Insulinshock and its treatment

When a person with diabetes goes into insulin shock, they are unable to function or unconscious and correcting the situation always requires assistance from an external party. The person should be placed in the recovery position to free the airways.

If the blood sugar level drops very low to < 2–3 mmol/l, person's ability to function and level of consciousness are reduced. This is called an insulin shock. The causes are the same as the causes of low blood sugar in general.

The blood sugar can drop this low especially if symptoms for low blood sugar have been reduced or disappeared entirely or if a person experiences recurring episodes of severe hypoglycaemia. In this case, the recommendation is continuous glucose sensing with alarm. One key contributor to insulin shock is heavy alcohol use.

Treatment of severe hypoglycaemia and insulinshock

If the person is conscious but unwilling to cooperate, for instance, they resist aid and refuse oral first-aid, call 112. If possible, measure or assist in measuring the person's blood sugar using a blood glucose meter or glucose sensor to confirm hypoglycemia. After that, if available and you know how to use the medication, you can administer glucagon to the person.

If the person is unconscious, place them in the recovery position to free the airways and call 112. If possible, measure the person's blood sugar using a blood glucose meter or glucose sensor to confirm hypoglycemia. After that, if available, you can administer glucagon to the person. If the person is convulsing, prevent the person from injuring themselves.

Important

Due to a risk of choking, do not give anything to drink or eat to an unconscious person.

Glucagon

Glucagon is an antagonistic hormone to insulin, which releases sugar stored in the liver into the blood circulation. A person using insulin therapy should keep a package of glucagon at home and the summer cabin or when hiking outdoors.

Glucagon is available with doctor's prescription at pharmacies either as an injection or spray. Family members and, if necessary, colleagues should learn how to give glucagon beforehand. Glucagon injection is given into a muscle in the thigh or upper arm. The glucagon nose spray is sprayed into either nostril. After getting the glucagon, a person will become conscious again within roughly 15–20 minutes. After that, they should eat something with carbohydrates in it.

The increase in the blood sugar level resulting from the glucagon continues for several hours after the medicine has been administred. Glucagon can can cause nausea.

Glucose infusion

Emergency medical professionals primarily treat insulin shock with intravenous glucose administration. Severe hypoglycemia and insulin shock requiring advanced emergency care may also require monitoring in a hospital setting. In addition to the infusion, it is advisable to eat once consciousness has been regained.

What happena after a severe hypoglycaemia?

The situation and underlying factors leading to hypoglycaemia must be investigated. It is also good idea to discuss the thoughts and feelings arising from a severe hypoglycaemia.

The insulin therapy and doses should be assessed using a glucose sensor and changed, if necessary.

The impact of severe hypoglycemia on traffic safety is also discussed.