Insulin is a hormone produced by the pancreas that plays a fundamental role in regulating the amount of sugar, or glucose, circulating in the bloodstream. Its primary function is to allow glucose to move out of the blood and into cells for energy or storage. Individuals who use manufactured insulin must balance the dose with carbohydrate intake and physical activity to maintain safe glucose levels. When the administered amount of insulin exceeds the body’s need, it drives too much glucose out of the blood, leading to hypoglycemia, or low blood sugar. This drop in blood glucose below 70 milligrams per deciliter (mg/dL) rapidly produces a range of physical and mental sensations.
Recognizing the Early Symptoms of Hypoglycemia
The first symptoms when blood sugar begins to drop are the result of the body’s counter-regulatory response, which triggers the release of hormones like adrenaline. This hormonal surge acts as a natural alarm system, producing sensations that feel like an abrupt rush of anxiety or nervousness. Physically, this reaction can cause a fine tremor or shakiness in the hands, a rapid heartbeat, and excessive sweating. These initial warnings require prompt attention to prevent the condition from worsening.
As the glucose level continues to fall, the brain is deprived of its primary fuel source, leading to symptoms known as neuroglycopenia. Since the central nervous system relies heavily on glucose, its function declines, manifesting as difficulties with thinking and coordination. A person might struggle with simple tasks, experience difficulty concentrating, or feel confused about their surroundings.
The cognitive impairment can progress to pronounced dizziness, weakness, or sudden fatigue. Speech may become slurred or slowed, mimicking intoxication, and clear judgment becomes compromised. Prompt treatment is crucial, as the ability to self-treat diminishes as neuroglycopenic symptoms worsen.
Immediate Steps for Reversing Low Blood Sugar
Immediate action is required to raise blood glucose quickly if the measurement is below 70 mg/dL or if symptoms of mild to moderate hypoglycemia are present. The accepted protocol for most adults is to consume 15 grams of a fast-acting carbohydrate. This amount of simple sugar provides a rapid glucose spike.
It is important to avoid foods containing fat, such as chocolate or cookies, as fat slows down glucose absorption and delays recovery.
- Three or four glucose tablets
- Half a cup (four ounces) of fruit juice
- Half a can of regular soda
- One tablespoon of honey or sugar
- Six to seven small hard candies
After consuming the carbohydrate, wait 15 minutes before rechecking the blood glucose level. If the level remains below 70 mg/dL, repeat the process by consuming another 15 grams of fast-acting carbohydrate. This 15-15 sequence is repeated until the blood glucose is back in a safe range, followed by a small snack containing protein and a longer-acting carbohydrate to stabilize the level.
Common Factors Leading to Excess Insulin Action
The most straightforward factor leading to excess insulin action is a simple dosing error, where a person accidentally takes a higher dose of insulin than prescribed or calculated for a meal. This surplus hormone overwhelms the body’s metabolic needs, resulting in a rapid and pronounced drop in blood glucose. Similarly, an error in timing can cause issues, such as taking a mealtime insulin injection and then delaying or entirely skipping the meal. The insulin is working to lower glucose, but the expected influx of glucose from the meal never arrives to meet it.
Increased or unexpected physical activity can also significantly increase the body’s sensitivity to insulin. During exercise, muscle cells become more efficient at absorbing glucose from the bloodstream, meaning the standard dose of insulin may exert a much stronger effect than usual. If a person undertakes a strenuous workout without adjusting their insulin dose or carbohydrate intake, the enhanced insulin action can lead to a hypoglycemic episode.
Another common contributor is the consumption of alcohol, particularly without food. The liver, which normally releases stored glucose into the bloodstream as a counter-regulatory measure, becomes preoccupied with processing the alcohol. This distraction impairs the liver’s ability to release glucose, allowing the circulating insulin to continue to lower blood sugar without the necessary counter-balance.