Many people with diabetes who take insulin or certain medications may face a serious issue where their blood sugar levels drop too low. This happens to approximately 2 out of every 100 individuals in the US each year, and it requires immediate attention.

A sudden drop in blood sugar can lead to diabetic shock, which can make the person feel dizzy and confused, or even cause them to faint. The danger isn’t just in the immediate effects, but also in the potential long-term damage to one’s health if not addressed promptly and effectively.

In this article, you will learn about diabetic shock, including its causes, and symptoms, how to respond to such emergencies, and prevention methods.

Key Takeaways

  • Diabetic shock, also known as hypoglycemia, can occur when blood sugar levels drop too low, leading to potential complications.
  • Symptoms of diabetic shock may include confusion, sweating, shakiness, and weakness, indicating an urgent need for intervention.
  • It is crucial to maintain blood sugar levels within a safe range, as hypoglycemia can affect approximately 2 in 1000 individuals with diabetes per year.
  • Rapid-acting carbohydrates, such as glucose tablets or fruit juice, can help elevate blood sugar levels quickly during an episode of diabetic shock.
  • If untreated, severe hypoglycemia can lead to seizures, unconsciousness, and, in rare cases, death, emphasizing the importance of timely intervention.
  • Diabetic shock can be triggered by excessive insulin or oral diabetes medication, delayed or missed meals, or increased physical activity.
  • Seeking medical attention promptly and ensuring long-term diabetes management are essential steps in preventing recurrent episodes of diabetic shock, reducing the risk of complications, and promoting overall health and well-being.

What is a Diabetic Shock?

Diabetic shock, also known as insulin shock or hypoglycemic shock, occurs when a person’s blood sugar drops to an extremely low level, leading to severe hypoglycemia. According to a study, blood sugar levels below 3.3 mmol/l (60 mg/dl) are considered too low, indicating hypoglycemia. This condition is an emergency that requires immediate treatment since it can cause severe complications such as seizures or diabetic coma. The onset of diabetic shock can occur rapidly, even when a person is closely following their diabetes treatment plan.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), this condition is more common among people with type 1 diabetes and those with type 2 diabetes who take insulin or other diabetes medications. Additionally, it is more prevalent in individuals aged 65 or older. In a global study, it was found that 4 out of 5 people with type 1 diabetes and nearly half of those with type 2 diabetes reported experiencing at least one low blood sugar event over 4 weeks.

What Causes Diabetic Shock in People with Diabetes?

Medical supplies for diabetic patients

When a person with diabetes experiences diabetic shock, it can be caused by various factors, including:

Insulin or Diabetes Medications: Taking insulin or other diabetes medicines, such as sulfonylureas and meglitinides, can cause blood glucose levels to drop too low. This is a common cause of hypoglycemia because these medications increase insulin in the body to reduce blood sugar levels.

Not Consuming Enough Carbohydrates: Foods and beverages containing carbohydrates are broken down into glucose, which raises blood glucose levels. If a person does not consume enough carbohydrates or skips or delays meals, their blood glucose level can drop to a dangerously low level.

Fasting: Continuing to take medications that lower glucose levels while fasting (for a medical procedure or other purposes) can also lead to low blood glucose.

Increased Physical Activity: Engaging in more physical activity than usual can lower blood glucose levels during the activity and up to 24 hours afterward.

Alcohol Consumption Without Enough Food: Alcohol can make it more difficult for the body to maintain stable blood glucose levels, especially if consumed without eating enough food. It can also mask the first symptoms of low blood glucose, potentially leading to severe symptoms.

Illness: Being sick can affect a person’s ability to eat or retain enough food, leading to lowered blood glucose levels.

What are the Symptoms of Diabetic Shock?

Infographic illustrating the symptoms of diabetic shock

The symptoms of diabetic shock can vary from person to person and are classified into two categories: mild-to-moderate and severe symptoms.

Mild-to-Moderate Symptoms

When your blood glucose level drops, you may experience mild-to-moderate symptoms that can make you uneasy. These symptoms include

  • Feeling shaky or jittery
  • Hunger
  • Tiredness
  • Dizziness, lightheadedness, confusion, or irritability
  • A rapid heartbeat or irregular heart rhythm
  • Headache
  • Blurry vision or difficulty speaking

Severe Symptoms

When your blood glucose level drops very low, your brain may not function properly, leading to severe symptoms. These symptoms include:


Blood glucose monitoring devices are crucial for people with diabetes. Buy Canadian Insulin offers Accu-Chek, Contour Next, and FreeStyle, among other brands, for accurate and convenient monitoring. These devices ensure reliable results, making it easier to manage diabetes effectively and respond quickly to glucose-level fluctuations.

Emergency Response to Diabetic Shock

Alt text: Elderly man getting blood glucose checked by nurse at home

Elderly man getting blood glucose checked by nurse at home

Knowing how to respond during a diabetic shock emergency is crucial. Recognizing the symptoms and taking immediate action can save lives. Below are some essential things to follow during an emergency.

Identify Symptoms: Look for signs of weakness, faintness, hunger, confusion, irrational behavior, sweating with cold, clammy skin, rapid pulse, palpitations, trembling or shaking, and a deteriorating level of response.

Assist with Intake of Sugar: Help the person to sit down. If they have their glucose gel or tablets, assist them in taking it. If not, give them something sugary, such as a 150ml glass of fruit juice or a non-diet fizzy drink, three teaspoons of sugar or sugar lumps, or sweets like jelly babies.

Monitor and Offer Further Assistance: If they improve quickly, give them more sugary food or drink and let them rest. If they have a glucose testing kit, assist them in checking their blood sugar level. Stay with them until they feel completely better.

If No Improvement: If there is no quick improvement, look for other reasons for their condition, call 999 or 112 for emergency help, and continue monitoring their breathing and response level.

Unresponsive Individual: If the person becomes unresponsive, do not try to give them anything to eat or drink as they may choke. Instead, open their airway, check their breathing, and prepare to give CPR if necessary.

Did you know?

According to the Emergency Medicine Journal, the Surrey Ambulance Service (SAS) received 1,779 emergency calls related to diabetes within a 12-month period, accounting for 50% of all calls. Out of these calls, approximately 889.5 people were transferred to the hospital due to diabetic emergencies such as hypoglycemia (diabetic shock) and other diabetes-related complications.

How to Prevent Diabetic Shock if You Have Diabetes?

Elderly woman checking her blood glucose level

If you take insulin or other medications that lower blood glucose, the following actions may help you prevent diabetic shock.

Monitor Blood Glucose Levels: Regularly check your blood glucose level using a blood glucose meter. This is the most common way to monitor levels. For those with hypoglycemia unawareness or frequent low blood glucose episodes, using a continuous glucose monitor (CGM) might be beneficial. A CGM can measure blood glucose regularly and alert you if it drops below your target range.

Maintain a Balanced Diet: Ensure your regular eating plan includes meals, snacks, and beverages that contain sufficient carbohydrates to help keep your blood glucose level within your target range. This helps to prevent drops in blood sugar that can lead to hypoglycemia.

Carry Fast-Acting Carbohydrates: Always carry a source of fast-acting carbohydrates, such as glucose tablets or a juice box, especially if you’re prone to low blood glucose episodes. This can provide a quick way to raise your blood glucose level if it begins to drop.

Safe Alcohol Consumption: If you consume alcoholic beverages, do so safely by eating food simultaneously. Alcohol can interfere with blood glucose levels and mask symptoms of hypoglycemia, increasing the risk of diabetic shock.

Exercise Safely: Physical activity can lower blood glucose during and after exercise. Check your blood glucose before, during, and after exercise. You may need to adjust your medication or carbohydrate intake to prevent low blood glucose. Eating a snack before exercising can help prevent a drop in blood glucose levels.

Adjust Your Diabetes Management Plan as Needed: Work closely with your doctor or healthcare team to ensure your diabetes management plan is effective. Discuss any concerns about medications that may cause low blood glucose and how you can prevent and treat symptoms.

Education and Preparedness: Educate family, friends, and coworkers about your diabetes management, including how to recognize symptoms of low blood glucose and what to do in an emergency. This can include how to administer glucagon if you are unable to treat yourself during a hypoglycemic episode.

Related Articles:

Canadian Insulin is committed to providing resources and information to help individuals with diabetes manage their health. For information on diabetes management, you can check some of our articles.


Diabetic shock is a serious medical emergency that can occur in individuals with diabetes who take insulin or certain medications. It is essential to recognize the symptoms and take immediate action to avoid severe complications such as seizures or diabetic coma. The article has provided a comprehensive guide to understanding the causes, symptoms, and emergency response to diabetic shock.

If you or someone you know has diabetes, it is crucial to have a plan in place to manage and respond to diabetic shock. This plan should include regularly monitoring blood sugar levels, carrying glucose gel or tablets at all times, and educating family members, friends, and coworkers about the signs of diabetic shock and how to respond in an emergency. By taking these steps, individuals with diabetes can help prevent diabetic shock and ensure prompt and effective treatment in the event of an emergency.

FAQs On Diabetic Shock

What are the three signs of a diabetic emergency?

The three signs of a diabetic emergency are low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetic ketoacidosis (DKA).

Can a person recover from diabetic shock?

Yes, a person can recover from diabetic shock by taking glucose or sugary foods immediately. However, monitoring blood sugar levels regularly is important to avoid further episodes.

Is diabetic shock the same as a seizure?

No, diabetic shock is not the same as a seizure. However, low blood sugar levels can cause seizures in some cases.

How long does diabetic shock last?

The duration of diabetic shock depends on the promptness of medical intervention. If left untreated, it can last for several hours, leading to severe complications.

Can a person survive diabetic shock?

Yes, a person can survive diabetic shock if they receive prompt medical attention and follow the prescribed treatment plan.

Can stress cause diabetic shock?

Stress can cause fluctuations in blood sugar levels, but it is not a direct cause of diabetic shock. However, stress can exacerbate the symptoms of diabetic shock.

What is the minimum blood sugar level before a person goes into a coma?

According to a study, coma can occur when the blood sugar drops to 2.3–2.7 mmol/l (41–49 mg/dl) (9) or even lower. However, these responses are typically corrected once the plasma glucose concentration is raised.


National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Low blood glucose (hypoglycemia). Retrieved from

Cryer, P. E. (2007, April 2). Hypoglycemia, functional brain failure, and brain death. Journal of Clinical Investigation, 117(4), 868–870.

Brackenridge, A., Wallbank, H., Lawrenson, R. A., & Russell-Jones, D. (2006). Emergency management of diabetes and hypoglycaemia. Emerg Med J, 23(3), 183–185.

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