Replies to This Discussion

Permalink Reply by Aimee on May 21, 2012 at 9:18am

Hi Cheryl,

I am extremely tired this morning because I was awake from 2 to 4am. My daughters BS was really high at 2am so I stayed up until 4am to make sure it came back down and a site change was not needed. I completely understand where you are coming from; our children go through so much with this disease that they can use a little help from us. I applaud you for waking up to check your son.

My daughter has never woken up from low blood sugars on her own. I wonder if it is more common for adults to wake from low blood sugar than children. I was a very sound sleeper as a child and young adult, but now wake up much easier (I wake up to low blood sugars).

It would make sense to me that young people could be more at risk for nocturnal hypoglycemia. I also wonder if the age group at most risk being from 15 to 25, could have anything to do with alcohol use? I know that I was more irresponsible with my alcohol use in my late teens and early 20's.

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Permalink Reply by Spock on May 17, 2012 at 5:41pm

I had a scary time today, and survived.

My CGM buzzed at 5 am and I treated with glucose tabs. Tested at 70--hubby went to work, as I seemed fine (70 is kind of common for me.) I went back to sleep.

To make a long story short, I struggled (and felt like a drunk) all morning, never getting to BG above 35.. Finally got it together enough to call my hubbie at 11 (have NEVER in 36 years, had to do this before..)

Once I knew he was coming to save me, my head kind of forced itself to clear, and I began to think clear enough to treat myself. Was still not in a good place when he arrived, but asked him for juice, got my glucose up, had lunch and a shower, and have been fine. EXHAUSTED, but going to sleep soon.

If I can survive this, I will not die for low blood sugar in my sleep. Scary episodes? Oh yeah. But after 50 years,I am OK. Take heart, Rudidoux!

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Permalink Reply by Super_sally on May 17, 2012 at 7:16pm

Can going low at night be avoided if one makes sure there is no fast acting insulin on board.

Assuming here that the basal is correct, but anyway it would act much slower and hopefully plenty of time to avoid problems even if one did end up going low?

Guess it's not that simple.

But I just try not to have any short IOB at night as my insurance.

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Permalink Reply by Sam Iam on May 17, 2012 at 9:07pm

Not in my experience. Your liver may stop releasing glucagon at night, causing you to go low on just your basal. Also, the delayed effects from exercise. Not to mention, the bolus insulin stays in your system stays in your system long after your pump says it's gone. I've had a lot of problem with night time lows, even taking reduced basal at night. I usually test in the middle of the night and my wife wakes me up and checks on me in the morning. Hate to scare you, but I've had a lot of issues with this in the past.

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Permalink Reply by Sam Iam on May 17, 2012 at 8:57pm

When I was younger, about 8-15 on MDIs, I had quite a few night time seizures. Usually, my parents would give me a glucagon shot and honey or glucose gel. I'd wake up very sick, throwing up, but not remembering. A few times I woke up in the hospital on a glucose drip. I always assumed that if you go low in your sleep and no one's there to help, that's pretty much game over. I would go to sleep over 150. Sometimes I'd wake up low. Often, I'd wake up high, but attribute that to going to bed high. My liver has never kicked in to stop a hypo, to my knowledge. I'm relieved to know that it happens. Now I'm trying to go to bed around 135-140. A couple lows, but nothing major.

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Permalink Reply by Brunetta on May 17, 2012 at 10:46pm

Sorry to hear you have had a history of hypo-induced seizures..So glad that you have obtained some releif from them and have your wife to help you out; just in case a hypo occurs and you do not awaken on your own: What a blessing and how caring she is....

God Bless,
Brunetta

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Permalink Reply by Brian (bsc) on May 18, 2012 at 3:15am

One real problem when you have multiple lows is that once your liver has kicked in with a counterregulation, it has become depleted of glycogen. It can take 24-48 hours for your liver to replenish glycogen stores. Subsequent lows can leave you at risk since your liver cannot counterregulate properly.

When you are young and active, you may also be prone to overnight lows due to what they call post exercise hypoglycemia. Many kids have this and it is a serious problem. It seems to be caused by the sudden uptake of glucose into your muscles as part of recovery and it can cause harsh lows even with seemingly normal levels of basal.

If you woke up high, it is likely that your liver kicked in to deal with a low. I'm glad things are better, but your story is very sobering.

I also think it is much safer to not eat and bolus before bedtime so that overnight all you have in your system is basal.

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Permalink Reply by jeffri kay on May 22, 2012 at 8:05am

thanks for this information bsc. where did you learn about the first portion of your discussion relating to counterregulation/subsequent lows?

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Permalink Reply by Brian (bsc) on May 22, 2012 at 9:40am

I read a lot. There is a reasonable description of some of this in the discussion of pediatric hypoglycemia at medscape.

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Permalink Reply by jeffri kay on May 23, 2012 at 10:14am

thanks:)

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Permalink Reply by Sam Iam on May 18, 2012 at 10:47am

Thanks. I guess I'm lucky not to be "dead in bed". For the record, I now believe that all of these occurrences were avoidable. At the time, I was taking a ton of insulin. ~150u / day N+R. I was loosely following an ADA diet, and had no idea that there was a relationship between carbohydrates and BG. This all happened before the age of the internet. I did not know any other T1s, and considered these seizures normal. At the time, I was told by Doctors that hypo events like these were to be expected with tight control. I no longer believe this to be the case.

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Permalink Reply by Stoyan on May 18, 2012 at 9:34am

It does happen it seems, and it shows that unfortunately no matter how well prepared we are, no matter what kind of treatments they come up with, the fear will always exist that such accidents can happen. The only way to get rid of it for sure would be to find a cure for diabetes. A cure is what we need.

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