Insulin, a hormone produced by the pancreas, plays a central role in regulating the body’s blood sugar (glucose) levels. It allows glucose from the bloodstream to enter cells for energy or storage. While essential for healthy glucose balance, an excessive amount can disrupt this, leading to blood sugar levels dropping too low. This can trigger symptoms from mild discomfort to severe, life-threatening complications.
The Body’s Response to Excess Insulin
When the body receives more insulin than needed, this excess rapidly removes glucose from the bloodstream, leading to hypoglycemia. Normally, when blood sugar levels fall, the body releases hormones like glucagon to signal the liver to release stored glucose. However, excessive insulin can overwhelm this counter-regulatory mechanism.
Brain cells rely almost exclusively on glucose for their energy supply. Without adequate glucose, brain function can become impaired, leading to neurological symptoms. The body attempts to compensate by activating the “fight-or-flight” response, releasing hormones like adrenaline, which contribute to some of the early physical symptoms of low blood sugar.
Identifying the Symptoms
Symptoms of low blood sugar vary and may progress in severity as levels fall. Mild hypoglycemia typically manifests with symptoms such as trembling, sweating, a rapid heartbeat, and feelings of hunger or anxiety. Dizziness, lightheadedness, and a tingling sensation around the lips, tongue, or cheeks may also occur.
As blood sugar levels continue to drop, moderate symptoms can emerge, impacting cognitive and motor functions. These may include confusion, difficulty concentrating, irritability, slurred speech, or blurred vision. A person might also experience weakness or clumsiness, making routine tasks challenging.
In severe cases, when blood sugar levels become extremely low, the brain can be significantly affected, leading to dangerous symptoms. These can include seizures, loss of consciousness, or coma. Such severe episodes require immediate medical attention due to the potential for serious complications.
First Aid for Low Blood Sugar
The “Rule of 15” is a widely recommended first-aid approach for mild to moderate hypoglycemia. This involves consuming 15 grams of fast-acting carbohydrates, waiting 15 minutes, and then rechecking blood sugar levels. If the blood sugar remains below 70 mg/dL, the process should be repeated until levels return to a safe range.
Examples of fast-acting carbohydrates include glucose tablets, 4 ounces (half-cup) of fruit juice or regular soda (not diet), or one tablespoon of sugar, honey, or syrup. Once blood sugar has stabilized, consuming a longer-acting carbohydrate, such as a meal or snack containing protein and complex carbohydrates, can help prevent another drop.
For severe hypoglycemia where an individual is unconscious or unable to swallow, emergency glucagon is an appropriate treatment. Glucagon, available as an injection or nasal powder, signals the liver to release its stored glucose, thereby raising blood sugar. If glucagon is administered, the person should be turned onto their side, as nausea and vomiting can occur upon regaining consciousness.
Serious Complications and Medical Emergencies
Untreated or prolonged episodes of hypoglycemia can lead to serious health consequences. The brain relies on glucose for energy, and a sustained lack can result in brain dysfunction or, in rare cases, permanent brain damage. Seizures and coma are potential outcomes of severe hypoglycemia.
Low blood sugar can impair judgment, coordination, and reaction time, increasing the risk of accidents. This can be particularly dangerous when performing tasks that require concentration, such as driving or operating machinery. Individuals experiencing severe symptoms like unconsciousness, seizures, or an inability to raise blood sugar despite treatment, or if glucagon has been administered without improvement, warrant immediate medical attention. Calling emergency services is necessary in these situations.
Strategies to Prevent Hypoglycemia
Preventing low blood sugar involves careful management and consistent habits. Accurate insulin dosing is fundamental; individuals should carefully measure their prescribed doses and understand how they relate to their activity levels and food intake. Consistent meal timing and matching insulin doses to carbohydrate consumption are also important.
Regular blood glucose monitoring allows individuals to track patterns and make timely adjustments to their insulin regimen or eating habits. Continuous glucose monitoring (CGM) devices can provide real-time alerts for dropping blood sugar. Physical activity affects insulin needs, so adjusting insulin doses or consuming extra carbohydrates before or during exercise can help prevent drops.
Alcohol consumption can also lower blood sugar levels, especially when consumed on an empty stomach. Certain medications can interact with insulin and affect blood sugar levels; discuss all medications with a healthcare provider. Informing close family and friends about the condition and how to respond in an emergency can provide an additional layer of safety.