Diabetes itself is generally associated with hyperglycemia (high blood sugar levels), but people with diabetes can also develop hypoglycemia (low blood sugar levels) due to treatment with insulin or medications that lower blood sugar. This happens when the insulin dose is too high, if the person doesn't eat enough after taking insulin, or if they exercise too much without adjusting their food intake. Although diabetes primarily causes hyperglycemia, people who take insulin are also at risk of hypoglycemic episodes. In the case of an insulin overdose, acute hypoglycemia can occur, leading to severe symptoms such as loss of consciousness, coma, and, if not treated promptly, can be fatal. Therefore, while diabetes usually causes hyperglycemia, hypoglycemia remains a significant risk for people using insulin.