Diabetic Shock or Severe Hypoglycemia
Rachita    narsaria

December 12, 2019

What is diabetic shock?

Diabetic shock occurs when blood sugar levels fall dangerously low. Diabetic shock isn't a medical term, but people often use it to describe a condition of acute hypoglycemia or insulin shock or low blood sugar shock that needs another person's help. Hypoglycemia translates into low blood sugar. The body does not get the energy throughout its cells that it needs.

People with moderately low blood sugar are often conscious and can treat themselves. Individuals who experience hypoglycemia may often experience headaches, dizziness, sweating, shaking, and a sense of anxiety.

When someone experiences diabetic shock or severe hypoglycemia, they may lose consciousness, have difficulty talking, and experience double vision. Early treatment is vital because blood glucose levels that remain low for too long may cause seizures or diabetic coma.

Hypoglycemia can sometimes occur rapidly and may even happen when someone follows their diabetes treatment program. Knowing the symptoms, possible complications, and potential treatment options can be vital for a person living with diabetes.

See: Type 2 Diabetes Diet - One Day Meal Plan Suggestions

What causes diabetic shock?

Carbohydrates, the primary source of the sugar, are produced in the liver and absorbed into the bloodstream to fuel the body's organs and cells. Hormones, primarily insulin and glucagon,  control the glucose concentration. However, epinephrine (adrenalin), norepinephrine, and the growth hormone can also impact glucose concentration. Improper functioning of these regulators can cause excessive levels of blood glucose (hyperglycemia) or insufficient levels (hypoglycemia). Low blood glucose (also called hypoglycemia, insulin response or insulin shock) is when your glucose levels have dropped low enough that you will need to take action to bring them back to your target range. According to the ADA, this is considered when your blood glucose falls to less than 70 mg/dL. However, speak with your diabetes care team about your blood glucose goals, and what level is too low for you. It's important to keep in mind that blood sugar levels vary widely from one individual to another. There are multiple ways in which hypoglycemia can occur.


Drug-induced hypoglycemia

Drug-induced hypoglycemia is the most frequently seen and most dangerous kind of hypoglycemia and is a complication of diabetes. Hypoglycemia occurs most often in people with diabetes who have to inject insulin occasionally to lower their blood glucose. Though other diabetics are also vulnerable to low blood sugar episodes, they have a lesser chance of a severe outcome than people with diabetes depend on insulin. This fact has to be recognized and treated immediately. Otherwise, severe hypoglycemia in the insulin-dependent diabetics can cause convulsions leading to amnesia and unconsciousness. Death, though rare, is a potential outcome.

In insulin-dependent diabetics, hypoglycemia, commonly referred to as insulin shock, can be caused by numerous factors.

These include overmedicating with manufactured insulin, missing meals, eating too little food, exercising vigorously, consuming too much alcohol, or some combination of the items listed.


See: Honey And Diabetes

Severe hypoglycemia or diabetic shock symptoms

Carbohydrates in food are converted into sugar. This sugar goes into the bloodstream and circulates throughout the body. Simultaneously, the liver, pancreas, and adrenal glands release a mix of chemicals that regulate how the body's cells absorb that sugar. These regulators include insulin, glucagon, epinephrine (adrenaline), and norepinephrine. As the amount of carbs consumed is not the same, the unique combination of these regulators released after digestion of carbohydrates is not the same.

Interactions among the regulators are complex. Any abnormalities in the efficacy of any one of those regulators may reduce or increase the body's absorption of sugar. Gastrointestinal enzymes like amylase and lactase that break down carbohydrates might not be functioning correctly. These abnormalities can produce hyperglycemia or hypoglycemia and determined in a blood sugar test. Cellular sensitivity to these regulators can be altered in a variety of ways. Over time, an individual's stress level, exercise routines, advancing age, and dietary habits also affect cellular sensitivity. A diet consistently overly full of carbohydrates increases insulin requirements with time. Finally, cells may become less receptive to the effects of these regulating chemicals, which may result in glucose intolerance.

Diet is a critical factor in producing as well as the primary way of controlling hypoglycemia. Diets typical in the West contain excess refined carbohydrates, such as sweeteners that convert into sugar easier. In lesser developed parts of the world, the regular food contains even higher amounts of carbs. Processed dairy products, meat, vegetables, grains, and fruits are part of the diet. However, this dietary habit is balanced. People eat more complex carbohydrates, smaller meals, and usually convert carbohydrates to energy through physical labor.

A person's blood sugar level rises and falls during the day. Typically, it increases after a meal and dips after exercise or fasting. Most individuals don't suffer any adverse effects of these changes, but they can cause problems for those who have diabetes.

Early symptoms of severe hypoglycemia (in the drug-induced sort of hypoglycemia) resemble an extreme shock response.

Signs of low blood sugar levels may include:

• heart palpitations

• emotional outbursts

• hand tremors

• fainting

• numbness around the mouth

• brain fog

• dilated pupils

• sweating

• cold and pale skin


Some of these symptoms mimic those of other conditions. Depression, sleeplessness, irritability, lack of concentration, crying spells, and suicidal tendencies commonly seen in the nervous system, and psychiatric disorders could also be hypoglycemic symptoms.

Symptoms may also change over time in the same person. A few of the factors which may affect symptoms include physical or psychological activities, physical or mental state, the time elapsed since the last meal, the duration of sleep, and the amount of daily exercise.


See: Are bananas good for diabetics

Treatments for low blood sugar

People with diabetes can monitor their blood glucose levels using a  glucometer. The person with diabetes places a small blood sample onto a test strip which the machine can read. If the test shows that the blood glucose level is too low, the diabetic may rectify the problem by drinking or eating extra carbohydrates.


Low Blood Sugar

 A person with type 1 or type 2 diabetes with symptoms of low blood sugar can take some measures to help increase their blood sugar levels to a healthy level. The American Diabetes Association (ADA) recommends people with diabetes should check blood sugar levels. When the levels are low, eat a sugary snack or beverage containing 15 grams (g) of carbohydrate, then recheck blood glucose levels after about 15 minutes.

If the levels remain low, repeat the process and eat another sugary food or beverage. After the levels have returned to normal, one can return to the regular meal and snack program.

Doctors can also prescribe a hormone called glucagon to individuals that are in danger of diabetic shock. Glucagon comes in a syringe, and someone could use it in an emergency to assist their blood sugar levels in returning to normal.


If an individual experiencing hypoglycemia becomes unconscious, turn them on their side and deliver a glucagon shot. According to the ADA, the individual should come round within 15 minutes. If they don't, they will require immediate medical care, so call 911.


Successful treatment of hypoglycemia over time requires the individual to follow a modified diet. Patients are often encouraged to eat small but frequent meals throughout the day also, avoid excess simple sugars, fats, and fruit beverages. 


Among the herbal remedies commonly suggested for hypoglycemia is a decoction (an infusion made by boiling) of gentian (Gentiana lutea). It needs to be drunk warm 15-30 minutes before a meal. Gentian may help stimulate the endocrine (hormone-producing) glands.


In addition to the dietary alterations recommended above, Individuals with hypoglycemia may benefit from supplementing their diet with chromium, which may help improve glucose levels. Chromium is present in whole-grain bread or cereal, cheese, molasses, lean meats, and brewer's yeast. Eating oats can also help stabilize glucose levels, as do daily supplements of vitamin E. 

People with hypoglycemia should stay away from alcohol, caffeine, and cigarette smoking because these substances can cause substantial swings in glucose levels.


Those patients with severe hypoglycemia need to see a doctor and get fast-acting glucagon injections that may stabilize their blood sugar within about 15 minutes.


See: Diabetic Meal Plan For Type 2 Diabetes

Prevention of diabetic shock

Preventing allergic insulin reactions in diabetics requires taking sugar readings through regular blood sampling. Insulin can then be controlled based on these readings. Maintaining a healthy diet is also a variable. 

Summary

According to ADA, the only sure way to know whether you are experiencing low blood glucose is to check your blood glucose, if at all possible. If you're experiencing symptoms and you're not able to check your blood glucose for any reason, treat the hypoglycemia.

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