From the Guidelines
No, hyperglycemia cannot directly cause hypoglycemic shock (insulin shock) due to excessive glucose intake. Hypoglycemic shock, also known as hypoglycemia, occurs when blood sugar levels drop too low, not when they are too high. This condition typically happens when diabetic patients inject too much insulin, skip meals, exercise vigorously without adjusting insulin doses, or drink alcohol without eating [ 1 ]. Symptoms of hypoglycemia include shakiness, dizziness, confusion, rapid heartbeat, and in severe cases, seizures or loss of consciousness.
Treatment of Hypoglycemia
If someone experiences hypoglycemia, immediate treatment involves consuming fast-acting carbohydrates like juice, glucose tablets, or candy, followed by a more substantial snack [ 1 ]. For severe cases where the person is unconscious, emergency glucagon injection may be necessary. The body naturally produces insulin to lower blood sugar, so consuming excessive sugar typically causes hyperglycemia (high blood sugar), not hypoglycemia. However, in rare cases, reactive hypoglycemia can occur when the body overproduces insulin in response to a large sugar intake, but this is different from hypoglycemic shock that diabetics experience [ 1 ].
Key Points to Consider
- Hypoglycemia is treated with ingestion of 15–20 g glucose or any form of carbohydrate that contains glucose [ 1 ].
- The response to treatment of hypoglycemia should be apparent in 10–20 min, and plasma glucose should be tested again in 60 min [ 1 ].
- Changes in food intake, physical activity, and medication can contribute to the development of hypoglycemia [ 1 ].
- Adding protein to carbohydrate does not affect the glycemic response and does not prevent subsequent hypoglycemia [ 1 ].
From the FDA Drug Label
OVERDOSAGE Hypoglycemia may occur as a result of an excess of insulin relative to food intake, energy expenditure, or both. PRECAUTIONS General Inadequate dosing or discontinuation of treatment may lead to hyperglycemia and, in patients with type 1 diabetes, diabetic ketoacidosis.
The FDA drug label does not answer the question.
From the Research
Hyperglycemia and Hypoglycemic Shock
- Hyperglycemia is a common feature of critically ill patients, and it has been associated with adverse outcomes in acute myocardial infarction and acute heart failure 2.
- However, there is no direct evidence to suggest that hyperglycemia can cause hypoglycemic shock due to excessive glucose intake.
- Hypoglycemic shock, also known as insulin shock, is a condition that occurs when the body's blood sugar levels drop too low, typically due to excessive insulin administration or other medical conditions 3, 4.
Relationship between Hyperglycemia and Hypoglycemia
- Hyperglycemia and hypoglycemia are two distinct conditions, and hyperglycemia does not directly cause hypoglycemic shock 2, 5.
- However, patients with hyperglycemia may be at risk of developing hypoglycemia if they are treated with insulin or other glucose-lowering medications 4, 6.
- In some cases, pseudohypoglycemia may occur, where finger-stick glucose measurements are inaccurate due to impaired microcirculation, leading to a false diagnosis of hypoglycemia 5.
Glucagon and Insulin Action
- Glucagon plays a crucial role in glucose metabolism, and its excess or deficiency can affect insulin action 6.
- Glucagon excess can contribute to hyperglycemia, while a reduced glucagon response to insulin-induced hypoglycemia can promote severe hypoglycemia 6.
- The relationship between glucagon and insulin action is complex, and further research is needed to understand the mechanisms involved in hyperglycemia and hypoglycemia 6.