Symptoms and Signs of Diabetic Reaction

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 10/12/2021

Doctor's Notes on Diabetic Reaction

The two main forms of diabetes are type 1 diabetes in which absent or low insulin levels prevent cells from taking up and using sugar for energy, thus requiring insulin injections, and type 2 diabetes, in which cellular resistance to insulin reduces glucose uptake, often requiring medication to improve the sensitivity of cells to insulin. The most common diabetic reactions are low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia).

Symptoms of low blood sugar (hypoglycemia) diabetic reactions include

  • rapid onset of cool,
  • pale,
  • moist, and clammy skin;
  • dizziness,
  • headache,
  • rapid pulse, and
  • shallow breathing.

If untreated, symptoms may progress to confusion, nonsensical behavior, coma, and death. Symptoms of high blood sugar (hyperglycemia) diabetic reactions occur gradually over several days and include

  • increasing thirst and urination,
  • skin feels warm and dry,
  • shallow breathing,
  • rapid and weak pulse, and
  • a sweet odor to the breath.
  • A person with high blood sugar may become confused or comatose, which may lead to death.

What Is the Treatment for a Diabetic Reaction?

A diabetic reaction that leads to low blood sugar is treated with glucose. Diabetics are taught to carry around a sugary snack (candy, glucose packet, sugar packet) in case they get symptoms of low blood sugar. If the person is still awake and has mild symptoms of low blood sugar, give them a sugary snack, fruit juice, soda (not diet soda), or a piece of candy. 

If the person is unresponsive, call 911. If you have been trained to give a glucagon injection, administer it while medical rescue is on the way. Do not put food or drinks into the mouth of someone who is unresponsive.

If the person has a high blood sugar reaction with confusion, rapid breathing, or is not responding, call 911 immediately. If you have been trained to use a glucometer to check the blood sugar, do so while awaiting medical rescue.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.