Health Topics for Diabetes

Department of Internal Medicine

Diabetes Services

General Endocrinology and Diabetes Services

Hypoglycemia (insulin shock)

Hypoglycemia means low blood sugar. It occurs when there is not enough sugar or glucose in the blood. It is also called insulin shock or insulin reaction. Hypoglycemia is most common in type 1 diabetics, especially diabetics who have tight control of their blood sugar level. People with Type 2 diabetes who take insulin or certain diabetic medications may also have hypoglycemia reactions. People who control their diabetes with diet and exercise rarely have this reaction. Some people who do not have diabetes also have a problem with hypoglycemia, but it usually occurs in a milder form.

The causes of low blood sugar include:

• missing a meal
• taking too much insulin, or medication
• unexpected or excessive exercise
• drinking alcohol
• certain other medications
• older age
• vomiting and diarrhea
• other medical problems or
• an unknown cause

Hypoglycemia can happen even when everything possible is being done to control the diabetes. Sometimes it just cannot be prevented. It is very important to treat it quickly so it does not get worse. People with diabetes need to know the symptoms of low blood sugar and how to treat it.

The common symptoms of hypoglycemia include:

• shakiness
• dizziness
• weak feeling
• sweating
• nervousness
• fast heart rate
• pale skin color
• hunger
• difficulty paying attention or confusion
• headache
• sudden moodiness or behavior changes and
• tingling sensations around the mouth

When any of these symptoms happen, the blood sugar level should be checked. Low blood sugar needs to be treated as quickly as possible. The best way to treat low blood sugar is with 3 glucose tablets, one-half cup of fruit juice, or 5 to 6 pieces of hard candy. If none of these are available, drink one-half can of regular soda, one-half cup of low-fat milk, or eat some other form of carbohydrate.

Fifteen to 20 minutes after treating low blood sugar, the blood sugar level should be tested again. If the blood sugar is still low, treat it again. A regular meal or snack should then be eaten as planned. This is needed to keep the blood sugar level up.

If hypoglycemia is not treated quickly, a diabetic could pass out. Call the emergency medical system 911 if a known diabetic is unconscious and can not be awakened. If their healthcare provider has prescribed glucagon, it should be injected while waiting for emergency help to arrive.

To prevent hypoglycemia, do the following:

• keep blood sugar in normal range
• check blood sugar regularly and whenever symptoms of hypoglycemia occur
• know what causes hypoglycemia
• know the symptoms of hypoglycemia
• carry glucose tablets or hard candy at all times
• wear a medical ID bracelet or carry a diabetic ID card
• let friends, co-workers, or family members know how to give an injection of glucagon
• eat a full meal at regular times; do not skip meals or eat partial meals
• eat more than usual when exercising and
• check blood sugar more often when you are ill, eating less, or exercising more than usual

Last Reviewed 2005

For more information, contact your local chapter of the American Diabetes Association, call the national office at (800) 342-2383, or visit their website at www.diabetes.org.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional. HIL File DIAB4396.rf2 VRS# 4396 Data Version 7.0 Copyright 1999, 2002-2003 McKesson Health Solutions LLC. All rights reserved.