Every other day morning fits

[The friend]

Hi everyone,

I'm new to this condition so please excuse my ignorance, recently my friend moved in with me and she has diabetes (Type 1 I understand as she has to inject herself with insulin before meals). She has been injecting herself for around three years as she suffers from high blood sugar levels, recently she has been suffering from morning fits where she wakes up screaming in pain and can't move her body. The only thing I can do is calm her down with breathing techniques so she is in control of the pain and ask her what her body needs as surprisingly in most cases it's not insulin that helps her, it's sugar.

We recently went to the hospital that normally treats her in Malaysia (this is where we live) as they checked everything and they said she is fine and everything is normal, but I know in my heart it is not and of course by the time we get her to hospital her bloods are balanced because we need to take immediate action to get her out of what I call the "danger zone" when it happens. Thing is this is happening every other day and she unusually sleeps a lot, has anyone had any experience with this before? Also is it possible for someone to go from high blood sugar diabetes to low blood sugar diabetes and if so what normally causes this and how do you treat it? I'm no doctor, in fact I have little experience prior to this with diabetes at all so I'm afraid I'm doing everything wrong and that I'm potentially creating more problems, but what I do know is that she is not fine as the doctor is suggesting. Anyone out there gone through this before?

 

[jack412]

If there is no local support, it would be best for your girl friend to have a look at the free on line course and workbooks, i assume she is on basal bolus, but Google will give you other work books if different

The first thing she needs to do is a basal test and join the forum
http://www.diabetes.co.uk/forum/threads/newly-diagnosed.60873/#post-583801

 

[Charles Robin]

Hi and welcome to the forum.

If your friend is having fits most mornings, the problem is her insulin dose. As you are in the dark over the condition, I will give a brief overview here:

Insulin is the hormone that the body releases in order to regulate blood sugars. It allows our bodies to take sugar out of the bloodstream, and use it to power our cells. It also allows us to store some of the energy, and is essential for fat storage and building muscles. In a non diabetic this system is automatic; You eat, and your body automatically releases the correct amount of insulin to deal with the fuel from the food. However, a type 1 diabetic can no longer produce their own insulin (for some reason not very well understood, their body's immune system decides to destroy the cells that produce insulin). Therefore, they have to inject the insulin instead.

This is where the issues come in. There is no 'one dose size fits all.' Whereas a non diabetic automatically gets the correct dose, those who inject insulin have to take an educated guess. To function properly, our bodies need to have a certain amount of sugar in our blood stream at all times. If the insulin dose is too little, our blood sugars rise too high. Over time (usually years or decades), high blood sugars cause damage to many different parts of the body. This can lead to blindness, kidney failure, limb amputation and more. However, having too much insulin is equally dangerous. If there is too much insulin in our bodies, too much sugar will be taken out of our blood stream. This means that the body does not have enough fuel to function correctly. Having low blood sugars is often referred to as having a 'hypo'. (This is short for hypoglycaemia, but that's a bit too much of a mouthful for every day use!). Some of the most extreme symptoms are those you have witnessed your friend suffering from; fits. Other symptoms can be similar to being drunk; slurred speech, anger, confusion. The symptoms can vary hugely between individuals, and even from one hypo to the next.

Important; You should never, ever treat a hypo with insulin. This will just make it worse. The body needs more sugar, so someone having a hypo needs to eat or drink something sugary as soon as possible. This will bring their blood sugars back up, and alleviate the symptoms very quickly. An untreated hypo can lead to brain damage, but this is thankfully rare, especially if treated quickly. I have had type 1 diabetes for 24 years. I have had more hypos than I can count, including fits like your friend is having, and I have suffered no lasting damage.

So, on to the important bit; How to stop the fits. Your friend needs to reduce their insulin dose, probably the one that they have in the evening before bed (Note that I said reduce, not cancel the dose. The body has to have insulin to function). Does she have a machine to test her blood sugars with? In the UK, it's taken as gospel that a type 1 diabetic needs to test their blood sugars to work out their insulin requirements, but this may be different where you live. If she does not have one, I would strongly advise trying to acquire one, even if you have to purchase it. There are many good brands, the one I use is called OneTouch, although Accuchek is also good.

Your friend should also talk to their health care team about learning to match their insulin requirement to their food intake; a process often referred to as carbohydrate counting. Again in the UK there is nutrition information on pretty much everything, so it's easy to work out how much carbohydrate/sugar is in something. If the same info is not available where you are, I would recommend getting hold of a book called Carbs and Cals. I think there is a kindle edition available if you can't get a physical copy. It has nutrition information on a huge range of foods, and photos to go with it so you can see what portion size they are referring to.

It will probably take a lot of trial and error to get the dose right, but with a blood testing meter your friend can see if they are going too high/ low and adjust their insulin to match. (In the UK, we measure our blood sugars on a scale of Mmols. A 'normal' blood sugar reading is anything between 4.0 mmols and 7.8 mols. Anything lower is classed as a hypo, and needs to be treated with glucose (a can of coke or a sugary snack works well, glucose tablets are also great if you can get them). Anything above 7.8 is higher than normal, although lots of diabetics don't worry until their levels get into the teens. An occasional high blood sugar is unlikely to cause long lasting damage, but if your friend is getting a lot of highs, they may need to look at adjusting their diabetes control, to avoid health problems later on.

*phew* sorry for the long post, I know that's a lot to take in. If you want anything clarified, or just have a general question, feel free to send me a message, or post again in the forum. Best of luck.

 

[Daibell]

I agree with Charles' post. It sounds like a hypo thru low blood sugar. It may be a small reduction in her 24 hr insulin will help. Yes, carb-counting with the meal-time rapid insulin is the best way of using rapid insulin. If your friend eats a lot of carbs it would be useful to reduce those and reduce the insulin to match. The blood sugar swings reduce as your insulin intake reduces and hence the risk of hypos is reduced. Using a meter regularly is essential if you are prone to hypos; even if not.

 

[The friend]

Thank you so much for taking the time to reply, there's so much stuff on the internet and it's hard to process it in a way I can understand or put into practice, so I really appreciate your post. I will get her the blood sugar reader so we can work out what to do with her doses and look at her carb intake as she does enjoy carbs. Thank you so so much, once again!

Hi and welcome to the forum.

If your friend is having fits most mornings, the problem is her insulin dose. As you are in the dark over the condition, I will give a brief overview here:

Insulin is the hormone that the body releases in order to regulate blood sugars. It allows our bodies to take sugar out of the bloodstream, and use it to power our cells. It also allows us to store some of the energy, and is essential for fat storage and building muscles. In a non diabetic this system is automatic; You eat, and your body automatically releases the correct amount of insulin to deal with the fuel from the food. However, a type 1 diabetic can no longer produce their own insulin (for some reason not very well understood, their body's immune system decides to destroy the cells that produce insulin). Therefore, they have to inject the insulin instead.

This is where the issues come in. There is no 'one dose size fits all.' Whereas a non diabetic automatically gets the correct dose, those who inject insulin have to take an educated guess. To function properly, our bodies need to have a certain amount of sugar in our blood stream at all times. If the insulin dose is too little, our blood sugars rise too high. Over time (usually years or decades), high blood sugars cause damage to many different parts of the body. This can lead to blindness, kidney failure, limb amputation and more. However, having too much insulin is equally dangerous. If there is too much insulin in our bodies, too much sugar will be taken out of our blood stream. This means that the body does not have enough fuel to function correctly. Having low blood sugars is often referred to as having a 'hypo'. (This is short for hypoglycaemia, but that's a bit too much of a mouthful for every day use!). Some of the most extreme symptoms are those you have witnessed your friend suffering from; fits. Other symptoms can be similar to being drunk; slurred speech, anger, confusion. The symptoms can vary hugely between individuals, and even from one hypo to the next.

Important; You should never, ever treat a hypo with insulin. This will just make it worse. The body needs more sugar, so someone having a hypo needs to eat or drink something sugary as soon as possible. This will bring their blood sugars back up, and alleviate the symptoms very quickly. An untreated hypo can lead to brain damage, but this is thankfully rare, especially if treated quickly. I have had type 1 diabetes for 24 years. I have had more hypos than I can count, including fits like your friend is having, and I have suffered no lasting damage.

So, on to the important bit; How to stop the fits. Your friend needs to reduce their insulin dose, probably the one that they have in the evening before bed (Note that I said reduce, not cancel the dose. The body has to have insulin to function). Does she have a machine to test her blood sugars with? In the UK, it's taken as gospel that a type 1 diabetic needs to test their blood sugars to work out their insulin requirements, but this may be different where you live. If she does not have one, I would strongly advise trying to acquire one, even if you have to purchase it. There are many good brands, the one I use is called OneTouch, although Accuchek is also good.

Your friend should also talk to their health care team about learning to match their insulin requirement to their food intake; a process often referred to as carbohydrate counting. Again in the UK there is nutrition information on pretty much everything, so it's easy to work out how much carbohydrate/sugar is in something. If the same info is not available where you are, I would recommend getting hold of a book called Carbs and Cals. I think there is a kindle edition available if you can't get a physical copy. It has nutrition information on a huge range of foods, and photos to go with it so you can see what portion size they are referring to.

It will probably take a lot of trial and error to get the dose right, but with a blood testing meter your friend can see if they are going too high/ low and adjust their insulin to match. (In the UK, we measure our blood sugars on a scale of Mmols. A 'normal' blood sugar reading is anything between 4.0 mmols and 7.8 mols. Anything lower is classed as a hypo, and needs to be treated with glucose (a can of coke or a sugary snack works well, glucose tablets are also great if you can get them). Anything above 7.8 is higher than normal, although lots of diabetics don't worry until their levels get into the teens. An occasional high blood sugar is unlikely to cause long lasting damage, but if your friend is getting a lot of highs, they may need to look at adjusting their diabetes control, to avoid health problems later on.

*phew* sorry for the long post, I know that's a lot to take in. If you want anything clarified, or just have a general question, feel free to send me a message, or post again in the forum. Best of luck.

 

[Jaylee]

Hi, I agree with the above advice..

Type 1 diabetes is like a balancing act between the dose of insulin taken to maintain healthy blood sugar levels & the carbohydrate it acts apon..
Your friend doesn't appear to get this right..
I can also tell you from experience there is no pain involved.. But there is a bad feeling of confusion like taking illegal drugs or alchahol if not treated with sugar immediately, this "fit" or hypoglycaemia will result in coma/unconsciousness...!
A sugary drink like coke or sweets, maybe cake will solve this.. Sounds silly, but in short that is the only thing you need if the sugar is low..!

I'm trying to shorten this for you in "bite sized chunks".. Your friend should be asking this advice.
But you are a saint for trying to help.

Does your friend take a night time injection before bed?
If you could find out what sort of insulin your friend uses, that would help? There should be two types? A long acting insulin & a short acting insulin for meals...

 

[Charles Robin]

Thank you so much for taking the time to reply, there's so much stuff on the internet and it's hard to process it in a way I can understand or put into practice, so I really appreciate your post. I will get her the blood sugar reader so we can work out what to do with her doses and look at her carb intake as she does enjoy carbs. Thank you so so much, once again!

No problem at all, very happy to help. Diabetes can be managed brilliantly with the right information, but getting that information can be a lot more difficult than it should be. Is your friend willing to register on the forum? Whatever problems they face, it's almost certain that someone here has faced the same, and come out the other side stronger for it. That goes for mistakes made as well. There are over 100,000 members of this forum, and I have yet to meet one that gets everything perfect all the time (that definitely includes me). Your friend should know that she can post without getting judged, and can drastically improve her quality of life (and of those around her) with the tips on offer here.