Living with diabetes can be challenging, especially when it comes to managing insulin levels. One common issue that many individuals face is an insulin reaction. This happens when your body’s sugar levels drop too low after taking insulin or other medications. It’s a situation that can catch you off guard, especially in the early stages of diabetes management. Adjusting your diet and medication to suit your lifestyle takes time; during this period, insulin reactions are common.

The feeling of an insulin reaction can be alarming. You might feel shaky, sweaty, or even dizzy without warning. It’s a sign that your body is crying out for help, needing a quick sugar fix to stabilize. This sudden drop can be scary, and it’s a reminder of the delicate balance that needs to be maintained. It’s a problem that disrupts your day and poses a serious risk if not addressed promptly.

Fortunately, there are ways to manage and prevent insulin reactions from taking over your life. In this article, we will help you understand an insulin reaction, its causes, and the treatment and long-term approaches to prevent it.

Key Takeaways

  • An insulin reaction refers to the body’s response to insulin, a crucial hormone for regulating blood sugar levels. It’s essential to understand both the beneficial effects of insulin and the potential risks associated with its imbalance.
  • Having too much insulin in your body can lead to hypoglycemia, a condition characterized by abnormally low blood sugar levels. This imbalance can affect overall health, leading to symptoms such as dizziness, confusion, and in severe cases, unconsciousness.
  • Insulin reactions can occur unexpectedly due to various factors, including incorrect insulin dosage, skipping meals, or engaging in unplanned physical activity. These factors can disrupt the delicate balance required for optimal insulin function.
  • The treatment for an insulin reaction primarily involves the prompt administration of glucose or sugar to counteract the effects of low blood sugar. This can be in the form of glucose tablets, sugary drinks, or snacks.
  • Preventing insulin reactions involves carefully monitoring blood sugar levels, adhering to a balanced diet, maintaining a regular exercise regimen, and following a prescribed insulin administration schedule. Education on recognizing early signs of hypoglycemia is also crucial.

What Exactly Is an Insulin Reaction?

An insulin reaction, also known as insulin shock or hypoglycemia, occurs when the blood glucose (sugar) level drops below normal. This condition is particularly relevant to individuals with diabetes who use insulin to control their blood sugar levels. Insulin is a hormone produced by the pancreas that helps the body’s cells use glucose for energy. In people with diabetes, either the body does not produce enough insulin or cannot use it effectively, leading to the need for insulin therapy.

What Happens If You Have Too Much Insulin in Your Body?

man laying in bed experiencing an insulin reaction

Under normal circumstances, the body maintains a delicate balance between glucose (sugar) in the bloodstream and insulin, a hormone produced by the pancreas. After you eat, your blood glucose levels rise, which signals the pancreas to release insulin. Insulin acts as a key, allowing glucose to enter the body’s cells to be used for energy.

Any excess glucose is stored in the liver and muscles as glycogen or converted into fat for long-term storage. Between meals, the pancreas produces less insulin as blood glucose levels drop. This balance ensures that your body’s cells have a steady supply of energy while preventing blood glucose levels from becoming too high (hyperglycemia) or too low (hypoglycemia).

When the body produces too much insulin, it can lead to hypoglycemia. Excess insulin causes too much glucose to be transported out of the bloodstream and into the cells, depleting the blood’s glucose levels below the normal range.

Symptoms of mild to moderate hypoglycemia can include:

  • Hunger
  • Shakiness or tremors
  • Sweating
  • Dizziness
  • Light-headedness
  • Rapid heartbeat
  • Irritability or mood changes
  • Fatigue
  • Weakness

If blood sugar levels continue to fall without treatment, more severe symptoms can occur, such as:

  • Confusion
  • Difficulty speaking
  • Seizures
  • Loss of consciousness

Effects of Excessive Insulin on Overall Health

Frequent episodes of hypoglycemia can have long-term effects on overall health. Low blood sugar can lead to cognitive issues, such as difficulty concentrating and memory problems. Severe hypoglycemia, especially if it leads to loss of consciousness or seizures, poses immediate dangers, including the risk of accidents or injuries. Over time, the stress of recurrent hypoglycemia can also contribute to cardiovascular problems, such as heart disease.

Moreover, the fear of hypoglycemia can impact the quality of life, leading individuals to alter their insulin management in a way that avoids low blood sugar at the cost of higher overall blood glucose levels, potentially leading to poor long-term diabetes control and an increased risk of complications associated with hyperglycemia, such as nerve damage, kidney disease, and vision problems.


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Why Can Insulin Reaction Occur Unexpectedly?

A man sitting at his kitchen table looking at a glucometer and experiencing low blood sugar

Insulin reactions, or hypoglycemic episodes, can occur without warning due to the complex interplay of factors that affect blood sugar levels in individuals with diabetes. These unexpected occurrences can be attributed to several reasons:

  • Variability in Insulin Absorption: The rate at which insulin is absorbed into the bloodstream can vary based on the injection site, insulin type, and individual physical activity. For instance, insulin absorbed more quickly than anticipated can lead to a sudden drop in blood sugar levels.
  • Inconsistent Food Intake: Skipping meals or eating less than usual without adjusting insulin doses can cause blood sugar levels to fall unexpectedly. The timing of meals in relation to insulin administration is crucial in maintaining stable blood sugar levels.
  • Unplanned Physical Activity: Exercise increases the body’s insulin sensitivity and glucose usage, leading to a potential drop in blood sugar. Engaging in unexpected or more intense physical activity than usual without adjusting food intake or insulin dosage can trigger an insulin reaction.
  • Alcohol Consumption: Alcohol can interfere with the body’s ability to maintain blood sugar levels, potentially causing delayed hypoglycemia even hours after consumption.
  • Medication Interactions: Certain medications can enhance the effects of insulin or otherwise impact blood sugar levels, leading to unexpected fluctuations. Some medicines can also affect blood sugar. These include Aspirin, Amiodarone, Doxycycline, Quinine, Ketoconazole, Gabapentin, Topiramate, Valproate, Haloperidol, Propoxyphene, Chlorpromazine, Sertraline, Propranolol, Disopyramide, ACE inhibitors, Fluoroquinolone antibiotics, Indomethacin, Pentamidine, Gatifloxacin, Cibenzoline.
  • Individual Variations: Factors such as stress, illness, or hormonal changes can also affect blood sugar levels and insulin needs, making it challenging to predict how the body will respond at any given time.

Health Note

People who have been diagnosed with diabetes for 10-20 years and/or have been on high doses of insulin for a prolonged period are more susceptible to “insulin unawareness.” This condition can cause sudden hypoglycemia without any warning signs, therefore, it is recommended that they check their blood sugar levels before driving.

What Is the Treatment for Insulin Reaction?

The treatment for an insulin reaction aims to restore blood glucose to normal levels as quickly as possible. According to a study conducted by R G Brodows et al., the treatment for insulin reactions in diabetics involves administering carbohydrates to correct hypoglycemia.

The study showed that insulin-dependent diabetics were given 20 grams of carbohydrate in the form of milk, orange juice, or D-glucose, or 40 grams of carbohydrate as orange juice after their plasma glucose level had dropped to 55 mg/dL at a steady-state plasma free insulin concentration of about 50 microU/mL. The findings indicated that 20 grams of carbohydrate as D-glucose effectively corrected hypoglycemia without causing rebound hyperglycemia.

This treatment was also effective in spontaneous episodes of hypoglycemia in an outpatient setting. The study concluded that the D-glucose content of the ingested carbohydrate is a crucial determinant of the glycemic response and that ingestion of 20 grams of D-glucose provides an effective glycemic response for at least 40 minutes during moderately severe hypoglycemia. Additionally, consuming complex carbohydrates, protein, and fat can help stabilize blood sugar levels and prevent another drop.

How Can You Prevent Insulin Reactions?

An elderly woman testing her blood sugar levels with a glucometer

To prevent future insulin reactions, it’s essential to address the underlying causes and consider long-term strategies, which may include:

  • Adjusting Medication Doses: Reviewing and potentially adjusting insulin or other diabetes medication dosages can help prevent imbalances that lead to hypoglycemia.
  • Diet and Meal Planning: Eating balanced meals and snacks regularly throughout the day can help maintain stable blood sugar levels. This includes paying attention to carbohydrate intake and ensuring a good mix of proteins, fats, and fibers.
  • Monitoring Blood Sugar Levels: Regular monitoring can help identify patterns of blood sugar fluctuations, allowing for adjustments in diet, activity, and medication before levels become too low.
  • Education on Alcohol Consumption: Understanding how alcohol affects blood sugar levels and learning to moderate intake can prevent unexpected drops in blood sugar.
  • Exercise Management: Adjusting carbohydrate intake or insulin doses before, during, and after physical activity can help maintain stable blood sugar levels.
  • Emergency Preparedness: Individuals at risk of severe hypoglycemia should wear medical identification and ensure that family, friends, and coworkers know how to assist, including administering glucagon if necessary.

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When managing diabetes, it’s essential to understand insulin reactions. These reactions happen when there’s too much insulin in your body, causing low blood sugar levels. Knowing the signs of an insulin reaction, such as sweating, shaking, and confusion, is crucial. To treat it, quickly consume fast-acting carbohydrates like juice or glucose tablets. Preventing insulin reactions involves monitoring your blood sugar levels regularly and adjusting your insulin dosage as needed. 


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FAQs On Insulin Reaction

How can an insulin reaction be treated in the workplace?

Immediate treatment involves giving the person a quick-acting carbohydrate, such as lump sugar or candy, especially if they are conscious and able to swallow. Further treatment should be conducted privately to avoid embarrassment and include additional carbohydrates until recovery.

What is a nocturnal insulin reaction? 

A nocturnal insulin reaction is hypoglycemia that occurs during sleep, with symptoms like depression, difficulty waking, early morning headaches, night sweats, and increased appetite.

How are insulin reactions diagnosed? 

A low blood sugar level associated with symptoms of hypoglycemia confirms an insulin reaction. Further diagnosis involves understanding the cause through patient and witness history.

What is the prognosis for someone who has an insulin reaction?

Insulin reactions are usually easily treated with little consequence, but prolonged low blood sugar can lead to significant organ damage.

What are glucose tablets and sugar wafers?

Glucose tablets and sugar wafers are products designed to quickly provide glucose to the bloodstream, helping to treat or prevent insulin reactions.

What is glucagon, and how is it used in insulin reactions?

Glucagon is an injectable medication that raises blood sugar levels and can be used in emergencies to treat low blood sugar levels in people with diabetes.

What should you do after treating an insulin reaction with glucose?

After treating with glucose, it’s important to regularly check blood sugar levels (every 15-20 minutes) to ensure they do not drop again and not to leave the person alone.

Why is it dangerous to put food or drink into an unconscious person’s mouth during an insulin reaction? 

There is a risk of aspiration into the lungs, which can cause pneumonia.

What is the significance of blood sugar levels below 50 mg/dL during an insulin reaction?

Blood sugar levels below 50 mg/dL (or 2.78 mmol/L in SI units) usually indicate an insulin reaction, which affects brain function due to a lack of glucose in the bloodstream.


Brodows, R. G., et al. (1984). Treatment of insulin reactions in diabetics. JAMA, 252(24), 3378-3381.

Medically reviewed by John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism. (n.d.). What Facts Should I Know about Insulin Reaction? WebMD. Retrieved from

Martin, M. M. (n.d.). Insulin Reactions. Westfield Nursing Journal. Retrieved from