Type 2 b/s 19 loss of consciousness

[MikeyMarine]

Hi I just read a book by a type 1 diabetic and she said something about a loss of consciousness with a blood sugar of 19 on her glucometer, lowest I've ever been is 31 . My question is, if I become unconscious with hypo, ( I live alone) will my glucose slowly come back up and regain consciousness , it increases every night while I sleep . what would be the symptoms of having lost consciousness due to hypo? and do I need to do anything like an alarm system etc for unexpected lows

haven't ever been over 300 since diagnosed

 

[Jaylee]

Hi I just read a book by a type 1 diabetic and she said something about a loss of consciousness with a blood sugar of 19 on her glucometer, lowest I've ever been is 31 . My question is, if I become unconscious with hypo, ( I live alone) will my glucose slowly come back up and regain consciousness , it increases every night while I sleep . what would be the symptoms of having lost consciousness due to hypo? and do I need to do anything like an alarm system etc for unexpected lows

haven't ever been over 300 since diagnosed

Hi,

welcome to the forum. You seem to me from your profile an insulin dependant Type 2..?
What meds are you prescribed?
On insulin? Doubtful consciousness if lost would be regained without 3rd party assistance.

Are you using a sensor to monitor your BGs? You could be experiencing a “compression low” at night, if so..

 

[EllieM]

Hi I just read a book by a type 1 diabetic and she said something about a loss of consciousness with a blood sugar of 19 on her glucometer, lowest I've ever been is 31 . My question is, if I become unconscious with hypo, ( I live alone) will my glucose slowly come back up and regain consciousness , it increases every night while I sleep . what would be the symptoms of having lost consciousness due to hypo? and do I need to do anything like an alarm system etc for unexpected lows

haven't ever been over 300 since diagnosed

Hi @MikeyMarine and welcome to the forums.

I see from your profile that you are on insulin glargine (aka lantus).

I assume that you are measuring your blood sugar in mg/dL (the UK forumites use mmol/L - just multiply or divide by 18 to convert between the units if you are confused by the readings that other people mention - so 19mg/dL is just over 1 mmol/L and I think I would be unconscious at that level.).

The liver produces glycogen when your blood sugar is low and hopefully will pull you out of a night time hypo, but because some of your insulin is injected rather than internally produced, it is possible for there to be too much in your system for your liver to cope with.
Glycogen and Diabetes - Role, Storage, Release & Exercise

As an insulin dependant T1, I have woken at night with a hypo (I keep glucose by my bed) but once in the past my partner found me unconscious and fitting (during pregnancy when I kept my bgs unusually low) and had to call for medical help.

I now wear a continuous glcuose monitor with alarms (mine is a decom) which wakes me at night if I go too low.

I suspect/hope but don't know that the risks are much less for a T2 who is still producing some of their own insulin (which will be turned off in the event of low blood sugar) but there is still the risk of an insulin overdose eg accidental double injection of glargine?

 

[Seacrow]

The reason many of us are scared of going hypo and unconscious is that the effects are potentially so severe. If the brain is not getting enough glucose it shuts down the body, this is becoming unconscious. If the liver does not kick in and dump a load of glycogen (which can happen due to disease or recent hypos), then the brain begins to cut off parts that are not essential for life. This leaves you with brain damage, the severity of which depends on how deep and how long the hypo was. The next stage is brain death from lack of food, which is dying without regaining consciousness.

These are really rare events, fortunately, but are the reason why every hypo needs to be treated immediately. In the UK anyone using insulin can ask for a continuous blood glucose monitor, this alarms when you go too low. Mine has woken me at night several times so I can eat sugar, where being hypo unaware I might not have woken up.

If I hypo at night, I tend to wake up damp, covered in sweat and thirsty. This will be different for different people though.

 

[MikeyMarine]

thank you all for your replies, tghe bfook I am reading is called TOOt SWEET by Laura Kronen , obviously she recovered from it and the book sounds like she has frequent episodes of losing consciousness (also sounds like she doesn't manage well) but I don't walk in her shoes so,,,, my last 2 a1c tests have been 6.2 then 5.9 so I think I am doing something right, but still I don't want to pass out and then come back as a dain bramaged kindney donor needer

 

[jonathan183]

If your on insulin and live alone you should have a CGM with at least a low alarm, what the exact alarm level should be set at is a discussion to have with your medical support team. 19mg/dl is far too low a level to have an alarm set at.

 

[Fenn]

Hi, welcome, I agree with above, get a CGM and have a low alarm to wake you, I have slept through lots of hypos and always my blood numbers come back up on their own, this is not a theory I would want you to test, best of luck.

 

[HSSS]

In the UK anyone using insulin can ask for a continuous blood glucose monitor,

Are you sure? I thought it was restricted to type 1 and even then some local ccg’s make unofficial hurdles to jump through still. And isn’t it usually flash not continuous ie a libre not dexcom etc as standard

 

[iwilltouchyourcat]

Are you sure? I thought it was restricted to type 1 and even then some local ccg’s make unofficial hurdles to jump through still. And isn’t it usually flash not continuous ie a libre not dexcom etc as standard

My DSN said that they could justify getting me a CGM even if I am not Lada and type 2 if it turned out I needed insulin…but then she also said I should eat more baked potatoes sooooo…..

 

[MikeyMarine]

baked potatos, yup even the person who graduates in last place at doctor schoool is still called doctor, we gotta watchem

 

[NicoleC1971]

The OP is in the US I think so a CGM may be available via his/her insurance provider.
IF I were a type 2 on insulin, I'd be wanting to get off the stuff by changing my diet.
This can't be done without sensible medical help so that meds can be reduced in tandem with the need for insulin.
Being on insulin means dosing mistakes are made particularly if you are taking a basal and bolus regime but surely a type 2 taking a basal dose only is unlikely to go hypo unless he or she goes very low carb overnight?
Sounds as if the fear comes from a type 1 story of someone who hasn't got much hypo warnings which is symptomatic of overly frequent hypos but must be a bit different to someone on just a 24 hour basal rate who could further reduce their risk by not needing insulin in the first place i.e. a lower carb diet.

 

[MikeyMarine]

agreed, I started at 40 units of basal, now am at 30, lost 20 lbs, changed diet, still have some lows between 3.3 and 2.0 but they are infrequent have lost some of the warning signs, no longer sweat profusely or get warm or agitated mostly just feel a little un coordinated and can tell my mental state is off, ( my friends wanna know what's the difference)

 

[Seacrow]

IF I were a type 2 on insulin, I'd be wanting to get off the stuff by changing my diet.
This can't be done without sensible medical help so that meds can be reduced in tandem with the need for insulin.

And sometimes it's simply not possible to come off insulin at all.

Being on insulin means dosing mistakes are made particularly if you are taking a basal and bolus regime but surely a type 2 taking a basal dose only is unlikely to go hypo unless he or she goes very low carb overnight?

Making a mistake with a basal can be more dangerous than with a bolus. To a certain extent, if you overdose a bolus you eat an extra amount of carbs, and hope that fixed it. If you overdose on basal you then have up to 24+ hrs where you have to check your blood glucose frequently, and snack almost continuously at a rate that matches the amount of overdose. It's a PITA and exhausting.

Sounds as if the fear comes from a type 1 story of someone who hasn't got much hypo warnings which is symptomatic of overly frequent hypos but must be a bit different to someone on just a 24 hour basal rate who could further reduce their risk by not needing insulin in the first place i.e. a lower carb diet.

Again, not every type two can reduce their insulin requirements, you are extremely lucky to be able to come off insulin. Some people can't low carb, or have other co-morbidities which reduce hypo warnings.

 

[EllieM]

Though I agree that it would be worth @MikeyMarine asking for a cgm , I should point out that diabetics managed for decades before cgms were invented and very very few of us succumbed to night time hypos.

@MikeyMarine has your bg really been as low as 2 (36mg/dl) ? I can still treat hypos in the high 2s but at 40mg/dL I'm not sure I'd have the mental clarity to do so. I have been rescued by friends, work colleagues and family when too confused to make rational decisions about glucose consumption. So I'd definitely recommend that you let your friends know about hypos.

My hypo awareness is much less than it was 5 decades ago but I still find that my ability to so maths or spatial awareness is the first thing to go (though I'm not great at spatial awareness in the first place. ).

 

[Seacrow]

Though I agree that it would be worth @MikeyMarine asking for a cgm , I should point out that diabetics managed for decades before cgms were invented and very very few of us succumbed to night hypos.

My step grandfather was inducted into his diabetes procedures with a group of lads in the 1950s. (Yes, they separated males and females, possibly because the age group was from eight to eighteen). They used to meet up again once a year. By the tenth year 5 out of 11 of them had died from insulin overdose, mostly the 'dead in bed' syndrome (just didn't wake up).

I don't know if this is geographically or demographically biased, but talking to older diabetics, historically this was the primary cause of death. As soon as blood tests became easier and available, this death rate dropped dramatically.

As little as twenty years ago (at my diagnosis) dsns were saying if your blood measurements haven't been what you expected during the day, set one or two alarms to wake up and test in the night. They obviously thought dead in bed was still something to worry about.

 

[EllieM]

They used to meet up again once a year. By the tenth year 5 out of 11 of them had died from insulin overdose, mostly the 'dead in bed' syndrome (just didn't wake up).

Thanks for sharing, that is truly scary. Interesting that my mother, also diagnosed in the 50s in her early twenties, never warned me about this as a child or as an adult. Maybe she didn't know? (She died at 78, mainly caused by smoking for 50 years, though the T1 didn't help.)

I know last time I googled it the results were inconclusive. I guess if someone dies during the night you can't really prove it was from a hypo....
https://www.diabetes.co.uk/diabetes-complications/dead-in-bed-syndrome.html
This article is stating 6% of T1 deaths under 40, which is consistent with my google searches.

Doesn't really fit with your stepgrandfather's experience. (I know 10 is a small sample, but even so....) I wonder if there was something else going on or whether insulin overdoses were just that much more frequent then.

Further googling suggests a heart issue maybe triggered by a hypo?
Cardiac arrhythmia precipitated by hypoglycemia being
considered the immediate cause of death in DIB syndrome
https://www.researchgate.net/publication/316735549_Dead_in_bed_syndrome_Mystery_and_fear

I can't find anything on dead in bed in older or non T1 diabetics....

 

[Seacrow]

@EllieM This particular group was teenage boys, who got to see a doctor once a year and one group meeting. Add to that the testing to see what your glucose levels were was to go pee on a tablet, and you got an inaccurate result that told you what your results were a few hours ago. They were working class (terribly un pc) and the surrounding culture said in the evening you went out to the pub, occasionally got roaring drunk and poured yourself into bed.

I think all these factors removed the boys who were going to push their luck and left a more staid and sensible older population. We really don't know how good we've got it today.

 

[MikeyMarine]

Though I agree that it would be worth @MikeyMarine asking for a cgm , I should point out that diabetics managed for decades before cgms were invented and very very few of us succumbed to night time hypos.

@MikeyMarine has your bg really been as low as 2 (36mg/dl) ? I can still treat hypos in the high 2s but at 40mg/dL I'm not sure I'd have the mental clarity to do so. I have been rescued by friends, work colleagues and family when too confused to make rational decisions about glucose consumption. So I'd definitely recommend that you let your friends know about hypos.

My hypo awareness is much less than it was 5 decades ago but I still find that my ability to so maths or spatial awareness is the first thing to go (though I'm not great at spatial awareness in the first place. ).

well best I can tell yes, the conversion chart says 36 on a glucometer is 2 and 27 is 1.5 mine was 30 so somewhere between 2 and 1.5 I am going to extremes carb limiting picking potatos out of soup fr example cooking my own vegetables fresh or frozen no seasoning I want to get down to 165 to 145 lbs body weight , get off insulin and maybe some more of these pills I'm at 180 now ( pre morning poo )

 

[NicoleC1971]

And sometimes it's simply not possible to come off insulin at all.



Making a mistake with a basal can be more dangerous than with a bolus. To a certain extent, if you overdose a bolus you eat an extra amount of carbs, and hope that fixed it. If you overdose on basal you then have up to 24+ hrs where you have to check your blood glucose frequently, and snack almost continuously at a rate that matches the amount of overdose. It's a PITA and exhausting.


Again, not every type two can reduce their insulin requirements, you are extremely lucky to be able to come off insulin. Some people can't low carb, or have other co-morbidities which reduce hypo warnings.

I do get that not all type 2s can come off insulin but surely it might be possible to reduce the insulin by reducing carbs? Again lower and better carbs not full out keto obviously as we all have to make changes at our own pace.
My dad is being threatened with going onto insulin and believes his insulin production is now 'borderline' and we hope that his c peptide levels will rise once his insulin resistance lessens afrer 13 years of type 2.
As a t1 when on injections I could only overdose myself a maximum of twice a day with 2 doses of levemir but then I was putting up to 24 units in so it was hard to accidentally double that and if taking a smaller amount I guess it would be easier!
Just for my information can you tell me which co morbidities are associated with loss of hypo awareness ?

 

[MikeyMarine]

I do get that not all type 2s can come off insulin but surely it might be possible to reduce the insulin by reducing carbs? Again lower and better carbs not full out keto obviously as we all have to make changes at our own pace.
My dad is being threatened with going onto insulin and believes his insulin production is now 'borderline' and we hope that his c peptide levels will rise once his insulin resistance lessens afrer 13 years of type 2.
As a t1 when on injections I could only overdose myself a maximum of twice a day with 2 doses of levemir but then I was putting up to 24 units in so it was hard to accidentally double that and if taking a smaller amount I guess it would be easier!
Just for my information can you tell me which co morbidities are associated with loss of hypo awareness ?

hypertension controlled hypothroid controlled high cholesterol controlled male pattern baldness running rampant overweight 180 should be 146 to 160 feet stink nose runs strange noises from both ends that scare the dawg, my last g/p visit he said I was in good shape for a 76 year old man great i'm 64.. I think my diabetes got started when I got run over by 2 fork lifts and spent a year in bed , weight went to 240 took me a year go get it back to 170 and I was pre diabetic the whole time I went back to 208 when thyroid died, Now with gym 5 to 7 days a week and eating nothing tasty or digestible I'm back down some /. I did some research on loss of hypo awareness , turns out the same thing that causes numbness in feet and tingling in hands etc can affect the autonomic and central nervous systems causing loss of temp control, heart rythm disruptions etc,
I like most, have been down some roads, some not paved, some wet and muddy, so there's some antiinflammatories otc that may fight with my liver occasionally added into the mix, non drinker non smoker non women chaser, (can't find any slow enough to keep in sight) Mark Twain would say I'm on a sinkin ship with nothing to throw overboard. but I do swear occasionally.