Hi all, I've had a few severe lows and a few seizures in my lifetime, always during my sleep (when I'm awake, I can tell I'm hypo and just eat, but it doesn't always wake me up if I'm sleeping). It hadn't happened in well over a decade, but after switching to a pump and switching insulins in July, I've had a few severe nighttime low incidents in just the last few weeks.

The latest was yesterday morning around 4am (no apparent seizure, but my wife couldn't easily wake me and got out the glucagon before it went that far). The weird thing this time is that while I usually feel fine within a short period after the incident, after this latest one, I'm still feeling a bit "off" 24 hours later. I feel vaguely woozy and foggy, and have spotty headaches coming and going in assorted places - none of which is enough to keep me from functioning relatively normally, but enough to be very noticeable to me as clearly abnormal, almost like a bad hangover, and I am concerned I may have incurred some substantial brain injury.

Has anyone else experienced lasting effects from severe lows and/or from glucagon administration anything like this? Any thoughts on causes, similar experiences, or suggestions on how to speed or otherwise assist recovery would be much appreciated.

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Hi Jim,

Sorry to hear about your recent hypoglycemia problems. I have recurring difficulties (especially nocturnal) and will share my own experiences with you. Before I get into it - YES, I have had the "bad hangover" experience the following morning, particularly after the more-severe experiences. In my experience, the duration of this "hangover" corresponds to how LOW we get, and for how long we remain at that very low state.

My diabetologist (an I.M.) referred me to a neurologist after I explained some of my "events" to him where my personal experiences parted from those I have heard / read-about in other diabetics. After a lot of tests (I have very good medical benefits) we met to discuss results. His advice began with a strong caution to work harder to avoid hypoglycemia. At the time of his testing there was (probably IS~) no way to measure hypoglycemic caused neuron loss. As far as "lasting effects" and "cumulative effects": I suspect that there ARE, but the onset of those effects is very gradual therefore it will be a challenge to characterize them. And - how can we distinguish them from other age-related problems like geriatric-dementia?

I urge you to keep a journal (log) about these experiences and include each of your lingering symptoms - and their duration. Then discuss them with your diabetologist at your next meeting. He will then (after testing??) develop a plan to reduce your problems.

On your pump: Find your basal rate. I think you should reduce the rate ... possibly to zero at those times where you keep having the worst problems. Don't forget to set the rate back to your "normal" metabolic rate after you rise!

Finally: I have found that aspirin and naproxen sodium work well for the pain. For the disorientation, vision and other symptoms I get relief with strong coffee! Keep me posted: my e-mail address is Skybum@Mindless.com

Good Luck! and Best Regards -
James
When I go low (so far 31 is the lowest) I am foggy and just feel like my head is not on straight for about 24 hours. I don't know what to do about it but I wish I did.
after a severe low that goes on for a while before i notice I feel really dumb for a couple of days after, maybe killed off a few too many brain cells by starvation? i had a really bad episode (www.einspineto.blogspot.com//2009/04/i-think-i-have-done-such-good-...) for a full recap. i think when ive had a lot of lows recently a good low will feel a lot worse. sme nights i cant do any more than lay on the couch and stare off into space after a superlow. and it seems the longer i have this disease the worse they get. and its all accompanied by some recovery highs to boot. i've started ussing symlin after severe night lows to cut down on that and it works a little.
for a while i was really scared i was doing permanent damage that would just get worse as i experienced more and more lows. but the brain always comes back on line. i havent gotten any stupider (hah) in the long run. the brain recovers and then all is well again, at least until the next low.
Thanks very much all! Interesting to hear your reports and sorry to hear you've gone through some of the same things. James, after consulting with my endo, my night time basals have been reduced and I've gone a couple of nights now without ill effect.

A little over 48 hours "the incident," I'm finally feeling a bit better - the fog has largely lifted though not completely and the feeling that it's improving has me a bit less panicky about it. Lots of water and vitamins, though I don't know if they actually DID anything or if my body just needed time to clear out the garbage (or still is). Oy vey. I feel like I killed a few neurons that time, or perhaps more than a few - the best way I could describe it is like a vicious hangover. I really must avoid this at all costs even if it means being high for extended periods. (I'm finding that Apidra is absorbed noticeably more slowly for me than Humalog, on average, but my body did not like Humalog from the pump and my sites got inflamed too quickly.)
Hello Jim:

Ever had a real hangover??? And that is something we do completely to ourselves... "after shocks" from a low are not that much different. Your body has been through some massive hell... to all kinds of organs and body chemistry sometimes it requires some time to recover, return back to relatively normal.

In all candor I've told my wife I would rather be dead than have her (or anyone else) ever use glucagon on me. I have never ever had a "good experience" with it, not ever in c, 40 years. James is right if you are getting your teeth kicked in, cut the heck back on the insulin... being a ~little high~ beats a hypo always IME-IMHO.

Question though is glucagon yours/her "first line" of defense to a hypo???


Is there anything you've tried to counteract these headaches, the woozyness, etc. thats worked well? Been a long time for me but obscene amounts of water, some tylenol, did not hurt as I recall

Stuart
Nothing so far! (And this is the first time it's happened.) And no, glucagon is only used if I'm literally unconscious or unable to get up - which has been only a few times in my lifetime, unfortunately 3 of which were in the last month, and 2 in the last week.

Lots of water doesn't seem to be working, and I've still got an on and off sensation of wooziness or disequilibrium 5 days later (I almost want to say vertigo but there's no sensation of spinning or falling), which is scaring the heck out of me. I also have transient headaches.

I feel like my logic/conscious cognition centers are working ok, as is my memory, but that my equilibrium is definitely off. It's not enough to render me nonfunctional, or even perceptibly compromised to my wife, but enough to make me feel unwell for a substantial portion of the day. If it's not better in another day or two I'm going to seek a neurological consult. {Sigh}
Hello Jim:

3 freakin times in the last blessed month is a GIANT siren telling you to CUT BACK brother!

Keep aiming for your low target number and you've been taken out three times in the last 30 days. Thats too many. Pull up (literally) before it happens again!

You need to contact your endo and get the referral or the necessary evaluation. You shouldn't still feel that way days later. The next day, ok sure, but days later does not sound good. I assume your BG is not testing low/lowish while getting these feelings correct?.

Make the call ASAP. Could be something that will go away easily. Could be BP, could be a lot of things you want under glass and labeled so they don't cause more trouble. You've had enough for one month.

Make the call.

Stuart
Indeed, I have cut back already after chatting with him, and I'll be chatting with him again today. Fortunately, at long last, yesterday I felt a vast improvement, very little disequilibrium - the effect is finally wearing off, thank g-d. After nearly a week! This must've been a damned severe event. Whew!
Hello Jim:
Any prayer it was you still be strung out by being consistantly too low???

Stuart
I don't think so, but thankfully, the symptoms have largely subsided at this point. I'm still a little headachey for brief periods, but I felt no disequilibrium all day yesterday, and the headaches are lessening every day (and I'm confident this too will disappear with time). Whew.

Note to self: Much preferable to run high than to die in bed.
== IF our hypoglycemic episodes DO kill-off brain cells we can only HOPE that it works in much the same way as BEER does!
("CHEERS" Per Cliff Clavin's "Buffalo Theory" - as explained to Norm ...)

"Well ya see, Norm, it's like this... A herd of buffalo can only move as fast as the slowest buffalo. And when the herd is hunted, it is the slowest and weakest ones at the back that are killed first This natural selection is good for the herd as a whole, because the general speed and health of the whole group keeps improving by the regular killing of the weakest members.

In much the same way, the human brain can only operate as fast as the slowest brain cells. Excessive intake of alcohol, as we know, kills brain cells. But naturally, it attacks the slowest and weakest brain cells first. In this way, regular consumption of beer eliminates the weaker brain cells, making the brain a faster and more efficient machine.

That's why you always feel smarter after a few beers."
Let's hope the new/faster ones are just getting in shape to join the party soon!

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