Insulin Reaction

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Insulin Reaction Definition
• Insulin Reaction Causes
• Insulin Reaction (Low Blood Sugar) Symptoms
• Nocturnal (While Asleep) Insulin Reaction
• Insulin Reaction Times
• When to Seek Medical Care
• Insulin Reaction Diagnosis
• Insulin Reaction Treatment
• Insulin Reaction Self-Care at Home
• Insulin Reaction Medical Treatment
• Insulin Reaction Prevention
• Insulin Reaction Prognosis
• Synonyms and Keywords
• Author and Editor

Insulin Reaction Definition

An insulin reaction occurs when a person with diabetes becomes confused or even unconscious because of hypoglycemia (hypo=low + glycol = sugar + emia = in the blood) caused by insulin or oral diabetic medications. (Please note that for this article blood sugar and blood glucose mean the same thing and the terms may be used interchangeably.)

The terms insulin reaction, insulin shock, and hypoglycemia (when associated with a person with diabetes) are often used interchangeably.

In normal physiology, the body is able to balance the glucose (sugar levels) in the bloodstream. When a person eats, and glucose levels start to rise, the body signals the pancreas to secrete insulin. Insulin "unlocks the door" to cells in the body so that the glucose can be used for energy. When blood sugar levels drop, insulin production decreases and the liver begins producing glucose.

In people with diabetes, the pancreas is unable to produce enough insulin to meet the body's demand. Treatment may include medications taken by mouth (oral hypoglycemics), insulin, or both. The balance of food intake and medication is not automatic, and a person with diabetes needs to be aware that too much medication or too little food may cause blood sugar levels to drop.

Interestingly, brain cells do not need insulin to access the glucose in the blood stream. Brain cells also cannot store excess glucose, so when blood sugar levels drop, brain function is one of the first parts of the body to become affected.

In an insulin reaction, the blood sugar levels are usually below 50 mg/dL (or 2.78 mmol/L in SI units).

Insulin Reaction Causes

Insulin reactions occur when there is an imbalance of food intake and the amount of insulin in the body. The oral hypoglycemic mediations can remain active in the body for more than 24 hours. The effects of Injectable insulin can be short or very long depending upon the type. Even in individuals whose diabetes is well controlled and regulated with medication, a variety of factors can cause the insulin/glucose levels to fluctuate from the normal range.

Perhaps the most common cause of an insulin reaction or hypoglycemia is a missed meal. Once insulin is injected or a diabetes medication taken, its effect needs to be balanced by caloric intake from food (providing glucose to bind with the insulin). If the amount of calories eaten decreases, blood glucose levels drop and the insulin acts unopposed, which causes the characteristic symptoms of an insulin reaction. An insulin reaction can also occur with exercise. When a person exercises the muscle cells need extra energy (glucose), and if food intake is decreased, the blood sugar levels will drop.

Another common cause of insulin reaction is medication error. If a person with diabetes injects too much insulin or takes too many diabetic drugs, the insulin levels in the blood rise because there is not enough glucose in the blood to bind to the insulin, and an insulin reaction occurs.

Blood glucose levels are also affected by the function of the adrenal and thyroid glands. Disorders of these endocrine glands can also affect the balance between insulin and glucose in the body.