Insulin, a hormone produced by the pancreas, plays a central role in regulating blood sugar levels in the body. It acts like a key, allowing glucose from the bloodstream to enter cells for energy or be stored for later use. When the body does not produce enough insulin or cannot use it effectively, as seen in diabetes, synthetic insulin is often prescribed to help manage blood glucose. While essential for maintaining stable blood sugar, administering too much insulin can lead to dangerously low blood sugar levels, a condition known as hypoglycemia.
Recognizing the Signs
Hypoglycemia occurs when blood glucose levels fall below 70 milligrams per deciliter (mg/dL), though symptoms can vary. Early indicators include shakiness, sweating, and increased hunger. Individuals might also experience dizziness, paleness, a rapid heartbeat, or feelings of anxiety and irritability.
More severe symptoms can emerge, impacting cognitive and physical functions. These can manifest as confusion, unusual behavior, or difficulty concentrating. Blurred vision, slurred speech, or clumsiness may also occur. In extreme cases, severe hypoglycemia can lead to seizures, loss of consciousness, or even a coma. Some individuals may experience hypoglycemia unawareness, where they do not perceive the typical warning signs.
Common Causes
Several scenarios can lead to too much insulin. One cause is taking a higher dose of insulin than prescribed or injecting it incorrectly. This can occur if a meal is skipped or delayed after insulin has been administered, or if less food is eaten than anticipated. The timing of insulin with carbohydrate intake is also important; not aligning them correctly can cause a rapid drop in blood sugar.
Unexpected or increased physical activity can also lead to hypoglycemia, as exercise can make the body more sensitive to insulin and consume more glucose. Alcohol consumption, especially on an empty stomach, is another factor that can significantly lower blood glucose levels. Changes in other medications or underlying health conditions can also alter insulin requirements, leading to an excess if dosages are not adjusted.
Immediate Steps to Take
When experiencing mild to moderate hypoglycemia, swift action is necessary. The American Diabetes Association recommends the “Rule of 15”: consume 15 grams of a fast-acting carbohydrate (e.g., four glucose tablets, half a cup of fruit juice, or a tablespoon of sugar). After 15 minutes, recheck blood sugar levels. If blood sugar remains below 70 mg/dL, repeat the process until levels return to a safe range. Once blood sugar is above 70 mg/dL, consuming a small snack containing protein and carbohydrates, like cheese crackers, can help stabilize levels and prevent another drop.
For severe hypoglycemia, particularly if the individual is unconscious or unable to swallow, glucagon administration becomes necessary. Glucagon is a hormone that prompts the liver to release stored glucose into the bloodstream, raising blood sugar. It is available as a prescription injection or nasal spray, and caregivers should be trained on its proper use. If a glucagon injection is not available, or if the person does not recover within 10 minutes after administration, emergency medical services should be contacted immediately. Never attempt to give an unconscious person food or drink by mouth, as this poses a choking hazard.
Preventing Future Episodes
Implementing proactive strategies can reduce hypoglycemic episodes. Consistently monitoring blood sugar levels, whether with a blood glucose meter or a continuous glucose monitor, helps individuals understand their patterns and take action. Adhering to a consistent meal schedule and carbohydrate intake, ensuring it aligns with insulin dosages, is also important. It is helpful to carry fast-acting carbohydrate snacks at all times, such as glucose tablets or juice, for immediate treatment if symptoms arise.
Adjusting insulin doses based on physical activity levels or during illness is another preventative measure, as these factors can alter glucose metabolism. Open communication with healthcare providers is important; discussing any concerns, changes in lifestyle, or frequent low blood sugar episodes allows for personalized adjustments to the diabetes management plan. Educating friends, family, and colleagues about the signs of hypoglycemia and how to assist in an emergency can also provide safety.