Diabetic shock is a state of severe low blood sugar, known as hypoglycemia. Diabetic shock is an emergency and can lead to a diabetic coma without treatment.

Hypoglycemia can sometimes happen rapidly and may even occur when a person follows their diabetes treatment plan.

Knowing the symptoms, potential complications, and possible treatment options can be vital for a person living with diabetes.

This article goes into more detail on what diabetic shock is, its symptoms, causes, and more.

A female nurse speaking to a female patient who appears shocked.Share on Pinterest
SDI Productions/Getty Images

Diabetic shock, also known as insulin shock or hypoglycemic shock, occurs when a person’s blood sugar drops extremely low.

People with mild low blood sugar, known as hypoglycemia, are usually conscious and can treat themselves. People often experience headaches, dizziness, sweating, shaking, and a feeling of anxiety.

However, when a person experiences diabetic shock or severe hypoglycemia, they may lose consciousness, have trouble speaking, and experience double vision. Early treatment is essential because blood sugar levels that stay low for too long can lead to seizures or diabetic coma.

The following illustration summarizes the impact that diabetic shock can have on the body.

Diabetic shock effects on the body.Share on Pinterest
Illustration by Stephen Kelly

Diabetic shock occurs because a person’s blood sugar drops too low. Some potential causes include:

  • taking too much insulin
  • ignoring mild hypoglycemia
  • excessive, unusual activity or exercise without adequate changes to carbohydrate intake
  • missed meals
  • using too much diabetes medication

Anyone living with diabetes can experience diabetic shock.

A person with type 1 diabetes will likely experience hypoglycemia an average of 2 times per week.

Studies have historically indicated that people living with type 2 diabetes who take insulin are at a lower risk of experiencing hypoglycemia.

However, other research studies indicate that more people with type 2 diabetes may be getting the condition than previously thought.

Risk factors can include:

  • changing exercise routines
  • eating too little (fasting)
  • advanced age
  • living with diabetes for a longer time
  • taking more insulin than needed
  • illness
  • excessive alcohol consumption

A person’s blood sugar levels naturally rise and fall throughout the day. Typically, they rise shortly after a meal and dip after physical activity or fasting.

Most people do not feel any negative effects from these changes. However, they can cause problems for people with diabetes.

Early or mild signs of low blood sugar levels may include:

  • a headache
  • nervousness
  • anxiety
  • dizziness
  • sweating
  • shakiness
  • irritability
  • moodiness
  • hunger

Symptoms of hypoglycemia often get worse and can even be fatal if left untreated. Symptoms of diabetic shock or severe hypoglycemia may include:

  • blurry or double vision
  • seizures
  • convulsions
  • drowsiness
  • losing consciousness
  • slurred speech
  • trouble speaking
  • confusion
  • jerky movements
  • clumsiness

Hypoglycemia can also disrupt a person’s sleep due to:

If a person suspects they have hypoglycemia, they should get treatment as soon as possible. Hypoglycemia affects a person’s movement and ability to think clearly, which can cause serious accidents, especially while driving or working.

Some people may not experience the typical symptoms of hypoglycemia. Doctors call this hypoglycemia unawareness.

Hypoglycemia unawareness is more common when a person has had diabetes for a long time or if the person has experienced frequent episodes of hypoglycemia.

Lack of initial warning signs, such as shaking and sweating, may cause the episode to progress fast to seizure and loss of consciousness.

If a person’s hypoglycemia awareness is impaired, it is imperative that they monitor their blood sugar levels very closely.

A person should call 911 if they suspect their symptoms are due to severe hypoglycemia. People with a person experiencing severe symptoms should call 911 as soon as possible.

Taking insulin is a definitive cause of hypoglycemia.

Other oral diabetes medications, especially those in the sulfonylurea and meglitinides classes of drugs, can also lead to low blood sugar. Examples of such drugs include Amaryl, Glyburide, and Glipizide.

Causes are similar to the risk factors and include:

  • changing exercise routines
  • eating too little (fasting)
  • taking more insulin than needed
  • illness
  • excessive alcohol consumption

If a person living with type 1 diabetes or type 2 diabetes notices symptoms of low blood sugar, they can take steps to help raise their blood glucose levels to an acceptable range.

According to the American Diabetes Association (ADA), a person should check blood glucose levels first.

If the levels are less than 70 milligrams per deciliter (mg/dl), consume a sugary snack or drink containing 15 grams (g) of carbohydrates, then recheck blood sugar levels after about 15 minutes. This is known as the 15-15 rule.

If the levels are still low, repeat the process and consume another sugary food or drink. Once the levels have returned to normal, a person can return to their regular meal and snack schedule.

Doctors may prescribe a hormone called glucagon to people who are at risk of diabetic shock. Glucagon comes in a syringe, and a person can use it in an emergency to help their blood glucose levels return to normal.

If a person experiencing hypoglycemia becomes unconscious, a person should call 911. Then they should turn the affected person on their side and deliver a glucagon shot.

According to the ADA, the person should come around within 15 minutes. They will need immediate medical attention if they do not. For this reason, calling for emergency help is the first step.

How to administer glucagon

To administer a glucagon injection, a person should:

  • Unseal the vial of powder
  • Take off the needle cover from the syringe
  • Insert the needle into the vial and push the plunger to release all the saline into the powder
  • Swirl the vial gently to make sure the powder dissolves in the liquid and the liquid is clear
  • Pull the plunger back to draw the liquid into the syringe.
  • Inject into the outer mid-thigh or arm muscle of the person.
  • Turn the person on his or her side in case of vomiting, which commonly occurs after an injection.

However, if a person can keep a glucagon nasal spray on hand, this may be easier for a friend or family member to administer.

A person should take the warning signs and symptoms of hypoglycemia extremely seriously. When blood glucose levels are too low, it can affect brain functioning and lead to complications, including:

  • loss of consciousness
  • seizures
  • death

When treating hypoglycemia, it is vital that a person does not take more glucose than they need, as this can cause blood sugar levels to rebound too high.

A person can make general lifestyle changes to help avoid diabetic shock and hypoglycemia, including:

  • monitoring their blood sugar levels closely
  • avoiding skipping meals or snacks
  • taking medication as prescribed, on time, and in precise amounts
  • keeping a log of any low blood sugar reactions or symptoms
  • eating a meal or snack when drinking alcohol
  • adjusting medication and calorie intake when increasing physical activity levels
  • using continuous glucose monitors with alarm features for low blood sugars
  • avoiding frequent episodes of hypoglycemia as this may lead to unawareness of the warning symptoms

Also, people can adjust their blood sugar targets according to their individual needs. For example, people with hypoglycemia unawareness might benefit from targeting a higher blood sugar.

People can prevent complications by carrying a medical alert bracelet or another form of identification to inform emergency personnel that they have diabetes.

A continuous glucose monitoring system with alerts may be a good solution for some. These devices regularly monitor a person’s blood sugar levels, which can help determine if levels drop too low or go too high.

To use, a person needs to insert a sensor into the skin, typically on the abdomen. The sensor then reads a person’s glucose levels and sends them to a smartphone, tablet, or dedicated monitoring device.

A person can get a continuous glucose monitoring system online or from pharmacies that carry medical equipment. In some cases, they may come as part of an insulin pump system. Some popular examples include Dexcom and Medtronic.

The following sections provide answers to frequently asked questions about diabetic shock.

What to do if someone goes into a diabetic shock?

A person should contact 911 right away.

If a glucagon emergency kit is on hand, they should open the package and follow the instructions to mix and administer the medication. Once given, they should turn the person onto their side and wait for emergency personnel to arrive.

Can diabetes cause sudden death?

Diabetic shock can, in rare cases, lead to death. A person has some time to get the appropriate treatment and prevent serious complications. However, treatment should still be prompt.

What happens with a person’s glucose level is too high?

High glucose levels are also a problem and can lead to potentially serious complications, including:

Symptoms of high blood glucose levels can include dry mouth, vision issues, increased thirst, and frequent need to urinate.

What is a diabetic coma?

A diabetic coma is a medical emergency that occurs either due to high or low blood sugar levels. Prompt treatment can help prevent brain damage or death. It can happen in both people living with type 1 and type 2 diabetes.

If left untreated, very low blood sugar levels or diabetic shock can lead to life threatening complications such as diabetic coma.

People living with type 1 diabetes are most at risk of diabetic shock. However, anyone living with diabetes is susceptible.

People can help avoid diabetic shock by carefully monitoring their blood glucose levels, following their treatment plan, and eating regular meals. If a person goes into diabetic shock, those with them should administer glucagon if there is any available and call 911.