Written by Dr. Matthew Capozzi, DPM, FACFAS, CWS (board-certified foot surgeon and wound specialist) · Medically reviewed by the CircuFiber Scientific Advisory Board · Updated: October 27, 2026

A "diabetic attack" is not one condition; it is the everyday name for a blood sugar emergency, either hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). High blood sugar builds over days and shows up as increased thirst, frequent urination, fatigue, blurred vision and, when severe, nausea and vomiting. Low blood sugar can hit within minutes and causes shakiness, sweating, hunger, confusion and a rapid heartbeat, and it can progress to seizures or loss of consciousness if it is not treated. Knowing which one you are dealing with tells you what to do: fast-acting carbohydrates for a low, and a blood sugar check, fluids and a call to your care team for a high.

Key Takeaways

• "Diabetic attack" means a blood sugar emergency. The two types are hyperglycemia (blood sugar too high) and hypoglycemia (blood sugar too low), and they need opposite responses.
• Hyperglycemia develops slowly over days or weeks, with increased thirst, frequent urination, fatigue, blurred vision and headaches. Untreated, it can progress to diabetic ketoacidosis or a diabetic coma.
• Hypoglycemia develops fast, often in people taking insulin or sulfonylureas, with shakiness, sweating, hunger, dizziness, irritability, confusion and a rapid heartbeat.
• Treat a low immediately with about 15 grams of fast-acting carbohydrate (glucose tablets, juice, regular soda), then re-check blood sugar in 15 minutes and repeat if needed.
• Call 911 if someone is confused, has a seizure, cannot safely swallow, or loses consciousness, or if vomiting, deep rapid breathing or fruity-smelling breath appear with high blood sugar.
• Regular monitoring, balanced meals and medication taken as prescribed prevent most diabetic attacks.

What is a diabetic attack?

A diabetic attack is a sudden or escalating episode of abnormal blood sugar that produces noticeable symptoms and needs prompt action. When we talk about a diabetes attack, it's essential to understand that this term can encompass a range of acute complications associated with diabetes, including hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar). Both conditions are serious and require immediate attention to prevent severe consequences. Doctors do not use the phrase "diabetic attack" as a diagnosis; they will talk about a hyperglycemic episode, a hypoglycemic episode, diabetic ketoacidosis (DKA) or a hyperosmolar state.

Hyperglycemia (high blood sugar)

Hyperglycemia occurs when our blood sugar levels spike above the normal range. This condition doesn't happen overnight; it builds over days or even weeks. We might notice symptoms like increased thirst, frequent urination, fatigue, and blurred vision. These signs suggest that our body isn't using insulin properly or we don't have enough insulin to process glucose in our bloodstream.

Hypoglycemia (low blood sugar)

Hypoglycemia is the sudden drop in our blood sugar levels, which can happen quickly and without much warning, making it particularly dangerous. Symptoms include shakiness, confusion, heart palpitations, and in severe cases, loss of consciousness. This condition often occurs in people who are managing their diabetes with insulin or certain medications that increase insulin production in the body. Our guide to recognizing low blood sugar levels covers the numbers in more detail.

Recognizing these symptoms early on is crucial for immediate treatment and to avoid the escalation into more serious health issues, such as diabetic ketoacidosis or a diabetic coma.

What are the symptoms of a diabetic attack?

The symptoms of a diabetic attack depend on whether blood sugar is too high or too low, and the two patterns look different enough that you can usually tell them apart. The table below compares hyperglycemia and hypoglycemia side by side, with the first step to take for each.

Hyperglycemia symptoms

Hyperglycemia is characterized by blood sugar levels that soar above normal. It doesn't always trigger immediate symptoms but over time, signs become evident and can worsen if not addressed. Key symptoms include:

• Increased thirst and dry mouth
• Frequent urination
• Fatigue
• Blurred vision
• Headaches

When blood sugar levels remain high for extended periods, it can lead to serious health issues, emphasizing the need for timely action.

Hypoglycemia symptoms

Hypoglycemia occurs when blood sugar levels drop too low. This condition can develop quickly, demanding swift recognition and treatment. Symptoms to watch for are:

• Shakiness or nervousness
• Sweating
• Dizziness or light-headedness
• Hunger
• Irritability or moodiness
• Confusion or difficulty concentrating
• Rapid heartbeat

In severe cases, if not immediately addressed, hypoglycemia can lead to unconsciousness or seizures, underscoring the importance of recognizing these signs early. It's essential for us to remember, everyone's experience with hypoglycemia might vary, making it all the more critical to pay close attention to how our bodies react under different conditions. Read more on recognizing hypoglycemia and quick fixes.

What does a diabetic attack feel like?

A diabetic attack usually feels like a cluster of symptoms that come on together and do not go away with rest: an exhaustion that sleep does not fix, an unquenchable thirst, trouble focusing your eyes, or sudden nausea. The sections below explain the five warning signs people most often describe and why each one happens.

Fatigue

Fatigue is often one of the first signs that something's amiss. It's a type of exhaustion that doesn't go away with rest or sleep. Fatigue associated with diabetes isn't just regular tiredness. It's a pervasive feeling of weariness that can significantly affect our daily lives. This is due to our body's inability to use glucose properly for energy, leading to an energy shortage. When our cells don't receive enough glucose, we're left feeling constantly drained, making even the simplest tasks seem daunting.

Several factors contribute to fatigue in diabetic individuals:

• High blood sugar levels make it difficult for glucose to enter our cells, depriving them of the energy they need.
• Low blood sugar levels also play a role. Without adequate glucose in the bloodstream, our body lacks the necessary fuel to function correctly.
• Dehydration, a common issue among those with high blood sugar levels, further exacerbates fatigue.
• Kidney strain from filtering high levels of glucose can lead to an overall feeling of tiredness.

Recognizing and acknowledging fatigue as a symptom of a diabetes attack is essential. It's our body's way of signaling that our blood sugar levels might be off, urging us to take corrective action. Monitoring our blood sugar levels closely and staying hydrated can help manage this symptom.

Unexplained weight loss

Unexplained weight loss in diabetes happens when the body cannot use glucose for energy and starts burning fat and muscle instead. Commonly, we associate weight loss with increased exercise or dieting efforts. But, in the context of diabetes, weight loss can often occur without any intentional changes in our lifestyle, ringing an alarm bell for potential concerns. This unexpected weight drop could be attributed to our body's inability to properly use glucose due to inadequate insulin production or resistance to insulin itself.

It's crucial to understand that unexplained weight loss isn't just about shedding a few unwanted pounds; it's a marker of our body's struggle to manage blood sugar levels. Ignoring this symptom can lead to a cascade of other health issues, emphasizing the importance of vigilance. Regular check-ups and monitoring can help detect this symptom early, and adjusting our diet and possibly consulting a nutritionist can provide our bodies with the necessary support.

Increased thirst and urination

Increased thirst and frequent urination are early warning signs that blood sugar is higher than normal. Our bodies are finely tuned machines that strive to maintain a delicate balance of fluids and electrolytes. When blood sugar levels soar, this balance is disturbed, leading to the body's attempt to flush out the excess glucose through urination. As a result, the frequent loss of fluid compels an increase in thirst.

The kidneys play a pivotal role in this process. Under normal circumstances, these organs filter our blood, reabsorbing glucose and turning it into energy. But, when glucose levels exceed their filtering capacity, the excess sugar is excreted into urine, bringing along fluids from the tissues, which leads to the frequent need to urinate. This increased urination can lead to dehydration, prompting an intense thirst.

Monitoring one's hydration levels becomes paramount, and staying ahead of dehydration requires disciplined intake of water and other hydrating fluids. We should pay attention to these symptoms and communicate with healthcare providers about any noticeable increases in thirst or urination. They might recommend adjusting your diet, medication, or exercise routines to help manage your blood sugar levels more effectively. If you have not been diagnosed and notice these signs, read about the early signs and symptoms of diabetes.

Blurred vision

Blurred vision during a diabetic attack is caused by high blood sugar changing the shape of the lens in the eye. High blood sugar levels can cause the lens inside the eye to swell, altering our ability to see. This swelling changes the shape and flexibility of the lens, temporarily impairing our focus. On the flip side, when blood sugar levels are brought back to the target range, vision often returns to normal. But, frequent fluctuations can lead to lasting damage, highlighting the importance of maintaining stable blood sugar levels.

Blurred vision might not always signal diabetes-related complications; it could also indicate the need for a new prescription for glasses or contact lenses. Nonetheless, if the onset of blurred vision is sudden and accompanies other symptoms of diabetes, it's a clear sign that medical advice is needed. Regular eye exams become a cornerstone in the management of diabetes, as these checks can help identify and mitigate risks early on, including diabetic retinopathy.

Nausea and vomiting

Nausea and vomiting are symptoms that should never be ignored during a diabetic attack, because they can signal that blood sugar is dangerously high or low. On one hand, high blood sugar levels, or hyperglycemia, can lead to a buildup of ketones, causing ketoacidosis, a serious condition that necessitates immediate medical attention. Conversely, hypoglycemia, or low blood sugar levels, can trigger our body's emergency response, resulting in nausea as a warning sign to ingest sugar.

Vomiting, although a more drastic symptom, serves as a clear indicator that our body is attempting to correct an imbalance. Nausea and vomiting in diabetes are often the body's response to:

• Sugar imbalance: Fluctuating glucose levels can disturb our body's normal functioning.
• Ketone buildup: Especially in type 1 diabetes, where it can lead to ketoacidosis.
• Medication side effects: Certain diabetes medications might provoke nausea as a side effect.

To manage these symptoms effectively, we recommend monitoring blood sugar levels closely to identify any discrepancies early on, staying hydrated, as fluids can help mitigate nausea and flush out ketones, and seeking medical advice promptly if symptoms persist or worsen. Vomiting that prevents you from keeping fluids down is an emergency.

What should you do during a diabetic attack?

What to do during a diabetic attack depends on whether blood sugar is low or high, so the first step is always to check it with a meter if one is available. If you cannot check and the person has the fast-onset symptoms of a low (shaking, sweating, confusion), treat it as low blood sugar; giving sugar to someone whose blood sugar is actually high does far less harm than withholding it from someone who is low.

If blood sugar is low: the 15-15 rule

Upon noticing the first signs of hypoglycemia, it's imperative that we act swiftly to elevate our blood sugar levels. Consuming fast-acting carbohydrates is a reliable method. Some examples of effective choices include:

• Glucose tablets or gel
• Fruit juice
• Regular (not diet) soda
• Candy
• Honey

After consuming about 15 grams of carbohydrates, we should monitor our blood sugar levels every 15 to 20 minutes, ensuring they return to our target range. The American Diabetes Association calls this the 15-15 rule: take 15 grams of carbohydrate, wait 15 minutes, re-check, and repeat until blood sugar is above 70 mg/dL, then eat a snack or meal so it does not drop again. If the person is unconscious, having a seizure or cannot swallow safely, do not give food or drink; use a glucagon kit if one is prescribed and call 911.

If blood sugar is high

For hyperglycemia, this might mean adjusting our diet, exercising, or taking medication as prescribed by our healthcare provider. Drink water to counter dehydration, take any missed insulin or medication as directed by your care plan, and re-check in a few hours. People with type 1 diabetes should check for ketones when blood sugar stays high or they feel unwell; moderate or large ketones, vomiting, stomach pain or deep rapid breathing mean possible diabetic ketoacidosis and need emergency care. Avoid vigorous exercise when ketones are present.

Which types of diabetes can cause a diabetic attack?

Any type of diabetes can produce a diabetic attack, but the most likely kind of attack differs by type and by treatment. Broadly, diabetes is categorized into three primary types: Type 1, Type 2, and Gestational Diabetes. Each type has unique triggers, risk factors, and management strategies. For a fuller comparison, see prediabetes versus type 1 and type 2 diabetes.

Type 1 diabetes

Type 1 Diabetes is an autoimmune condition where the body mistakenly attacks the insulin-producing cells in the pancreas, leading to little or no insulin production. This type of diabetes is usually diagnosed in children and young adults. The key to managing Type 1 Diabetes is monitoring blood sugar levels diligently and administering insulin through injections or a pump. Because insulin is essential, people with type 1 are at risk of both hypoglycemia (too much insulin) and diabetic ketoacidosis (too little).

Type 2 diabetes

Type 2 Diabetes is more prevalent and accounts for the vast majority of diabetes cases worldwide. It's characterized by the body's inability to use insulin effectively, leading to insulin resistance. Over time, the demand for insulin increases, and the pancreas cannot make enough to keep blood glucose levels normal. Type 2 Diabetes is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet, but genetics also play a significant role. Hypoglycemia in type 2 diabetes is most common in people who take insulin or sulfonylurea medications.

Gestational diabetes

Gestational Diabetes occurs during pregnancy and typically resolves after giving birth. But, it does increase the risk of developing Type 2 Diabetes later in life for both the mother and the child. Gestational Diabetes is diagnosed through a glucose tolerance test and is managed with diet, exercise, and insulin if needed.

How can you prevent a diabetic attack?

Most diabetic attacks can be prevented by keeping blood sugar steady through regular monitoring, consistent meals, and medication taken as prescribed. To stay ahead of hypoglycemia, regular monitoring of blood sugar levels is a cornerstone of effective diabetes management. Keeping a record helps us identify patterns and triggers that could lead to low blood sugar levels; these tips for blood sugar monitoring can help.

Integrating healthy habits like balanced meals timed regularly throughout the day, along with monitoring carbohydrate intake, can significantly reduce the risk of hypoglycemic episodes. Also, staying educated on our condition empowers us to make informed decisions about our health. Other practical steps include:

• Carrying a fast-acting carbohydrate source (glucose tablets, juice box) at all times if you take insulin or a sulfonylurea
• Checking blood sugar before driving and before, during and after exercise
• Having a sick-day plan from your care team, since illness commonly pushes blood sugar high
• Wearing medical identification so others know what to do if you cannot speak for yourself
• Keeping in regular contact with your healthcare team, who can provide personalized advice and adjustments to your treatment plan

For a broader checklist, read our guide to preventing diabetic emergencies.

When should you see a doctor or call 911 about a diabetic attack?

Call 911 immediately if a person with diabetes is unconscious, having a seizure, too confused to swallow safely, vomiting repeatedly, breathing deeply and rapidly, or has fruity-smelling breath. These signs point to severe hypoglycemia or diabetic ketoacidosis, both of which can be fatal without emergency treatment. Contact your doctor the same day if blood sugar stays above your target range despite following your plan, if you have had more than one low in a week, if you had a low that required someone else's help, or if symptoms such as blurred vision, unexplained weight loss or nausea keep returning. People with diabetes also have a higher risk of heart attack and stroke, and heart attack symptoms can be milder or atypical in diabetes, so chest pressure, shortness of breath, jaw or arm pain, or sudden weakness on one side of the body also mean calling 911.

Frequently asked questions about diabetic attack symptoms

What does a diabetic attack look like to someone else?

From the outside, a low blood sugar attack often looks like sudden drunkenness: the person may be shaky, sweaty, pale, irritable, confused, slurring words or unsteady on their feet, and in severe cases may have a seizure or pass out. A high blood sugar attack is subtler and slower: unusual tiredness, frequent trips to the bathroom, constant drinking, and, if it has progressed toward ketoacidosis, vomiting, deep rapid breathing and a fruity smell on the breath.

How long does a diabetic attack last?

A low blood sugar episode usually resolves within 15 to 30 minutes once fast-acting carbohydrate is taken, although you may feel tired or foggy for a few hours afterward. High blood sugar can take several hours to come back into range after medication, fluids and rest, and diabetic ketoacidosis takes hospital treatment over a day or more. An episode that is not improving with the steps above needs medical help.

How do you help someone having a diabetic attack?

If the person is awake and able to swallow, give them about 15 grams of fast-acting sugar (half a cup of juice or regular soda, glucose tablets, or a tablespoon of honey) and stay with them while they re-check their blood sugar in 15 minutes. If they are unconscious, having a seizure or cannot swallow safely, do not put anything in their mouth; place them on their side, use a glucagon kit if they carry one, and call 911.

Are diabetic attack symptoms the same as heart attack symptoms?

No, but they can overlap and people with diabetes are at higher risk of both. A heart attack causes chest pressure or pain, shortness of breath, pain spreading to the arm, jaw or back, nausea and cold sweats; in people with diabetes, nerve damage can blunt chest pain so the warning signs may be only sudden fatigue, breathlessness or nausea. When in doubt, treat chest symptoms as a possible heart attack and call 911.

What is a diabetic attack called medically?

Doctors describe a "diabetic attack" by its cause: a hypoglycemic episode (low blood sugar), a hyperglycemic episode (high blood sugar), diabetic ketoacidosis (DKA), or hyperosmolar hyperglycemic state (HHS). Severe hypoglycemia that leads to unconsciousness is sometimes called insulin shock, and a prolonged extreme of either high or low blood sugar can lead to a diabetic coma.

What causes a diabetic attack?

Low blood sugar attacks are usually caused by too much insulin or sulfonylurea medication relative to food and activity, such as a skipped meal, extra exercise, or alcohol. High blood sugar attacks are usually caused by missed medication, illness or infection, stress, or eating more carbohydrate than the treatment plan covers. Checking blood sugar regularly is the best way to spot the pattern behind your episodes; here is why checking your blood sugar matters.

References, studies and sources

• Centers for Disease Control and Prevention (CDC). Diabetes Basics. https://www.cdc.gov/diabetes/basics/diabetes.html
• American Diabetes Association. Hypoglycemia (Low Blood Glucose). https://diabetes.org/living-with-diabetes/treatment-care/hypoglycemia
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Low Blood Glucose (Hypoglycemia). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia
• Mayo Clinic. Diabetes: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
• MedlinePlus. Diabetes. https://medlineplus.gov/diabetes.html

About the author: Dr. Matthew Capozzi, DPM, FACFAS, CWS, is a board-certified foot surgeon through the American Board of Foot and Ankle Surgery. He is a Diplomate of the American Academy of Wound Management and Fellow of the American College of Foot and Ankle Surgeons. He completed a three-year residency program in Foot and Ankle Reconstructive Surgery at St. Francis Hospital & Medical Center in Hartford, CT in 2010. Dr. Capozzi is a board-certified Wound Specialist® granted by the American Academy of Wound Management.

Healthcare disclaimer: Always consult your physician before beginning any program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you experience any pain or difficulty, stop and consult your healthcare provider. CircuFiber socks are a general wellness product intended to promote a temporary increase in local blood flow and circulation; they are not intended to diagnose, treat, cure, or prevent any disease. Individual results vary.