Warning Signs And Treatment Options For Insulin Shock - Healthline

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What causes an insulin reaction?

People with diabetes must manage their glucose levels to keep them in range. This means juggling insulin amounts, carbohydrates, and exercise, among many other factors that affect blood sugar.

This is a basic tenet of diabetes, especially for those who live with type 1 or 2 and must self-administer insulin. Using insulin injections or an insulin pump can lead to human error, as too much insulin can be in the system, causing blood sugars to drop.

If your blood sugar drops too low, your body no longer has enough fuel to carry out its regular functions. This can cause hypoglycemia and an insulin reaction.

Some of the possible reasons for low blood sugar include:

missing a meal or not eating enough
taking too much insulin for what you’re eating
intense physical activity or exercising more than usual
drinking alcohol without eating any or enough food

What is insulin shock?

A term once used to describe insulin reactions included insulin shock.

This is an outdated phrase, based on how insulin was once used in the 1930s to 1960s for psychosis, schizophrenia, and other psychiatric issues at the time. Much like how electro-therapy was used, the medical professionals at the time used insulin to induce convulsions, seizures, comas, and a general state of “shock” in the brain in hopes of changing patients’ behavior.

This type of insulin shock therapy was largely discontinued in the 1960s. Afterward, the term was used more to describe how the body can go into “shock” from insulin.

What are the symptoms of hypoglycemia?

Blood sugar ranges may vary and depend on many factors specific to your diabetes management plan. In general, the American Diabetes Association (ADA) defines low blood sugar as 70 millimeters per deciliter (mg/dL) and severe hypos as 55 mg/dL or lower.

However, you may experience symptoms at different glucose levels. Symptoms may also be different for everyone.

If your blood sugar drops low you may experience mild to moderate symptoms, including:

blurry vision
dizziness
shaking or trembling
sweating or clamminess
unexplained hunger
uncharacteristic nervousness or anxiety
inability to focus or concentrate
sudden irritability
rapid pulse

Symptoms can be more severe depending on your blood sugar level and how you react to these instances. This can include:

confusion or a change in personality, including aggressive behavior or a short temper
coordination challenges, such as tripping or falling
fainting
seizures
coma

Some people may be more at risk for low blood sugar and severe symptoms, including older adults and people who don’t always feel their symptoms.

Learn more about blood sugar management and how this can lead to hypoglycemia.

How do you treat low blood sugar?

You may be able to address any mild to moderate hypoglycemia symptoms yourself.

A common treatment practice is known as the Rule of 15, which involves eating 15 grams of quick-acting carbs and then waiting 15 minutes before checking again. If blood sugars are still low, then you eat another 15g and wait to re-check.

However, more may be necessary for severe hypoglycemia.

How a low is treated depends on how the person experiencing it reacts at the moment and how much they can recognize what’s happening or participate in helping treat the hypo.

Severe lows may mean:

Calling 911, particularly if the person is unconscious.
Treat as outlined above unless the person is unconscious. Don’t give an unconscious person something to swallow as they may choke on it.
Give that person a glucagon injection or related glucagon treatment if they’re unconscious. If you don’t have glucagon, paramedics or emergency medical care may be needed.

Tips on preventing and treating severe lows

You can take steps to help prevent severe hypos from happening in the first place.

If they occur, you can take these advanced measures to help treat them immediately.

Keep glucose tablets or hard candy for times when your blood sugar dips too low.
Eat a snack if your blood sugar is under 100 mg/dL before physical activity. Keep a quick-acting carb snack with you when exercising.
Be cautious after vigorous exercise, as it can lower blood sugar for hours after the workout.
Be cautious when drinking alcohol, which can initially raise blood sugars but can lead to hypoglycemia hours later.
If you experience symptoms while driving, pull over immediately to treat the hypo.
Inform family and friends of the symptoms of hypoglycemia so they can help you if you start experiencing it.
Wear a medical ID so emergency technicians can treat you quickly.

Always communicate with your healthcare and diabetes care team, to help monitor your management and stay aware of potential patterns that might lead to hypoglycemia. Your care team may also include a nutritionist or dietitian to help guide you on the best food options for preventing low blood sugar.

The takeaway

Severe low blood sugars can cause your body to experience dizziness, shakiness, blurry vision, and other symptoms. This can be known as an insulin reaction because it involves having too much insulin in your blood for any number of reasons.

Your diabetes care team can help you establish and follow a management plan, which will include monitoring blood sugars and staying in range to prevent hypoglycemia.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Donnor T, et al. (2023). Insulin — Pharmacology, therapeutic regimens and principles of intensive insulin therapy.https://www.ncbi.nlm.nih.gov/books/NBK278938/
Dr. Manfred J. Sakel: Discoverer of insulin shock therapy - psychiatry in history (2022).https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/dr-manfred-j-sakel-discoverer-of-insulin-shock-therapy-psychiatry-in-history/A7E933069C3B8206F78F8C316A785AAE
Glycemic goals and hypoglycemia: Standards of Care in Diabetes — 2025. (2024).https://diabetesjournals.org/care/article/48/Supplement_1/S128/157561/6-Glycemic-Goals-and-Hypoglycemia-Standards-of
Low blood glucose (hypoglycemia). (n.d.).http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html
Mathew P, et al. (2022). Hypoglycemia.https://www.ncbi.nlm.nih.gov/books/NBK534841/
McCrimmon RJ. (2021). Consequences of recurrent hypoglycaemia on brain function in diabetes.https://pmc.ncbi.nlm.nih.gov/articles/PMC8012314/
Older adults: Standards of Care in Diabetes — 2025. (2024).https://diabetesjournals.org/care/article/48/Supplement_1/S266/157556/13-Older-Adults-Standards-of-Care-in-Diabetes-2025
Schwartz MW, et al. (2023). Brain glucose sensing and the problem of relative hypoglycemia .https://diabetesjournals.org/care/article/46/2/237/148337/Brain-Glucose-Sensing-and-the-Problem-of-Relative

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Medically reviewed by Marina Basina, MD — Written by Mike Hoskins — Updated on April 17, 2025

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What causes an insulin reaction?

What is insulin shock?

What are the symptoms of hypoglycemia?

How do you treat low blood sugar?

Tips on preventing and treating severe lows

The takeaway

How we reviewed this article:

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