Insulin is a hormone produced by the pancreas that regulates blood sugar. It transports glucose from the bloodstream into cells for energy or storage. An “overdose” of insulin occurs when more of this hormone is administered than the body actually requires. This excess insulin can lead to a state where blood sugar levels drop to dangerously low concentrations, a condition known as hypoglycemia.
Insulin’s Role in Glucose Regulation
After consuming food, carbohydrates break down into glucose, causing blood sugar levels to rise. This increase signals the pancreas to release insulin into the bloodstream. Insulin binds to receptors on cell surfaces, particularly on muscle, fat, and liver cells, allowing glucose to move from the blood and enter. Once inside, glucose is metabolized for energy, converted into glycogen for storage in the liver and muscles, or transformed into fat.
In individuals with diabetes, the body either does not produce enough insulin or cannot effectively use the insulin it produces, leading to an accumulation of glucose in the blood. Administering insulin as medication helps manage these elevated levels by facilitating glucose uptake. However, if too much insulin is present, it removes an excessive amount of glucose from the bloodstream, resulting in abnormally low blood sugar. This imbalance disrupts the body’s energy supply, especially for the brain, which relies on a steady glucose supply.
Recognizing the Signs of Too Much Insulin
Identifying early signs of excessive insulin is important for prompt intervention. These initial indicators, characteristic of mild to moderate hypoglycemia, often manifest as physical and cognitive changes. Symptoms frequently arise quickly, and their presentation can vary among individuals.
Symptoms involving the autonomic nervous system react to low blood sugar as a stressor. Common signs include shakiness or tremors, excessive sweating, and a rapid heartbeat. Individuals might also experience intense hunger or a tingling sensation around the mouth.
As the brain is deprived of its primary energy source, neuroglycopenic symptoms emerge. These can include confusion, dizziness, irritability, and anxiety. Visual disturbances, such as blurred vision, may occur, along with headaches and difficulty concentrating. Mood changes, ranging from unusual quietness to agitation, can also be observed.
Understanding Hypoglycemic Crisis
When low blood sugar is not addressed, it can progress to a severe state known as a hypoglycemic crisis. This occurs when blood glucose levels drop to critically low concentrations, depriving the brain of its essential energy source. The brain relies on glucose for proper function, so sustained deprivation can lead to severe neurological impairment. The progression from initial symptoms to a crisis can be rapid and dangerous.
In a crisis, individuals may exhibit severe confusion or disorientation, making coherent responses difficult. Speech can become slurred, or they may struggle to speak, resembling intoxication. Loss of coordination is common, such as difficulty walking steadily or performing simple motor tasks. Without intervention, these signs can escalate to seizures, which are uncontrolled electrical disturbances in the brain.
Severe outcomes of a hypoglycemic crisis include loss of consciousness and coma. Prolonged hypoglycemia can result in permanent brain damage. In extreme cases, a severe hypoglycemic crisis can be fatal.
What to Do in an Emergency
Responding effectively to a suspected insulin overdose requires immediate and specific actions. For a person who is conscious and able to swallow, the primary goal is to rapidly raise their blood sugar. Providing fast-acting carbohydrates is the most direct approach. Examples include glucose tablets, half a cup of fruit juice, a regular (non-diet) soda, or a handful of hard candies. These sugary items are quickly absorbed into the bloodstream, providing a rapid increase in glucose levels.
After consuming the fast-acting carbohydrates, it is important to re-check blood sugar levels after about 15 minutes to assess the response. If blood sugar remains low, the treatment with fast-acting carbohydrates should be repeated. Once blood sugar has stabilized and is within a safe range, a longer-acting carbohydrate, such as a small meal or snack containing protein and complex carbohydrates, can help prevent a subsequent drop.
If a person becomes unconscious or is experiencing a seizure, the situation is a medical emergency requiring immediate professional help. The very first step is to call emergency services, such as 911 or the local equivalent, without delay. It is crucial not to attempt to give any food or drink to an unconscious person, as this poses a significant risk of choking and aspiration.
If available and trained, a glucagon injection should be administered, as glucagon is a hormone that signals the liver to release stored glucose, thereby raising blood sugar. While waiting for medical assistance, position the person on their side to help prevent choking if vomiting occurs. Remaining with the individual until medical personnel arrive is important, and professional medical attention should always be sought for any suspected overdose, even if symptoms seem to improve.