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===Severe hypoglycemia=== People with [[type 1 diabetes mellitus]] who must take [[insulin]] in full replacement doses are most vulnerable to episodes of [[diabetic hypoglycemia|hypoglycemia]] (low blood glucose levels). This can occur if a person takes too much insulin or diabetic medication, does strenuous exercise without eating additional food, misses meals, consumes too much alcohol, or consumes alcohol without food.<ref name=":0">{{Cite web|title=Diabetic coma - Better Health Channel|url=https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma#diabetic-hyperosmolar-coma|access-date=2021-12-27|website=www.betterhealth.vic.gov.au}}</ref> It is usually mild enough to reverse by eating or drinking [[carbohydrate]]s, but blood [[glucose]] occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause unconsciousness during sleep. Predisposing factors can include eating less than usual or prolonged [[exercise]] earlier in the day. Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia. Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms. Twitching or [[convulsion]]s may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat: all signs of the [[adrenaline]] response to hypoglycemia. The individual is not usually dehydrated and breathing is normal or shallow. Their blood sugar level, measured by a [[glucose meter]] or laboratory measurement at the time of discovery, is usually low but not always severely, and in some cases may have already risen from the nadir that triggered the unconsciousness. Unconsciousness due to hypoglycemia is treated by raising the blood glucose with intravenous glucose or injected [[glucagon]].
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