Insulin shock is a term that refers to severe hypoglycaemia(low blood glucose).
Some consider it to be a somewhat outdated term, as is the term “insulin reaction” but it accurately describes the cause of severe hypoglycemia when there is too much insulin present, or not enough food eaten for the insulin administered.
Insulin shock can also be applied to induced hypoglycemia caused by reaction from too much oral diabetes medication.
The symptoms of diabetic 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.
Diabetic shock can also lead to a coma and death. It’s important that not only you, but 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.
Different people may have various “normal” ranges of blood glucose that feel comfortable to them, and not everyone experiences symptoms of insulin shock at the same range.
Some people lack total awareness of hypoglycemia (hypoglycemia unawareness) and may not even recognize that they are low.
This is particularly true for young children and those that suffer frequent episodes of hypoglycemia.
However, any reading of 50 mg/dL or lower can quickly lead to a situation where a person can lose consciousness, or become confused to the extent they are unable to care for themselves.
Hypoglycemia is a drop in glucose or blood sugar. Glucose is considered the body’s main energy source and is regulated by the pancreas.
Glucose fluctuates as the body eats food or drinks liquids for nutrition.
In a healthy person, most blood sugar levels stay in the normal range between 83 and 100. For someone suffering from low blood sugar, these levels can drop dramatically.
Most people will start seeing symptoms of low blood sugar such as dizziness, sweating and shaking as the glucose drops in the 60 and below range.
Some people are hypoglycemic by nature because their body produces too much insulin—where they have to eat several times throughout the day to maintain normal sugar levels.
Others develop hypoglycemia when they take too much insulin, causing the sugar levels to drop rapidly as they body tries to find a fuel source to counteract with the overproduction of insulin that is in the body.
Diabetic hypoglycemia can occur in any person with diabetes who takes any medicine to lower their blood glucose, but severe hypoglycemia occurs most often in people with type 1 diabetes who must take insulin for survival.
Sometimes if the body receives too much insulin after an injection, the body may go into insulin shock.
This can happen rapidly within 15 minutes after an injection of a rapid- or short-acting insulin such as Humalog or Humulin, or it could be several hours later if the diabetic is taking an intermediate or long-acting type of insulin such as Lente or Lantus.
Hypoglycemia can also be caused by sulfonylureas in people with type 2 diabetes, although it is far less common because glucose counterregulation generally remains intact in people with type 2 diabetes.
Severe hypoglycemia rarely, if ever, occurs in people with diabetes treated only with diet and exercise.
What Causes Insulin Shock?
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. This can throw your system out of balance.
Other possible causes include:
Not eating enough
Exercising more than usual
Drinking alcohol without eating food
Departure from scheduling, stress, or even “no reason in particular.”
Diabetic Shock: Symptoms
Diabetic shock signs may vary from mild to moderate. Mild symptoms often include a shaky or weak feeling that comes on quickly out of nowhere. Sufferers may also experience a racing heart or a tingling feeling in their tongue or fingertips. Or, they may break out in a sweat.
At this stage, you can usually take immediate steps to recover. You might eat 15 grams of a quick-acting carbohydrate, such as some glucose tablets or high-sugar options like fruit juice, raisins, honey, or candy/sweets.
The idea is to give insulin something to work with, which will help stabilize your blood sugar and reduce symptoms.
If you feel better within 15 minutes or so, you’re likely on your way to a full recovery.
If not, you would continue to treat with 15 grams of carbohydrate until your blood sugar is up, and then be sure to eat a meal.
If you’re experiencing insulin shock, you may have some of the above symptoms, but they will progress more quickly.
Plummeting blood sugar can also cause:
4.poor coordination, tripping and falling
Insulin shock can also happen in the middle of the night, the symptoms may include:
2.crying out in your sleep
3.waking up confused or very irritable
4.very heavy sweating
More moderate symptoms may also cause neuroglycopenia. These symptoms largely affect the brain. Sufferers may feel anxious, moody or severely depressed for no discernible reason. Their personalities may change abruptly, or their moods may switch from one extreme to the next.
Neuroglycopenia may also cause confusion, slurred speech, forgetfulness or delirium. The sufferer may get a glassy look in their eyes or complain of blurred or double vision.
In extreme cases, sufferers loose coordination or have trouble moving freely.
In rare and very advanced cases, insulin shock sufferers may have difficulty breathing, may have seizures, slip into a diabetic coma or even die.
In most cases, the most severe symptoms of diabetic shock are easily avoidable. The key is for diabetics — and their friends and loved ones — to learn to identify the mild symptoms early on. The more quickly you identify and treat the symptoms of diabetic shock, the less severe the episode will be.
Treating Insulin Shock
Check your blood sugar if you can but if you cannot, begin to treat the diabetic shock symptoms anyway. But do not panic and start cramming food.
This list of snacks may help. Notice the amounts because the sugar in them will raise blood sugar enough for most of us.
1. One-half cup of any soda that is not diet.
2. One cup of milk or orange juice.
3. One tablespoon of sugar or honey.
4. One-fourth cup of raisins (a small palm full).
5. Five or six sweets, or three to five glucose tablets.
Wait 15 minutes and check your blood sugar again. If it is still low, repeat the snack. Wait another 15 minutes and repeat until your blood sugar is back in the 80s.
If you cannot swallow or are throwing up, someone needs to call emergency services so you can get intravenous glucose.
Insulin users have to be extra careful, because if you just injected insulin it will keep your blood sugar low even though you are treating diabetic shock symptoms with snacks.
Serious Symptoms-Glucagon Administration
Severe low blood sugar is very serious. If it happens, loss of consciousness may occur. When a person’s blood sugar falls this low, they may be physically unable to eat or drink a rapid-acting source of sugar (glucose).
They may need a Glucagon shot—and you, a family member, or another adult will need to be ready to give it to them.
Glucagon Practice And Storage
You may never have to use Glucagon, but if you ever do, one way to remember how to do it is to practice. You can also get suggestions from your healthcare provider about other helpful ways to practice.
How to Prevent Insulin Shock
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:
1.Always keep glucose tablets with you or get in the habit of carrying hard candy or jelly sweets for times when your blood sugar dips too low.
2.Always eat after taking your insulin shot.
3.Make sure you always ask your doctor how to use a new medication.
4.Take a sugary snack with you when exercising. Talk to your dietitian about the best things to eat before exercise.
5.Be cautious when drinking alcohol. Talk to your doctor about what’s best.
6.Be cautious after vigorous exercise as it can lower blood sugar for hours after the workout.
7.A vital step in preventing insulin shock is to maintain a proper diet. Diabetics may also find it necessary to monitor their blood-sugar levels on a regular basis. Low blood-sugar levels indicate that a person should immediately eat candy or some other sweet snack.
Insulin pumps are also effective in maintaining the proper level of blood sugar. These pumps can be implanted under the skin and programmed to continuously release the correct amount of insulin.
The Insulin Pump closely mimics the pancreas by consistently delivering basal insulin throughout the day and night and lets you program bolus insulin whenever needed. It’s a ‘smart’ device with advanced features designed to ensure safety, reliability, accuracy and durability.
Hypoglycemia can usually be controlled by learning and following certain dietary rules. These rules include the following:
Never skip breakfast.
Include protein in all meals and snacks.
Limit intake of fats, refined sugar, and processed foods. Become familiar with the sugar content in different kinds of vegetables and grain products.
Keep a food diary that can be used to predict which foods produce the symptoms of hypoglycemia.
Eat a regular but limited amount of fresh fruits.
Follow a diet that is high in fiber.
8.If you experience symptoms of hypoglycaemia while driving, pull over immediately.
9.Inform family and friends of the symptoms of hypoglycemia so they can help you if you start experiencing it.
10.Ask your doctor for glucagon, since all people on insulin should always have glucagon available.
11.Wear a medical ID so emergency services can treat you quickly.
12.A diabetic should not give themselves a shot of insulin and then go into the bathtub. The warm water increases circulation and a dose of insulin can begin to work faster and cause insulin shock.
Talk with your doctor about the timing of baths and insulin shots because how long you have to wait after an injection depends upon the type of insulin(s) you are using.
13.To prevent insulin shock you must learn how your body shows symptoms of hypoglycemia. The most common early warning symptoms are feeling:
If these symptoms are left untreated, it could lead to insulin shock and result in seizures, coma or even death. But prompt treatment of symptoms can prevent insulin shock.
When a person does go into insulin shock and loses consciousness, it may be necessary to administer an injection of glucagon to help the person regain consciousness and bring blood sugar levels back into a safe range. If a glucagon injection does not bring the person back to consciousness within a few minutes, emergency personnel should be called.
14.Keep medical information including a list of medications, known drug and environmental allergies, family contacts, and doctor information in your wallet, purse and glove compartment.
It is also helpful to emergency personnel if you write down your insulin schedule including amount and time normally given, your correction factor, and insulin-to-carb ratio.
15.A note that instructs anyone finding you unconscious or disoriented to immediately call emergency services or, if possible, administer glucagon, but not to try and force food or drink if you cannot swallow.
With the proper precautions, you can manage your diabetes and your insulin medications to keep your blood sugar levels steady.
The causes that cannot be helped are reactions to new medications, aging and illness.
The unfortunate fact is that sometimes diabetic insulin shock can happen for no reason at all. In this case, simply be prepared as best you can by always having a source of glucose with you and letting others know where they can find it in a hurry, if needed.
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