Hypoglycemia can develop if the body has too much insulin. Symptoms may include blurry vision, dizziness, shaking, clamminess, and a rapid pulse. This can quickly become an emergency.

You can experience hypoglycemia, sometimes known as an insulin reaction or low blood sugar, when there is too much insulin in your blood.

This can develop for a number of reasons, including taking too much insulin by mistake, missing a meal, having a low after exercise without eating or adjusting insulin amounts.

While hypos can be mild and treatable, they can also escalate to more severe low blood sugars and become medical emergencies. Someone else may need to help treat the low or call the paramedics.

People with diabetes must manage their glucose levels to keep them in range. This means juggling insulin amounts, carbohydrates, and exercise, among many other factors that affect blood sugar.

This is a basic tenet of diabetes, especially for those who live with type 1 or 2 and must self-administer insulin. Using insulin injections or an insulin pump can lead to human error, as too much insulin can be in the system, causing blood sugars to drop.

If your blood sugar drops too low, your body no longer has enough fuel to carry out its regular functions. This can cause hypoglycemia and an insulin reaction.

Some of the possible reasons for low blood sugar include:

  • missing a meal or not eating enough
  • taking too much insulin for what you’re eating
  • intense physical activity or exercising more than usual
  • drinking alcohol without eating any or enough food

What is insulin shock?

A term once used to describe insulin reactions included insulin shock.

This is an outdated phrase, based on how insulin was once used in the 1930s to 1960s for psychosis, schizophrenia, and other psychiatric issues at the time. Much like how electro-therapy was used, the medical professionals at the time used insulin to induce convulsions, seizures, comas, and a general state of “shock” in the brain in hopes of changing patients’ behavior.

This type of insulin shock therapy was largely discontinued in the 1960s. Afterward, the term was used more to describe how the body can go into “shock” from insulin.

Blood sugar ranges may vary and depend on many factors specific to your diabetes management plan. In general, the American Diabetes Association (ADA) defines low blood sugar as 70 millimeters per deciliter (mg/dL) and severe hypos as 55 mg/dL or lower.

However, you may experience symptoms at different glucose levels. Symptoms may also be different for everyone.

If your blood sugar drops low you may experience mild to moderate symptoms, including:

  • blurry vision
  • dizziness
  • shaking or trembling
  • sweating or clamminess
  • unexplained hunger
  • uncharacteristic nervousness or anxiety
  • inability to focus or concentrate
  • sudden irritability
  • rapid pulse

Symptoms can be more severe depending on your blood sugar level and how you react to these instances. This can include:

  • confusion or a change in personality, including aggressive behavior or a short temper
  • coordination challenges, such as tripping or falling
  • fainting
  • seizures
  • coma

Some people may be more at risk for low blood sugar and severe symptoms, including older adults and people who don’t always feel their symptoms.

Learn more about blood sugar management and how this can lead to hypoglycemia.

You may be able to address any mild to moderate hypoglycemia symptoms yourself.

A common treatment practice is known as the Rule of 15, which involves eating 15 grams of quick-acting carbs and then waiting 15 minutes before checking again. If blood sugars are still low, then you eat another 15g and wait to re-check.

However, more may be necessary for severe hypoglycemia.

How a low is treated depends on how the person experiencing it reacts at the moment and how much they can recognize what’s happening or participate in helping treat the hypo.

Severe lows may mean:

  1. Calling 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. Give that person a glucagon injection or related glucagon treatment if they’re unconscious. If you don’t have glucagon, paramedics or emergency medical care may be needed.

You can take steps to help prevent severe hypos from happening in the first place.

If they occur, you can take these advanced measures to help treat them immediately.

  • Keep glucose tablets or hard candy for times when your blood sugar dips too low.
  • Eat a snack if your blood sugar is under 100 mg/dL before physical activity. Keep a quick-acting carb snack with you when exercising.
  • Be cautious after vigorous exercise, as it can lower blood sugar for hours after the workout.
  • Be cautious when drinking alcohol, which can initially raise blood sugars but can lead to hypoglycemia hours later.
  • If you experience symptoms while driving, pull over immediately to treat the hypo.
  • Inform family and friends of the symptoms of hypoglycemia so they can help you if you start experiencing it.
  • Wear a medical ID so emergency technicians can treat you quickly.

Always communicate with your healthcare and diabetes care team, to help monitor your management and stay aware of potential patterns that might lead to hypoglycemia. Your care team may also include a nutritionist or dietitian to help guide you on the best food options for preventing low blood sugar.

Severe low blood sugars can cause your body to experience dizziness, shakiness, blurry vision, and other symptoms. This can be known as an insulin reaction because it involves having too much insulin in your blood for any number of reasons.

Your diabetes care team can help you establish and follow a management plan, which will include monitoring blood sugars and staying in range to prevent hypoglycemia.