But knowledge is power, right?
What is the deal with otherwise healthy type I's dying in their sleep from hypos? I had kind of assumed (or maybe convinced myself) that there had to be more to the story, like drugs or drinking, but I'm losing my resolve. Is it really just a crap shoot to go to sleep every night? Is it a Q of glycogen stores in the liver -- and if so, how does one make sure they're stocked up?
Ahhh. I'll have to read it someday anyway, even if it's just to show my support. He's been so maligned, poor guy!
JDRF recently published an ad of sorts which caused quite an uproar, documenting that approximately 1 in 20 before the age of 40 would die overnight of a low blood sugar. Studies I have come across have documented anywhere from approximately 1 in 10 to a little more than 1 in 20. I think the figures are higher as most doctors will not put death due to hypoglycemia on the death certificate (hard to prove). I also think, though, that more of these deaths occur during the teen years when there is a sharp increase in insulin needs that may decrease the same evening (growth hormones). And in young children; dosing for growing children can change every few days. Alcohol is a factor as well; even one or two drinks can cause problems as the liver will be metabolizing the alcohol and will not be able to kick in glucose when needed. Not all adults seem to get up and do the night checks every night so for most, I assume they must be more stable. Cgms and diabetic alert dogs would be great backups and for adults who suffer from lows overnights regularly, I hope they will be able to use these tools. P.S. Even though this has been our greatest fear, our DD has been very low at times (30s or less LO on meter), has always rebounded or we have always caught it, and has never had a seizure or lost consciousness due to a low. She has had Type 1 for seven years. We do multiple checks at night but she has gone very low between the checks sometimes. Cover all insulin on board that you need to before turning in, have 25 or 30 Ex-carbs for each drink of alcohol before turning in, set multiple alarms (one across the room) on nights you have had a lot of extra exercise or if you have had lows during the day. If you find you are running low overnight increase your bedtime target. Use cgms if your sugars remain very unpredictable. It can happen; but most are fine.
Jan, Those numbers are much higher than people upthread were saying. It seemed like there was a bit of a consensus that it was under 1%. I cannot believe that it is 1 in 20. If that were true, then my doctors (some have been pretty horrible, but several have been very much on top of things) have really dropped the ball. I actually asked a couple of doctors about whether or not I had to fear dead-in-bed syndrome (thought I didn't know what it was called then) and they very much discouraged me from even thinking about it. If the chances were really 1 in 20 or even approaching 1 in 10 that a low blood sugar would kill me, I cannot believe that my doctors could have been so cavalier. And I think our whole approach to treating type I's would be different. I doubt that "tight control" would have ever been something to strive for.
The only time I have ever done "night checks" as a regular thing was when I was pregnant. But even then I don't think my doctors said I should check during the night. I have never had a doctor even suggest it. Of course, the docs want you to check at least four times a day, and I don't think four is anywhere near enough -- for me, at least -- so I'm not saying the docs are right that night checks are not important. But I do think if so many people were dying from low blood sugars that they'd be suggesting that we test a lot more, and especially at night.
Ya know, I don't think any of my doctors have even been particularly interested in talking about my lows. When it comes up it is because I bring it up (most recently because I was having hallucinations which freaked me out) and they always brush it off (about the hallucinations doc said, "oh yeah, totally normal, don't worry about it" and that was the end of the conversation). I'd be pretty pissed to find out that I had a 5 to 10% chance of dying from one.
The JDRF ad was criticized upthread. The organization is shady for a number of reasons. Just take a look at their sponsor pages. The ad, itself, is exploitive and sickening. Studies that they pulled their statistics from were taken from the early 80's and 90's on relatively small groups of people 1000-2000 over a limited amount of time 1-10 years. If you get any deaths at all that can be attributed to hypoglycemia (probably not too difficult if you have people taking huge dosages of NPH). Then multiply them by an average lifespan, you are bound to get a figure that seems pretty high. Keep in mind that there is no mechanism to factor in our improvements in diet and technology, or advances we are bound to make in the future.
I also think that dying now from hypoglycemia vs keeping your BG high is a false choice. With proper treatment, many of us have found it possible to keep levels stable at near normal levels, while avoiding lows.
Another possible explanation is that nocturnal hypoglycemia has some sort of impact on heart rhythm. A recent study published in Diabetes Care discusses the issue. Those of us who have had a wicked nasty low know how hard it can be on the body. Obviously further research is necessary into this but it could be one possible explanation.
Ok, Being a diabetic for 38 years I've never heard of the "DIB" syndrome. I drink only upon occasion and when doing so always compensate with food and a lower bolus than normal. I do take medication to help me sleep due to Neurological problems and neuropathy. I usually wake up when my sugar is low. It has been years since I've had a low that caused wet sheets, etc. I guess a good question would be is this because of the Neuropathy/Neurological problems? Age? To me this is a most disconcerting conversation. I always check before bed and if necessary eat to bring my BG up. And I tend to eat things that have substance, i.e.,PBJ sandwich, Peanut food bars (Love them!). Health food bars, things that are easy to open and have carbs stated on the packaging.