insulin reactions....

[NeedingHelp]

I'm so glad to find this forum, as I have had little luck finding support for those of us new to partners with diabetes.

I've begun dating a man in his late 40's with type 1. Several times he's experienced insulin reactions while sleeping. They are always scary, particularly when he's mildly incoherent when he wakes.

I've gotten to the point where I do not sleep well, because I'm reaching over to check him for the sweats every couple of hours.

He's managed this successfully for 35 years, is absolutely dilligent in monitoring his BG, it's ritualistic. Every night at midnight, every morning at 6am, and several times during the day. We can have exactly the same meals and activity levels...and one time he's fine, other times the sheets are drenched, he's got the cold chills and the meter says 30.

There are always glucose tablets, glucose gel and OJ on the night table. He's never resorted to using them, will eat gingersnaps or something else instead. Sometimes I wish he WOULD use the tablets or gel, as I assume that would take his levels up faster. And the mild incoherence is scary to me, no matter how calm he says I act during these events (this attribute apparently gets me many brownie points). But I am not calm on the inside.

We had a talk about this when we first began seeing each other, thank God, or I would have had NO idea what was going on.

Does anyone have any words of support or thoughts on the matter?

[Amy C.]

30 is mighty low -- I would be concerned about seizures if he typical goes that low.

You are to be commended for learning about Type 1 diabetes, which could be a help in understanding what is going on. This site has a lot of information you can use.

Type 1 is not predictable if you only consider the amounts food, insulin, and activity. You have to consider the glycemic value of the food -- how fast it raises the sugar, where the shot was given and if the insulin is good, and the intensity of the activity. Also, the patterns may change and need to be noted. There are several other factors to consider as well, but these are the basics.

I wonder if your friend would be amenable to your testing him if you think he is low. That is what parents do for their kids. My son doesn't even wake up when the light is turned on for the few night blood tests. I would keep juice nearby -- drinking juice from a carton is quite easy for a semi-conscious person to do. The gel is sticky and the tabs need to be chewed. Sucking juice from a straw works well at this house.

If your friend goes down to 30 fairly often, there is a chance that he could need glucagon. I would ask him to let you learn how to use it. It is wonderful in raising the blood sugar very quickly for someone who can't take food.

By the way, going down to 30 is a sign that the diabetes is not well controlled. Low blood sugars need to be avoided.

[Sweetkidmom]

By the way, going down to 30 is a sign that the diabetes is not well controlled.

I don't wish to be argumentative, but is this necessarily the case? I've often read about hypo's (or insulin reactions) being termed "The Curse of Good Control".

A very slow-absorbing bedtime snack may help. A different insulin may help (Lantus helped a lot for my daughter's night-time hypos). Actually drinking the OJ or sugar stuff he keeps by the bed might help too - consider negotiating with him that you can give him this, if you wake up and find him sweating?

Insulin reactions are *really* scary - I woke up to my daughter convulsing one night :eek: after giving herself too much insulin (luckily sleeping next to me in my bed that night-she was to have been at a sleepover, but my instincts said no, at the last moment.) I hope I never have another experience like that!

Good luck :)
Kay

[Ellen]

Does he keep a Glucagon kit next to the bed? You'll need to be instructed how to use one in case he has a low blood sugar seizure and therefore unable to take any food/liquid by mouth.

http://www.childrenwithdiabetes.com/d_0n_022.htm

[NeedingHelp]

Thank you all for your responses. I ask him about a Glucagon kit. Knowing it's there might very well help me to sleep.

I know he very much prefers being low to being high. That's his decision, and since he is not experiencing any secondary health issues after living with his disease for this long, I won't second guess him.

Does anyone know of any discussion lists for adults with type 1?

You've been a very big help to me. Thank you.

[cydnimom]

There is no set way to tell if a low is going to happen or not - you can eat the same thing, have the same activity and your body will do something totally different everyday. Stress can factor into lows as well. Although stress usually leads to highs at the time of the stress because your liver releases sugar into your body, you also have to take into account that your body will be replacing that sugar into your liver at some point in time too thereby using up what you thought was the right amount of sugar you thought you had in your body.

Another suggestion you may want to make to him if he is having quite a few lows in the middle of the night is for him to set the alarm to check his bg at 3:00 am for a few nights to see if he can find a pattern and adjust his dose. Although, he may not take advice from you about his D if he's been looking after himself this long - just a thought.

[Sweetkidmom]

Don't know how he (or you) would feel about this gadget? Not 100% accurate, so you may get false alarms, but here is the URL:

http://www.diabetesnet.com/sleep_sentry.php?PHPSESSID=e7afbf231352fa00ee203cc 50c53bfbc

Kay

[mischloss]

I too was told that Lantus helps to regulate regarding lows for overnight. I love Lantus and my son thank goodness has not had a night sweat since coming out of the hospital in Sept. Also, your friend might consider going on a pump to be regulated better. Just thoughts. Keep apple juice in small cartons with the straw attached to the side on the bedstand. Glucogon in the nightstand as well. Our doctor even suggested to us that being a bit high at night is way better than going to bed in the low/normal range. He wants my son to have a bedtime snack of about 30 grams of carbs before bedtime without coverage to carry him through the night. So far our morning readings have been between 100-126 so I think it he is doing well with this method. Hope this helps in a way. My sister-in-law once dated a young man with T1 and she experienced the same night time reactions that you are with your man. Also beware that drinking causes sugar to spike and then come crashing down. If your boyfriend, has some beer or liquor it really puts a whole different spin on his insulin and carb reactions. My sister-in-laws friends would go out drinking with the boys. Of course you have the carbs of the beers to carry you through the night but then would be plummeting in his BG numbers later in the night because of the alcohol in his system. Just thought I would mention this as FYI.

[Momof4gr8kids]

My DH has type 1 diabetes. We have been married for 11 years, and have been together for 13. I have been through many lows with him. Luckily we have never had to use the glucagon shot (knock on wood ) I have seen him spit food at me, and act like a 2 year old, he has had reactions that are like a stroke where he couldn't use half of his body, and the other night he was trying to get to the kitchen through the dresser (which is the oppisite direction ). All of this is scarey, and I have had my sleepless nights too. Most of the time now I just get up, and get him a quick fix to raise him fast like glucose tabs, bananas, juice, or a sweet if that is what he wants. Then I give him something that will maintain, and I stay with him while he recovers. I guess I have gotten used to it, and unless it gets to where he needs to be seen like with the stroke reaction I just treat the low, make sure he is ok, and go back to bed. Sounds like you are doing the right things to try, and help him. The thing is you can only help him if he wants help. He knows what he is doing, and each person who lives with diabetes has their own way of doing it. I know some who don't do sweets at all, and others who eat a candy bar for breakfast daily. There are those that would rather run a little high, and those who would rather treat a low. Some carb count, others just have a feel for it. ect......I would sit down and talk to him about it alittle more.
There is a forum for those with type 1 diabetes at this link http://forums.childrenwithdiabetes.com/forumdisplay.php?f=6 if he would like to connect with others. If he is getting alot of lows he may want to adjust his long acting insulin, but that is up to him. Take care, and try to relax. You can't control this. That is for him to do no matter how frustrating that is sometimes.
Jamie

[BrendaK]

My mom has had diabetes for 39 years. She started experiencing a lot of the same problems that your partner has around 10 or so years ago. At the time she was on Regular and NPH insulins. She ALWAYS had a bedtime snack, had the same amount of activity every day, was VERY routine oriented. But NPH is SO unpredictable. And I think her body was just changing.

Please look into Lantus. Mom switched to lantus a few years ago and hardly ever has nighttime lows anymore. It's made us all sleep alot easier. (Can't say that about the day, though). She's one of those people who prefers being low(er) to being high... One of the consequences of that has become hypoglycemic unawareness, but that's for another thread.

Also, like Ellen said, PLEASE get trained in glucagon. My dad has had to use that on my mom several times over the last 30 years. It has saved her life.

[justlittleme123]

I'm new to this forum and was pleased to see the recent reply to this thread. I am the wife of a Type 1 diabetic and I just wanted to make sure that people know the side effects of glucagon. My husband has severe nausea and vomiting when I give him glucagon. Sometimes this happens before he is coherent, so I had to make sure he was on his side. Now I don't give him it anymore, I call the paramedics. I just thought you should be aware of this.

[Momof4gr8kids]

Justlittleme, Why is your DH having so many bad lows? I am also married to a type 1 for 11 yrs, and know you can't do anything about it but help out when needed. I however am very concened that you have had to give him from the sounds of it at least a couple of glucagon shots? I haven't had to even give one.
I know the vomiting while unconciuos is scarey, but aren't you worried that he may expire,or have brain damage before the peramedics can get there to treat? That is my worst fear. I am not trying to come off condisending as I have not ever had to give glucagon, and therefor can't even imagine being in your shoes. I am just concered. I hope that the lows get better.
Jamie

[EmmasMom]

Justlittleme, Why is your DH having so many bad lows? I am also married to a type 1 for 11 yrs, and know you can't do anything about it but help out when needed. I however am very concened that you have had to give him from the sounds of it at least a couple of glucagon shots? I haven't had to even give one.
I know the vomiting while unconscious is scarey, but aren't you worried that he may expire,or have brain damage before the paramedics can get there to treat? That is my worst fear. I am not trying to come off condisending as I have not ever had to give glucagon, and therefor can't even imagine being in your shoes. I am just concered. I hope that the lows get better.
Jamie

I'm with you Jamie! If I ever found my husband convulsing or unconscious I would not hesitate to give glucagon! The risk of death is very real if a severe low is left untreated.:eek: Luckily I have never had to give glucagon to my husband and have only had to help him on a few occasions by handing him something to eat or drink. He is very well controlled.
We have always been aware that vomiting was a side effect of glucagon, but would never consider withholding it for that reason. People vomit after CPR as well, but you wouldn't sit and wait for an ambulance if he wasn't breathing. The benefits clearly outweigh the side effects.
justlittleme, do you give him glucose while you wait for the paramedics? You can rub glucose gel, cake gel or liquid candy inside their cheek and it will help bring his sugar up even if he's "out".

[thebestnest5]

There is a prescription that should keep a person from wretching when they regain consciouness after Glucagon is given...it's called Metoclopramide syrup. Some people keep it with the Glucagon kit for administering. You could talk with your physician and get more information on it.


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Sheree

[justlittleme123]

Thanks Amy and Jamie and Sheree~

I appreciate your concern and I’ll take any sort of advice – anytime. My husband has been on a pump for 8 years now and I’ve only had to call the paramedics once or twice a year since he’s been pumping. (I say only because it used to be once or twice a month prior to the pump) He doesn’t check his BS often enough, he sometimes eats without taking a bolus and boluses without checking his BS sometimes also. It’s very frustrating. I’ve given him glucagon about 6 times in the past 13 years, and honestly, I don’t think I’ve given him one in the past 6 years. (We’ve been together 20, but the overnight lows didn’t happen in the beginning.) At first he didn’t have too much trouble with it, but after the 3rd one or so, he would vomit and be nauseous all day long after the episode. He asked me not to use it anymore and to call the paramedics instead. Luckily they are here very quickly and even luckier, he has never had convulsions with his hypoglycemic episodes.
Let me explain how it gets to this. I’ve trained myself to wake up three or four times each night and roll over and feel his body. If he is even the least big sweaty, I’ll check his BS. Sometimes, he’s just hot and I smile and go back to sleep. Other times I’ll wake up and he will be lying in a pool of sweat and I know that he must be low. Once I get him on his side (kind of hard - he’s 240 lbs) and test him (he’s been as low as 18 one time) I get the juice and see if he’ll drink. Usually he will be able to drink even if he is only partially responsive. But if the BS is too low, then his teeth are clenched and I am unable to get the straw into his mouth – that’s when I have to call 911. I do use the cake gel but it never seems to work well – The paramedics come and he is awake and grumbling within minutes. He eats something to sustain the BS, thanks me and we go back to bed. Yes, it’s scary, but after it has happened so many times, I feel like a pro.
I will definitely talk to his doctor about how much time he feels is too much time to wait for the medics. (I'll also ask him about the Metoclopramide syrup) Again, thanks for your concern.

[Momof4gr8kids]

He is lucky to have you there, and that you do wake up to check on him. Hang in there. BTW, I wish my DH was better about checking his blood too, lol. I think that is when we get most of our bad lows, or our high, highs. I also wish he would learn to carb count....
Jamie

[EmmasMom]

Wow, I'm really sorry to hear that! I can't imagine your frustration. If my husband was careless with his D and constantly needing my help because of it I think I'd be extremely resentful! My father lived much like your husband, but had no real choice since he didn't have access to a Glucometer or decent insulin, (he died in 1981, he was only 31). It was all very hard on my mother, but that's just how diabetes was then. Now things are so much better! I'm not downing your husband, and I know every one's D is different, but testing and carb counting just isn't that hard. I think having a baby with diabetes has made me much less sympathetic to adults, because if I can successfully manage her nightmare blood sugars they have no excuse. (But I'm sure I'm jaded:rolleyes:, my poor husband;))

[Momof4gr8kids]

My DH did not have a meter until his teen years. He was dx'd back in the days when it was 2 shots a day, and animal insulins were the only choice. Shortly after they came our with the humulin insulin, but it still wasn't that great. Since that was how he was taught I guess that is what he still does. It is hard to teach an old dog new tricks or so the saying goes. I also think he had to relolve around the diabetes in the first part of his life, and the second part he decided that that wasn't giving him quality of life. I think this has alot to do with it as far as my hubby goes. I can't do it for him, and I wouldn't if I could. I do care deeply about him and love him- don't take me wrong, but I just don't think I could handle it nor do I think I should have to handle it. For the most part he has it down pretty good on his own method though. His last A1C was 6.7, and his lows and highs are not that frequent which is pretty good for the way he manages it.

[justlittleme123]

Thanks ladies, really - your support is worth so much more than you know. I have been searching for a support group for spouses of diabetics, but they don't seem to exist, so my virtual support group - here and at a few other sites - has been quite helpful. If I knew how, I'd start one - and I'm seriously thinking about it. For now, we just started seeing a counselor and I'm hopeful he can help him (and us). The counselor is great - he used to be a CDE and is now a mental health counselor - and he's a diabetic to boot! (T2, tho). I do have to say that my husband is the most giving, sweetest, generous, loving man I know. He's a great husband and an even better father to our daughter - that's why it has been so hard on me. He would - and has - given everything he has to his family, friends and community. (Me included) But all I want is for him to be a little less selfless (helping others) and a little more selfish (helping himself). Kind of a funny situation I'm in.

[Momof4gr8kids]

Justlittleme, That is so cool, that you two are going to counseling. We did that a few years ago, and it really helped our marriage to be stronger.
I had the thought along with another mom who is also the wife, and mother of people with diabetes to start a support group, but we failed. The reason why is....after diagnosis people need the support, but after a while the knowledgable people tend to drop the meetings. Hopefully you will have better sucsess. Neither of us had enough room to support a group so we got a local endo to let us use his waiting room after hours. He also sat in along with a (can't think of the word) person who was in their last year of school for counsiling whos plan was to counsil people with cronic illnesses. We had a planned topic once a month with light refeshments, and had reps from companies when we were talking about insulin pumps, and meters and such. We did this for about 5 months before our numbers took a dive, and the last month no one showed so we took down our signs that we had posted in a few offices, and shut down.
Good luck, it was really great for us while it lasted!
I have some good news to report also. DH read Emmasmoms responce, and has decided to learn to carb count! Yay! I think he had been thinking of it since learning how to take care of our daughter Julia. He already knows the basics, he has just got to get with the doctor and figure out his carb to insulin ratio, and correction factor.
I hope everyone is doing well, Jamie

[Moondancer]

I know exactly what you mean when you say you may appear calm on the surface... but inside you want to scream! I couldn't agree more with those who suggested to learn about the glucagon and what to do in general. Sounds like you have done a lot of learning already. As you already know panicking will not help him or you so you just do what you know you have to do (and then later after the crisis you can fall apart! ;) ) Learning about what to do before needing to do it has helped me immensely in dealing with these situations. I even took a general first aid and CPR class. These helped my confidence level. Just knowing how to effectively position an unconscious person is a relief. It's such a small thing but so helpful to you both. I also remind myself it's not his fault on the few occasions when he throws things at me, yells at me, tells me to go to "you know where" etc, etc. We have even been able to laugh a few times after-the-fact when I tell him the very odd things he has said to me! Sometimes he will remember saying whatever it was and at the time it made perfect sense to him. This is one of the more frustrating things for me, trying to logic/reason with him when he wants something that I just can not give him like: Bring me my car, I want it. I know you have it! As if I were keeping it in my PJ's! Frustrating to us both at the time but quite humorous the next day. These things may never happen to you, but just know that it could happen and think about how to best handle it. Once his blood sugar rises he will be his adorable self again!

Forgot to mention that learning how to test his blood in case he can not has helped me too. I did it a few times when he was perfectly fine just to learn how so that when in the heat of the moment I was confindent I was doing it right.

[Lew]

My younger brother is T1 and now my boyfriend is, as well. One of my worst memories from my childhood is being home alone with my little brother when he went into seizures from going too low. I felt really helpless and terrified that he was going to die, that I was going to be to blame for it. My parents came home in the middle of it and could here my brother screaming and me crying from the garage. When they came in and took over, I just collapsed into a ball and cried. I remember my brother coming over to comfort me, telling me it was all okay -- he was 4 years old, I was 14. I never saw my brother go low again - my mother always took that upon herself and never made me deal with it again. And now my brother is in his early 20's and rarely ever gets so low that he seizes. My boyfriend, 36, is a different story. In the five months I've been dating him, he's seized on four different ocassions. The first he was alone and wrecked his car. The other three I've been with him. The last one was by far the most violent and the worst and took place in a foreign country. I've learned by now that if he wakes up (they always hit at night) in the night, it means he's low. I am a very light sleeper, so I automatically wake up if he moves. Usually there are about 30-60 seconds between him waking and seizing. This last time there was enough time for him to chew some glucose tablets, but then the seizures hit and they were the worst I've ever seen. He had told me he'd brought gel, but I looked where he'd said he put the gel, and it wasn't there. I had brought the tablets -- but you know how effective they are when one is seizing and can't chew. But it was all we had. He was face down on the floor, banging his head into the tiled floor, cracking open his forehead. He weighs 240 pounds. Even with all my strength, arms wrapped around him, legs on either side trying to pull him up, I could only get him a few inches off the floor. I had to break the tablets into pieces and shove them in between his teeth and cheeks, hoping they'd dissolve, hoping he wouldn't choke. Then he hit me several times and told me to get away - so I'm having to fight against that as well. I know they can't help it when they go low, but a 240 pound man can strike a blow. Usually it takes minutes to get him back, this seemed like 10. He kept screaming at me to give him the gel and I couldn't because he didn't bring it. I had no tools to work with other than the tablets and I was in a foreign country, so I couldn't even call 911. I thought he was going to die and I thought it's going to be my fault. When the seizures stopped he quietly thanked me and fell asleep. Needless to say, I didn't sleep that night or any other night of our trip. The next morning he asked why his head was bloody and I explained it to him. His response to me was to say, "Oh you have to just leave me alone if I am convulsing on the floor." I was so overtaken with rage that I told him to get out of our hotel room and I couldn't speak to him for a while. B/c, of course, if I'd left him on the floor to convulse, he would have died. And he has such a nonchalance about these lows -- but then he doesn't know what it's like to have to care for someone when they get that low.

He's very touchy about the subject (i.e., if I ask him to check or if he checks and I ask what his BS is) and tends to push me away, blow me off or get sarcastic with me when I try to get involved in any way. His job involves diabetes research, so you would think that he would be a little less defensive and a little more open about it. But he's not. And he absolutely refuses to wear a pump or a glucose monitor. He doesn't check very often but instead goes by how he feels, despite the fact that he's admitted he no longer feels the lows like he used to.

I am so conflicted about this. Having a brother with diabetes, I don't ever want any woman to reject him because he has the disease. It kills me to think that could happen to him. But here I am, having second thoughts about taking this on in my life. I just don't know if I can spend the rest of my life wondering if I am going to be awakened by my spouse going into convulsions. And, you know, maybe if he were more open to letting me get involved. If he even remotely acknowledged that it effects me too.

This last time terrified me. My hand is shaking as I type this, remembering him face down on the floor, his whole body convulsing, and me not having what I needed to help him and the slow realization that he really could die.

I just need to get this out. I can't tell my mother, don't want to scare her, can't tell my friends, they don't understand, can't tell his family, he won't let me, can't tell him, don't want to make him feel bad.

[ange_mom]

I know you wrote this a long time ago, but I cried today as I read it. I have only had 3 seizures to deal with since marrying my husband 8 years ago, but every one is terrifying. Just normal lows are terrifying. Dennis does tend to run things a bit higher in the night to prevent them during sleep, but tends to run low the rest of the time! I get tired of being hit, yelled at, and thrown across the room.
Men seem to be so private and touchy about their diabetes. Den never wants anyone to know so he doesn't test when he should and ends up looking foolish when he does go low.
Our son is newly diagnosed with type 1 at 3 1/2. I think it has helped Den realize that he needs to improve what he is doing. I have much less patience with his lows now that I have to deal with my son's diabetes all the time.
I'm so sorry you are in such a dilemma. I would marry Dennis all over again, but I had no idea what I was getting into 8 years ago!

[momandwifeoftype1s]

My husband had problems with middle of the night lows when we were first married. It is very frightening when your husband is incoherent in the middle of the night due to a low. You cannot reason with someone who has severe hypoglycemia. When Brian was low, he was crumbling crackers in the cat bowl, folding my clothes in a strange way, and his eyes were glossy. He was also mumbling and not answering my questions. I had to call 911 because at the time, I knew nothing about diabetes and my husband didn't have a glucagon pen. I have since educated myself, and learned what to do in emergencies. Plan ahead, because dealing a big, drunk-acting man is physically and emotionally scary. Brian also changed insulin to avoid the middle of the night lows. That seemed to help a lot. He also changed doctors due to a move, so he now sees the head of the endo practice at Vanderbilt. I'm very pleased about that.

By the way, I used expired glucagon pens to practice with. Since glucagon is rarely used (hopefully), it helps to actually go through the motions of injecting glucagon even if it's just into the sink. It was surprising to me that the powder and liquid take awhile to mix together and that it's hard to get all the glucagon into the pen.

I've been married to Brian for over 10 years. I would do it all over again, even with the diabetic emergencies.