Hypoglycemia, or abnormally low glucose (blood sugar), can occur when a person has an excess of the glucose-controlling hormone insulin. If not treated promptly, hypoglycemia can lead to insulin shock, a condition in which glucose levels drop quickly, leading to unconsciousness.

People at risk for hypoglycemia and insulin shock include those who take insulin or certain oral diabetes medications (antidiabetic agents), such as sulfonylureas or meglitinides, particularly if they also have hypoglycemia unawareness. Hypoglycemia unawareness refers to the body’s inability to experience or notice the typical warning signs of the early stages of hypoglycemia  – and thus the inability to take the appropriate action.

People with unstable diabetes are also at increased risk of hypoglycemia and insulin shock.

These indicators of hypoglycemia may include:

• Trembling or shakiness
• Hunger (polyphagia)
• Sweating
• Shallow breathing
• Dizziness
• Visual problems such as double vision
• Rapid heartbeat (palpitations)
• Anxiety, irritability or moodiness
• Confusion (sometimes mistaken for drunkenness or aggression)
• Incoordination
• Convulsions
• Fainting

Prevention of insulin shock relies on prevention of hypoglycemia. Good diabetes management is the most effective way to prevent hypoglycemia.  Patients should follow their physician-recommended schedule of diet, exercise and other treatments, which may include insulin and antidiabetic agents. People with diabetes should also determine what triggers low glucose levels and know the signs and symptoms of this condition. A sick-day plan can also help prevent hyperglycemic episodes.

It is important to treat low glucose levels quickly according to the individual’s physician-recommended plan because, without appropriate action, mild hypoglycemia can progress to insulin shock. A hypoglycemic individual who is incapable of swallowing or is unconscious may need an immediate injection of glucagon. Normally produced by the pancreas, glucagon is a hormone that raises glucose levels.  Under circumstances such as these and when glucagon is not available, emergency medical personnel must be summoned and the patient taken to the nearest emergency room, where treatment typically includes intravenous glucose.