Signs And Symptoms Of Low Blood Sugar
Each person’s reaction to low blood sugar is different. Learn your own signs and symptoms of when your blood sugar is low. Taking time to write these symptoms down may help you learn your own symptoms of when your blood sugar is low. From milder, more common indicators to most severe, signs and symptoms of low blood sugar include:
- Feeling shaky
- Color draining from the skin
- Feeling sleepy
- Feeling weak or having no energy
- Blurred/impaired vision
- Tingling or numbness in the lips, tongue or cheeks
- Headaches
- Nightmares or crying out during sleep
- Seizures
The only sure way to know whether you are experiencing low blood sugar is to check your blood sugar, if possible. If you are experiencing symptoms and you are unable to check your blood sugar for any reason, treat the hypoglycemia.
A low blood sugar level triggers the release of epinephrine , the fight-or-flight hormone. Epinephrine is what can cause the symptoms of hypoglycemia such as thumping heart, sweating, tingling and anxiety.
If the blood sugar level continues to drop, the brain does not get enough glucose and stops functioning as it should. This can lead to blurred vision, difficulty concentrating, confused thinking, slurred speech, numbness, and drowsiness. If blood sugar stays low for too long, starving the brain of glucose, it may lead to seizures, coma and very rarely death.
What To Do If You Have An Insulin Overdose
Donât panic. Most insulin overdoses can be treated at home. Follow these steps if youâre able:
Check your blood sugar. Youâll need to know where youâre starting from.
Drink one-half cup of regular soda or sweetened fruit juice, and eat a hard candy or have glucose paste, tablets, or gel.
If you skipped a meal, eat something now. Something with 15 to 20 grams of carbohydrates should raise your blood sugar.
Rest. Get off your feet and take a break.
Recheck your blood sugar after 15 or 20 minutes. If it’s still low, take another 15 to 20 grams of a quick-acting sugar, and eat something if you can.
Pay attention to how you feel for the next few hours. If you still have symptoms, check your sugar again an hour after eating. Keep snacking if your sugar is low.
Get medical help if your sugar level stays low after 2 hours or if your symptoms donât get better.
Don’t worry about pushing your sugar too high if it’s only for a short time. One high level won’t hurt you, but a very low level can.
If you’re unconscious or too confused or are having seizures, those around you will need to take control. Give your family and friends these instructions:
What Is Considered High Insulin Level
What are normal insulin levels? Insulin level Insulin level Values in pmol/L Fasting < 25 mIU/L < 174 pmol/L 30 minutes after glucose administration 30-230 mIU/L 208-1,597 pmol/L 1 hour after glucose administration 18-276 mIU/L 125-1,917 pmol/L 2 hours after glucose administration 16-166 mIU/L 111-1,153 pmol/L.
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How Are Insulinomas Diagnosed
Insulinomas can be difficult to diagnose. The average time between the start of symptoms and a diagnosis is about 3 years.
If your healthcare provider suspects an insulinoma, you may stay in the hospital for a few days. This is so your doctor can watch your blood sugar and other substances in your blood while you fast. You will not be able to eat or drink anything except water during this time. If you have an insulinoma, you will probably have very low blood sugar levels within 48 hours of starting this test. If your symptoms of low blood sugar have been after meals, you may also have a test of your blood sugar and insulin for several hours after a meal.
Your healthcare provider may also use imaging tests. These can help find out how big your tumor is and where it’s located. A transabdominal ultrasound study is usually the first test done. Other tests include endoscopic ultrasound, CT scan or MRI . If the insulinoma is too small to be seen with these imaging tests, you may need tests which sample blood from multiple areas of your pancreas to detect where the extra insulin is being release into your blood stream.
Insulinoma Causes And Risk Factors
It isnât clear why some people get insulinomas. Women are slightly more likely to have them than men. Most people get them between ages 40 and 60. Youâre also more likely to have an insulinoma if you have certain genetic conditions, including:
- Multiple endocrine neoplasia type 1: When tumors grow in glands that make hormones
- Von Hippel-Lindau syndrome: When tumors and cysts grow in many organs throughout the body
- Neurofibromatosis type 1: Noncancerous tumors in the nerves and skin
- Tuberous sclerosis: Noncancerous tumors that grow in organs like your brain, eyes, heart, kidneys, skin, and lungs
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Common Insulins That Are Available In The Us
Rapid-acting insulins
These start to work in 5 to 20 minutes, peak in 60 to 180 minutes and last for up to 6 hours. Examples include:
- insulin glulisine: Apidra.
Regular or short-acting insulins
These take minutes to work , peak in 30 to 45 minutes or 2 to 5 hours , and last for up to 2 hours or 6 hours . Examples include:
Intermediate-acting insulins
These start to work in 1 to 2 hours, peak in 4 to 12 hours and last for up to 21 hours. Examples include:
- Insulin isophane : Humulin N,
- Lispro protamine
Long-acting insulins
These take several hours to start working , have no defined peak, and last for up to 24 hours. Examples include:
- Insulin glargine: Basaglar, Lantus, Semglee, Toujeo Solostar.
Ultra long-acting insulins
These start to work in 1 to 2 hours, have a poorly defined peak at 9 to 12 hours, and can last for up to 42 hours. Examples include:
- Insulin degludec: Tresiba.
Pre-mixed insulins
Premixed insulins are usually cloudy and how quickly they work and how long they work for depends on what the ingredients they contain. Common premixed insulins include:
- NPH/regular
- Intermediate-acting insulin lispro protamine and rapid-acting insulin lispro
When Should I See My Healthcare Provider About Insulin Resistance
If youve been diagnosed with insulin resistance or conditions related to insulin resistance, its important to see your healthcare provider regularly to make sure your blood sugar levels are in a healthy range and that your treatment is working.
If youre experiencing symptoms of high blood sugar or prediabetes, contact your healthcare provider. They can run simple tests to check your blood sugar levels.
If you have a family history of diabetes or conditions that can cause insulin resistance, talk to your healthcare provider about your risk of developing insulin resistance.
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How Is Insulin Resistance Treated
Since not all factors that contribute to insulin resistance can be treated, such as genetic factors and age, lifestyle modifications are the primary treatment for insulin resistance. Lifestyle modifications include:
- Eating a healthy diet: Your healthcare provider or nutritionist may recommend avoiding eating excessive amounts of carbohydrates and eating less unhealthy fat, sugar, red meats and processed starches. Instead, theyll likely recommend eating a diet of whole foods that includes more vegetables, fruits, whole grains, fish and lean poultry.
- Physical activity: Getting regular amounts of moderate-intensity physical activity helps increase glucose energy usage and improve muscle insulin sensitivity. A single session of moderate-intensity exercise can increase glucose uptake by at least 40%.
- Losing excess weight: Your healthcare provider may recommend trying to lose excess weight to try treating insulin resistance. One study revealed that losing 7% of your excess weight can reduce the onset of Type 2 diabetes by 58%.
Over time, these lifestyle modifications can:
- Increase insulin sensitivity .
- Lower your blood glucose levels.
- Raise HDL cholesterol levels.
You may work with other healthcare providers, such as a nutritionist and endocrinologist, in addition to your regular doctor to come up with an individualized treatment plan that works best for you.
How Do You Store Insulin
Insulin is easily broken down by extreme temperatures, which means you need to be careful if you live in a part of the U.S. that gets very hot in summer, or very cold in winter.
All unopened vials and cartridges should be kept in the fridge, between 36-46 degrees Fahrenheit . Discard any insulin that you think may have inadvertently got too hot or too cold. The expiry date on insulin applies to unopened, refrigerated insulin.
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How Do Health Care Professionals Diagnose Type 1 Diabetes
Health care professionals usually test people for type 1 diabetes if they have clear-cut diabetes symptoms. Health care professionals most often use the random plasma glucose test to diagnose type 1 diabetes. This blood test measures your blood glucose level at a single point in time. Sometimes health professionals also use the A1C blood test to find out how long someone has had high blood glucose.
Even though these tests can confirm that you have diabetes, they cant identify what type you have. Treatment depends on the type of diabetes, so knowing whether you have type 1 or type 2 is important.
To find out if your diabetes is type 1, your health care professional may test your blood for certain autoantibodies. Autoantibodies are antibodies that attack your healthy tissues and cells by mistake. The presence of certain types of autoantibodies is common in type 1 but not in type 2 diabetes.
What Are The Complications Of Insulin Resistance
The majority of the complications that can result from insulin resistance are related to the development of vascular complications due to elevated blood sugar levels and elevated insulin levels .
Not everyone who has insulin resistance will have complications. If youve been diagnosed with insulin resistance, Type 2 diabetes or metabolic syndrome, its important to see your healthcare provider regularly and follow your treatment plan to try to prevent these complications.
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How Are Insulinomas Treated
Most insulinomas are not cancerous. Surgeons can usually remove them and resolve the condition. Sometimes this can be done using a laparoscope. In laparoscopy, the surgeon makes small incisions and uses specialized instruments to remove the tumor. If your healthcare provider thinks that surgery would not be a good option for you, non-surgical options are available. These would address the symptoms of hypoglycemia, such as eating small, frequent meals and taking some medicines to counteract the effects of the excess insulin.
While you are waiting for your surgery, you may stay in the hospital and get intravenous solutions to keep you from becoming hypoglycemic.
What Tests Will Be Done To Evaluate Insulin Resistance
Your healthcare provider may order the following blood tests to diagnose insulin resistance and/or prediabetes or diabetes:
- Glucose: A fasting plasma glucose or a glucose tolerance test may be used to screen for, diagnose and/or monitor prediabetes, type 2 diabetes or gestational diabetes.
- Glycated hemoglobin A1c : This test reveals your average blood glucose levels over the past three months.
- Lipid panel: This is a group of tests that measure specific lipids in your blood, such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.
Your healthcare provider may also order tests that can help diagnose other conditions that are associated with insulin resistance, such as metabolic syndrome, cardiovascular disease and polycystic ovary syndrome .
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Treating An Overdose Of Rapid
How you treat an overdose will depend on how quickly you realise the error.
If the insulin was administered more than 20 minutes ago, act quickly and take a good source of fast-acting carbohydrate immediately, such as glucose tablets or a very sugary drink. Follow this up with sufficient slower-absorbed carbohydrate, such as bread, to prevent hypoglycemia occurring later.
If you realise an error has been made within 20 minutes of injecting, you may not need to take sugar but you should have carbohydrate that will get absorbed relatively quickly. Avoid having fatty foods, if possible, as fat tends to slow down how quickly the carbohydrate acts.
It is common to need 10g of carbohydrate to counteract each unit of insulin. Its generally safer to have too much than too little carbohydrate when treating an overdose of insulin.
Test your blood glucose levels regularly and be on the lookout for symptoms of a hypo. If you feel hypo symptoms, or think you feel them, perform a blood test.
If the overdose is a large overdose, take carbohydrate first and then call your health team or out- of-hours service for advice.
Living With Insulin Resistance
Living with insulin resistance requires lifestyle changes as well as regular use of prescription medicine. You will have to be more careful in making meal and snack choices, reading labels, and maintaining a lower weight. You also will have to commit to regular exercise and take your medicines as prescribed.
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What Are The Symptoms Of Insulin Resistance
If you have insulin resistance, but your pancreas can increase insulin production to keep your blood sugar levels in range, you wont have any symptoms.
However, over time, insulin resistance can get worse, and the cells in your pancreas that make insulin can wear out. Eventually, your pancreas is no longer able to produce enough insulin to overcome the resistance, leading to elevated blood sugar , which does cause symptoms.
Symptoms of high blood sugar include:
- Increased thirst.
- Vaginal and skin infections.
- Slow-healing cuts and sores.
Many people have no symptoms of prediabetes, often for years. Prediabetes may be invisible until it develops into Type 2 diabetes. Some people with prediabetes may experience the following symptoms:
- Darkened skin in your armpit or back and sides of your neck, called acanthosis nigricans.
- Skin tags .
- Eye changes that can lead to diabetic retinopathy.
If youre experiencing any of these symptoms, its important to see your healthcare provider.
What Are The Causes
The typical cause of hyperinsulinemia is insulin resistance. Insulin resistance is what happens when your body doesnt respond correctly to insulin. This incorrect response causes your body to need the pancreas to produce more insulin.
As your pancreas makes more insulin, your body continues to resist and respond incorrectly to the higher levels of insulin. Your pancreas will continually need to make more to compensate. Eventually, your pancreas wont be able to keep up with the amount of insulin your body needs to keep your blood sugar at a healthy level. Insulin resistance can eventually lead to type 2 diabetes.
Less common causes of this condition are insulinoma and nesidioblastosis. Insulinoma is a rare tumor of the pancreas cells that produce insulin.
Nesidioblastosis is when the pancreas produces too many cells that make insulin.
Hyperinsulinemia may also develop after having gastric bypass surgery. The theory is that the cells have become too large and active for the body, but the body has changed significantly after the bypass. Doctors arent fully sure why this happens.
Other causes include:
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The Role Of The Pancreas In The Body
The pancreas plays a part in two different organ systems, the endocrine system and the exocrine system.
The endocrine system includes all the organs which produce hormones, chemicals which are delivered via the blood to help regulate our mood, growth, metabolism and reproduction.
Two of the hormones produced by the pancreas are insulin and glucagon
The exocrine system is made up of a number of glands which release substances such as sweat , saliva or, in the case of the pancreas, digestive enzymes
Producing Too Much Insulin
Excess insulin production occurs when your cells become insensitive to insulin. Think of it this way: insulin knocks on the door of your cells to tell them to let glucose in, but the cells dont answer the door in a timely manner. The pancreas releases more insulin in an effort to get glucose into cells and out of the bloodstream, where too much sugar floating around can damage nerves. A vicious cycle ensues where the pancreas produces more insulin to keep blood sugar balanced. After a while the pancreas can have trouble keeping up with the extra insulin production. Then blood sugar levels rise, increasing the risk of type 2 diabetes.
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Some Options Are More Affordable
Some brands of insulin and types of delivery devices are less expensive than others. For example, syringes tend to cost less than insulin pumps.
If you have health insurance, contact your provider to learn what types of insulin and delivery devices are covered. If your current insulin regimen is too expensive, talk to your doctor to learn if there are more affordable options.
In some cases, you might develop side effects from insulin, such as:
- low blood sugar
- pain or discomfort at the injection site
- infection at the injection site
- in rare cases, an allergic reaction at the injection site
Low blood sugar, or hypoglycemia, is one of the most serious potential side effects from taking insulin. If you start taking insulin, your doctor will talk to you about what to do if you experience low blood sugar.
If you experience any side effects from taking insulin, let your doctor know.
What Are The Differences Between The Different Insulins
Insulin is available as synthetic human insulin , insulin analogs , and biosimilars. Insulin analogs are better than standard human insulin at mimicking natural insulin release. It is easier to predict how fast and how quickly they will be absorbed and how long they will last. Biosimilars can be used in place of brand-name insulins and usually cost less.
Insulins are typically classified as rapid-acting, regular or short-acting, intermediate-acting, long-acting, and ultra-long acting insulins. Combination insulins, that mix together different types, for example, rapid-acting insulin with intermediate-acting insulin, are also available.
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