Diabetic sufferers play a constant balancing act with blood glucose levels. If levels are allowed to become too low, hypoglycemia occurs. Left untreated, hypoglycemia caused by too much insulin, will evolve into diabetic shock, also called insulin shock.
Blood Sugar Monitoring
Diabetics test blood glucose levels several times a day. Ensuring that these levels are within normal ranges at all times is a constant battle with diabetes. Every change, from food intake to exercise can produce a reaction, so monitoring blood sugar levels, allows sufferers to make necessary adjustments to avert potential problems.
Diabetes occurs because of the body’s inability to process glucose effectively. To process glucose, the body requires the hormone insulin that is produced by the pancreas. If insulin cannot be produced sufficiently, or used efficiently, glucose remains in the blood stream and elevates dangerously.
Type 1 diabetes is insulin-dependent. Sufferers of type 1 must physically put insulin into the body, via injection or an insulin pump. Type 2 diabetics produce insulin but it is either not enough, or as in insulin resistance, the body does not recognize it.
Type 2 can be controlled by changes in lifestyle such as diet and exercise, or a combination of these and oral medications. While hypoglycemia is more common in type 1, it does occur in both types of diabetes and is a result of blood glucose levels dropping too low.
Causes and Symptoms of Hypoglycemia
Blood sugar levels can be affected by food intake, exercise and medications. If a diabetic person changes one habit or norm without monitoring blood sugar levels, hypoglycemia may occur. There are several causes of hypoglycemia:
- Glucose is used too quickly by the body.
- Glucose is released too slowly.
- Too much insulin is administered.
- Too much oral medication is ingested.
- Food intake is not comparable with medication intake.
- Exercise is increased, without increasing food.
Symptoms of hypoglycemia above 40-55 mg/dL typically include:
- sweating
- hunger
- nervousness
- palpitations
- shaking
- fatigue
- nausea and vomiting
Moderate hypoglycemia above 20-40 mg/dL presents with:
- combativeness
- poor judgment
- poor coordination or acting "drunk"
Both mild and moderate symptoms of hypoglycemia can be treated effectively and is important in the prevention of insulin shock.
Treatment of Hypoglycemia
Immediate treatment of symptoms is crucial to prevent hypoglycemia from progressing into a diabetic coma. Treatment options are varied but basic; raise blood sugar levels as rapidly as possible. The best way to do this is orally, with:
- fruit juice or ½ cup of regular soda
- glucose tablets
- a tablespoon of either sugar or honey
Take a blood glucose level 15 minutes after sugar intake. If levels are still not within normal ranges, repeat the sugar intake and the blood testing.
Insulin Shock
When hypoglycemia is caused by too much insulin intake, it can lead to a diabetic emergency known as insulin shock. Extremely dangerous, this form of shock can cause seizures, stroke, unconsciousness, coma and death.
Insulin shock usually occurs when blood sugar levels drop below 20 mg/dL and the brain, starved of sugar, can no longer function. This is a true medical emergency.
The best treatment for insulin shock is prevention:
- Take blood glucose levels regularly, particularly before giving insulin.
- Ensure food intake matches exercise levels.
- Learn to recognize and treat the early symptoms of hypoglycemia.
- If managing blood sugar levels becomes difficult, talk to the doctor about changes in diet and medication schedules.
- Keep a diabetes journal to include glucose levels, insulin doses and times given.
- Teach loved ones the symptoms of hypoglycemia and how they can help in a crisis.
- Wear a medical bracelet that alerts others to the possibility of a diabetic emergency.
- Consider enrolling in a local Vial of Life program.
If hypoglycemia progresses into full blown insulin shock with a loss of consciousness, an injection of glucagon can help significantly until emergency personnel can get there. Talk to the doctor about glucagon therapy and have family members trained on when to give it and how to give it.
Sources:
Virtual Chembook. "Diabetes - Errors of Metabolism" Elmhurst College.edu
Mayo Clinic Staff. "Hypoglycemia" MayoClinic.com. Mayo Foundation for Medical Education and Research Jan. 12, 2010.
Elizabeth Batt - Elizabeth Batt is a former large animal nurse, certified NREMT, lover of equines and conservationist.
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