According to abbreviationfinder, HS stands for hypoglycemic shock. Diabetics can not only suffer from too high blood sugar, but also from too low. If the level is extremely low and unconsciousness occurs for this reason, specialists speak of hypoglycemic shock (colloquially: low blood sugar). This can be life threatening.
What is hypoglycemic shock?
Hypoglycemic shock is characterized by the sudden onset of a coma. It is a life-threatening condition that needs immediate treatment.
In diabetics, blood sugar levels can fluctuate greatly for a variety of reasons. If the value falls below 40 to 50 mg/dl, there is an acute danger. Such a case occurs when there is too much insulin in the blood.
Because the brain needs glucose to sustain vital functions, such a condition can become extremely dangerous. If the patient becomes unconscious, it is a coma. But hypoglycaemia is already announced in advance:
Those affected are pale, sweat, have cravings, may have seizures, tremble, are restless and may have mental problems, which can manifest themselves in agitation, confusion or hallucinations. The heart rate accelerates and blood pressure increases. If a hypoglycemic shock occurs, action must be taken even more quickly than in the case of a diabetic coma.
Causes
The question is: How does such a dangerous hypoglycaemia occur? One possibility is that a diabetic may have overdosed on their blood sugar-lowering medication or insulin.
Hypoglycemic shock can also occur if those affected eat too little (especially carbohydrates) or exercise too much without adjusting their insulin or medication doses. For this reason, optimal dose adjustment is essential. Excessive alcohol consumption can also be critical for people without diabetes. Because the liver is busy breaking down alcohol, it may not be able to produce enough glucose (dextrose) and the brain becomes deficient.
Hypoglycemia then occurs. But even with excessive consumption of foods with a high glycemic index, which trigger a strong release of insulin, the blood sugar level can drop rapidly as a result.
Symptoms, Ailments & Signs
Hypoglycemic shock is characterized by the sudden onset of a coma. It is a life-threatening condition that needs immediate treatment. Treatment consists of administering glucose in the form of dextrose or, in the case of unconsciousness, in the form of an infusion. In addition to the coma, there is a tendency to cramps and increased reflex readiness.
In addition, there is heavy sweating and damp and pale skin. In addition, heart palpitations are common. In contrast to a diabetic coma, however, the symptom of complete dehydration is absent. Since the coma in hypoglycemic shock does not otherwise differ from a diabetic coma, it is only possible to distinguish between the two disease states by the signs that occur.
Laboratory tests find very low blood sugar levels. In addition, hypoglycemic shock is announced by various symptoms that already occur with moderate hypoglycaemia. These are symptoms that can also occur with other diseases. In connection with diabetes, however, they provide valuable information about a possible imminent loss of consciousness.
These signs include sudden restlessness, food cravings, difficulty concentrating, dizziness, nervousness, blurred vision, panic, tremors or palpitations. There are also sensory disturbances, difficulty speaking, tingling, cold sweats, weak knees and a furry taste in the mouth. After the administration of glucose, the symptoms regress immediately.
Diagnosis & History
Life-threatening hypoglycaemia can last for hours and days. Therein lies the clinical problem. It is initially announced by symptoms of the autonomic nervous system and the central nervous system.
Cravings, sweating, nausea, tremors, vomiting and headaches, lack of concentration, increased irritability and confusion are the first signs. If the blood sugar level falls even further, primitive forms of expression such as smacking, grimacing and grasping can occur.
Speech disorders, double vision, seizures, paralysis and respiratory and circulatory problems then occur. Eventually, hypoglycemic shock occurs in the form of unconsciousness. The victim falls into a coma. The course of the symptoms is very fast. For this reason, diabetics must monitor themselves closely. The blood sugar level must be checked at the first sign.
Complications
This shock usually causes a number of different complaints and symptoms. The person affected primarily suffers from vomiting and severe nausea. A general feeling of illness occurs and the patient usually feels tired and exhausted. Physical stress or sporting activities are no longer possible, resulting in a severe reduction in quality of life.
Furthermore, there is trembling all over the body and sweating. It is not uncommon for those affected to suffer from coordination and concentration disorders. As it progresses, the patient may also lose consciousness if the symptoms are severe. If the shock is not treated, it usually results in death. If unconsciousness occurs, the patient may be injured if they fall.
The shock is usually treated by importing glucose and leads relatively quickly to a positive course of the disease. There are no further complications if the treatment is carried out quickly and at an early stage. However, the patient can suffocate if he loses consciousness and no other person provides help.
When should you go to the doctor?
Mild hypoglycemic shock usually resolves on its own as soon as a small meal with enough carbohydrates is eaten. Severe hypoglycaemia, on the other hand, must always be treated by a doctor. If the person is still conscious, they can be given dextrose or an appropriate emergency medication. The measures must be repeated at intervals of 15 minutes until the blood sugar level is stable again or a doctor arrives.
If you are unconscious, call the emergency services immediately. Until professional help is available, the affected person must be supplied intravenously with the necessary active substance (e.g. glucagon or glucose). Hypoglycemic shock must always be discussed with the doctor in charge. The anamnesis is necessary to determine the cause of the hypoglycaemia and to adjust the therapy accordingly. In addition, the doctor may prescribe a stronger drug if needed to prevent future seizures. A disturbed perception of hypoglycaemia may also be the cause, which must be recognized and treated with medication.
Treatment & Therapy
If hypoglycemic shock is imminent, countermeasures should be taken immediately. If the blood sugar level turns out to be too low, the person concerned must take glucose immediately.
One way is to stick one to four tablets of glucose between your teeth and cheek. The glucose dissolves slowly and thus enters the bloodstream. The patient who is still conscious can also eat other high-carbohydrate foods that cause blood sugar levels to rise rapidly. Sugary drinks like fruit juices are also an option. Diet drinks, on the other hand, should be avoided because they lead to even more insulin release and thus further lower the blood sugar level.
If these measures are not sufficient, then an intravenous glucose infusion is indicated. This applies when the patient is already unconscious, because then the swallowing reflex no longer works and aspiration can occur. It is also possible for the emergency doctor or rescue service to administer glucagon intramuscularly, optionally also in the subcutaneous fatty tissue. However, the latter does not work with excessive alcohol consumption. If hypoglycaemia occurs, an ambulance must be called immediately. Glucose infusions or the intramuscular administration of glucagon should only be carried out by specialists.
Prevention
The best way to prevent dangerous hypoglycaemia from occurring in the first place is to adjust the insulin and medication doses precisely to the body’s requirements. This applies when a patient eats less and does more sport as part of a diet or eats less and moves more in everyday life.
Both the type and amount of food and exercise are factors that a patient should keep in mind. Eating too little, eating too much, or eating high glycemic index foods are not good options for sufferers.
A diabetic should therefore constantly monitor their blood sugar level in order to be able to intervene quickly before the blood sugar level drops too far. He should also be very careful when administering insulin or medication. For fear of the consequences of diabetes, many sufferers tend to inject more than necessary. The exact dose adjustment of insulin or medication is therefore best carried out by a doctor.
Aftercare
Hypoglycemic shock is associated with type 2 diabetes mellitus. Follow-up is closely linked to lifelong medical care. For the patients, this means that they have to attend regular check-ups with their doctor after stopping the medication. Here the blood values are checked in order to follow the development.
Patients can also measure their own values and improve their health through certain lifestyle changes. Switching to a balanced diet is a very important point in this context. Appropriate training, i.e. participation in a nutrition course, may help.
With more health awareness and a nutritionist, diabetes patients are able to eat more vitamins and less fat. This gradually leads to a better body feeling. In addition to the nutritional advice, which should be renewed occasionally, there are also other appointments. The ophthalmologist should be visited once a year and the podiatrist will also identify any deterioration at an early stage.
In this way, it is possible to prevent diabetes from leading to visual problems or problems with the feet. The disease itself can neither be stopped nor cured, but its progression can be slowed down. The right way of life helps, which the patient should discuss with the doctors and a nutritionist.
You can do that yourself
In the case of a slight hypoglycaemia, it is sufficient in most cases if the person concerned consumes plenty of glucose and carbohydrates. A glass of soda or some crackers will balance blood sugar levels and relieve discomfort.
Hypoglycemic shock always requires medical attention. An ambulance is urgently needed. Insulin must not be injected in this situation. If the person is conscious, they should sit down with their legs up and drink plenty of water (at least 1 liter per hour). Physical exertion should be avoided for the time being. In addition, blood sugar levels should be checked every two hours. If the blood sugar level has not normalized after six hours, the person concerned must be taken to the hospital. In the event of unconsciousness or vomiting, first aid must be given immediately until the emergency doctor arrives. The diabetic must be in the stable side position brought and non-fixed dentures must be removed. If present, glucagon should be injected.
After a stay in hospital, the person concerned must take it easy for a few days. In addition, the cause of the hypoglycemic shock should be determined so that further complications can be avoided in the future.
