagnosis, an endocrinologist will first need a blood and urine test, which will show the level of glucose. In addition, additional tests may be ordered. For example, analysis for HBA1C (glycosylated hemoglobin) is a rather complex study that can only be carried out in well-equipped laboratories.

The analysis will show how much glucose was in the body in the last 12 days, based on the amount of glycosylated hemoglobin in red blood cells: hemoglobin has the property of combining with glucose, becoming glycosylated. In some cases (most often for pregnant women), the doctor may recommend a glucose tolerance test, i.e. resistance of body cells to insulin.

Thus, the diagnosis of type 1 diabetes is not difficult and is carried out in a short time. Therefore, it is extremely important for the patient to pay attention to his health and monitor the first symptoms of diabetes, to prevent serious complications due to the timely visit to a specialist.

Treatment of type 1 diabetes mellitus

Despite the fact that type 1 diabetes is a chronic disease (it is impossible to completely cure the patient), it is quite possible to turn the course of the disease into a controlled channel.

With diagnosed type 1 diabetes, in the vast majority of cases, insulin therapy is prescribed – hormone administration by injection. The injected hormone is used by the body to process the incoming glucose.

In addition to insulin therapy, depending on the patient’s condition, drugs that lower blood sugar levels may be prescribed. And a diet will definitely be prescribed, because the treatment of type 1 diabetes largely depends on following the recommendations for eating habits:

• frequent, moderate meals,
• a large number of vegetables in the diet,
• refusal of fast carbohydrates,
• restriction of sweet, starchy foods.

There are many myths surrounding type 1 and type 2 diabetes. But even with such a serious illness, with a proper responsible approach, people restore the quality of their lives. It should be noted that the success of treatment also depends on the experience and qualifications of the attending physician.

It is important for the patient to learn to live with his disease, and for this the doctor must choose the most effective therapy, answer all the patient’s questions, and help understand the treatment plan. This applies to diet, allowable physical activity, the correct doses of insulin, the way it is administered, as well as taking additional drugs if necessary.

At the FSCC FMBA, the management of patients with type 1 and type 2 diabetes mellitus is built on a long-term basis from early diagnosis to a stable course of the disease. Our doctors stay in touch, ready to answer all the patient’s possible questions about their condition and the disease in general.

We do not insist on regular consultations, we stand for maximum trust between the patient and the attending physician for prompt correction of the treatment regimen, if necessary. In addition, the specialists of our center have developed a special program for the early diagnosis of type 1 and type 2 diabetes – Diabetes under control.

This program is recommended for anyone who has noticed mild symptoms of diabetes, or who already has close relatives. The program includes the necessary tests and consultations with specialists who will give a professional opinion on the risk of developing type 1 and type 2 diabetes. After all, like any other disease, diabetes is much more effectively controlled when detected in the early stages.

Thanks to the versatility of the center, our endocrinologists, with the help of colleagues from other departments, successfully cope with the complications and consequences of type 1 diabetes. Earlier we touched on ketoacinosis, but in addition to it, there are often cardiovascular complications associated with a change in blood density against the background of high sugar content in it: the risk of developing atherosclerosis, vision problems (due to insufficient blood supply to the organs of vision), problems with the legs (with insufficient blood supply affects the nerve endings of the lower extremities, especially the feet, up to diabetic neuropathy), kidney damage, periodontitis.

Such a wide range of complications requires complex management of the patient by several specialists, and often by several departments. But it is precisely this multifunctional approach to treatment that is bearing fruit – we offer our patients qualified medical care in one place at a convenient time for them.