My partner had a hypo

darren1

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Hello

I have been with my partner for 8 years, he is a type 1 diabetic age 30, had it since 13.

Last week I woke up at 5am in the morning to him having a hypoglycemic seizure - I am sure you can imagine the rest.

In 8 years, this is the first time this has happened and it terrified the life out of me. He has not had a hypo for 10 years prior to that.

We were both obviously shaken up and its been a tough week going to bed and worrying about what happened. He has been given the all clear and it has been put down to being out of routine 'cos he was off work.

I am finding that I am asking a lot of about his sugar levels and feeling nervous whenever he eats or drinks anything! To begin with he was reassuring but now he is getting quite cross with me for asking. Is this normal? How do I get on past this??

Another thing I am wondering is that the paramedic give him an injection of Glucagon because he was not accepting any gel or fluids orally. Should we have a Glucagon injection pen at home for emergencies?

I am also a bit unhappy with the after treatment - He was discharged from hospital after a few hours and I am concerned there has been no 'diabetic' type followup, except a blood test at his GP. Why didnt he see a diabetic specialist at the hospital? I kinda feel like the attitude at the hospitals and paramedics was that 'this just happens'.
 

hanadr

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My husband has been T1 for over 30 years and had no trouble recently, but a few years ago ended up in A&E several times.He was almost always discharged quickly [ several times after being given a slice of toast and marmalade, by the A&E sister.] and only ever kept in ONCE. there was never any follow up.
If you feel the need for a follow up check, I suggest you contact his GP.
You say you are his partner. Do you have any legal rights to do this for him [such as civil partnership or marriage?] If not, you will have to persuade him to go to the doctor of his own volition.
Hana
 

darren1

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Hi Hana

No we are not married or in a civil partnership - I never thought about the legal side of things!
To be honest, he would not be very impressed if I contacted his GP.

Am i correct that not all diabetics will have a seizure during a hypo? He has had a brain scan and that was fine.

Anybody know if we should have a glucagon pen?
 

michaeldavid

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Provided you get some medical guidance about it, I don't see why you shouldn't be able to keep a glucagon pen and give such an injection yourself. However, I believe the effectiveness of glucagon depends on the store of something-or-other within the liver: the patient will need to have eaten relatively well quite recently, I believe.

Much simpler and quicker is the following course of action. If I began to have a hypo during the night, my mother would hear this. She would quickly grab some granulated sugar and a cup of water. And she'd dip her fingers into the water, and then into the sugar. She would then brush that sugar across my lips. (Nb. She had to watch out not to get her fingers bitten!) My unconscious response was to lick my lips. She'd keep doing that, and I'd soon start to come round without the need to telephone 999. (Nb. I'd need to eat or drink something further.)

Obviously, you'd have to make the judgement yourself regarding whether or not to 'phone 999 immediately. But you never know how long you may have to wait for the ambulance to arrive. Moreover, even using the telephone would take up vital moments. And if you catch the hypo early enough, then you would be able to bring your partner around in the quickest way possible. That's what my mother did on more than one occasion.

Your partner should look at, and think carefully about, his diabetic control. No hypo is inevitable. (I'll repeat that: no hypo is inevitable - or at least, not for me it isn't. But note that some people, even medical experts, erroneously count any mere blood-sugar reading below 4mmol/l as being a hypo.) And one should always learn something from ANY hypo.

Nowadays, my own control is excellent. And I have recently made quite few postings on this website with regard to my own diabetic control.
 

Juicyj

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Hi there,

If your partner manages good control then hypos can normally happen a couple of times a week, so this is keeping within a range of 5 to 7/8 and managing perfect carb/insulin ratios. I've had poor blood glucose control for a while simply to avoid having hypos, but i've recently been on a Dose Adjustment for Normal Eating course and if I want to have a healthy life I need to have tight controls over my BG readings, which means 1/2 hypos a week. I test regularly so can normally get them sorted before they spiral out of control - DAFNE is advisable if your partner needs to manage this better. Seizures are not normal in a hypo but should be checked out by the doctor. A glucagon injection should only be used if you're not able to treat your partner with oral form of glucose and you will need to visit your GP to find out how to administer this.

It's great you want to help so much, but speaking as a type 1, support is the best way to help. So please encourage your partner to speak to a diabetic nurse if you have concerns that they are not managing this well.

Good luck :thumbup:
 

Stefano

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Hi I'm 33 years diabetic. Last time I fainted due to hypos was more than 10 years ago. Unfortunately I know it can happen again especially in the night. Last time I fainted I had seizure as well which I actually was told is not uncommon and is a sign of your brain suffering due to low blood sugar.
You or your partner can ask the Gp for glucagon.


Sent from the Diabetes Forum App
 

Embabe25

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I have a glucagon kit given to me because I was pregnant. I don't see why you can't have one though.

I fit whenever I faint. I've never lost consciousness due to a hypo but have done when getting blood taken.

Glucagon should only be used when the patient is unconscious so the doc might argue that if your man is unconscious then an ambulance should be called anyway


Em x
 

lexilox

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Most hypos are treatable fairly quickly and easily with sweet food or drink. Some however, especially during sleep can be awful. I have always been told that all type 1s should have a glycogen injection in case of a severe hypo. They are a lifesaver. I've had one, or even two kits in my house for as long as I can remember. They go out of date after about two years and when they do the old one is used on an orange for my hubby to practice with before throwing in the sharps bin. I've only needed it once in over twenty years though. Please don't try to feed anyone who is not conscious. Glucose gel is available free on prescription prescription to t1s and is great for getting BGs back up when you're a bit too low to safely chew or to drink without dribbling everywhere. Choking is a big danger and should be remembered when trying to help someone who is hypo. If you can get your partner to see the GP or specialist nurse that's a really good idea.
 

Liang171717

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Hypoglycemic is big problem for diabetes and use insulin, as sometime, we cannot inject right amount insulin and eat right amount food, so if we inject more insulin, then we will face that problems, so we need to change insulin and we need use amino acid to produce insulin, as amino acid can change blood sugar into nutrition part for people organ and need time to digestion that, so people cannot Hypoglycemic
 

Hellbunny

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Definitley get a glucogon kit, your partner needs to ask his DSN to tell your GP to write a prescription for one (sorry abit of gobbledegook there!) We have one in the fridge for me and so far my partner hasn't needed to use it but its useful to have in just incase.
 

darren1

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Thanks so much for your advice everyone! I am amazed at the level of support on here.

I spoke to him about the glucagon pen last night which he had never heard about so its something to think about.

I never thought to rub sugar onto his lips - something to keep in my mind if it happened again.
 

michaeldavid

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It seems that most people who are diabetic, or who know someone who's diabetic, would NEVER THINK of rubbing wetted sugar onto the lips of someone who's in the early stages of a hypoglycaemic coma - and then doing it again, until they start to come round. (Note that, even if you're unconscious, you can't really choke on a bit of wetted sugar that's been smeared onto your lips.)

Perhaps it's just too simple a recourse. And most people, albeit perhaps unconsciously, seem to have a profound objection to any kind of simplicity. (Indeed I believe that's a profound problem of modernity. And it's A VERY SIMPLE problem! But it's not very readily remedied.)

There's a parallel problem with highly economical, visually read blood-sugar testing strips, as opposed to the exorbitantly expensive meter-read sticks. (Without them, the blood-sugar control that I manage to achieve would be economically unviable.) You could get some Betachek Visual for your partner - they're dead cheap. (Perhaps I shouldn't use the word 'cheap' - people don't like that either.)

There's the same problem with using a bare lancet to gently jab yourself to get a blood-sample, rather than using the nasty spring-loaded gadgets. And there's the same problem yet again with regard to the re-use of lancets (umpteen times) until they begin to lose their exquisite sharpness, rather than just dumping them after a single use.

I will pass on your thanks for the sugar tip to my 92-year-old mother. And for my own part, I'll pass my own thanks on to her. (In fact, I'll show her this whole thread.) She was in her early adulthood during World War Two. She abhors the very idea of waste. And she passed that on to me.

Accordingly, I hope I'm not wasting my time here writing this. I'm not writing it for you alone, Darren!
 

phoenix

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Hi,
I too think that having a glucagen kit available is a good idea. We have one in the fridge, OH has never needed to use it but it's there, just in case.
Fortunately most hypos aren't so 'severe' but it is worth knowing what to do.
Heres a pdf written for parents with standard advice.
http://www.uhsm.nhs.uk/patients/Patient ... caemia.pdf
 

michaeldavid

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I've read the article referred to. And I note that the 'standard advice' is that "If the [patient] is unconscious, no food or fluids should be given by mouth".

But where is the suggestion for the elementary remedy that potentially saved my life, several times?

When I was in an unconscious state, and my mother smeared wetted sugar onto my lips, she brought me round far faster than a medically trained professional could have done. (We were living in the middle of the countryside, and an ambulance might have taken quite some time to arrive.)

She didn't give me anything by mouth. She merely smeared wetted sugar onto my lips. And in my unconscious state, I licked my lips.

She did the same thing again until I began to come round. (Then, and only then, did she give me food/fluid by mouth.)

WHY IS THAT NOT STANDARD ADVICE?
 

phoenix

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The reason given is because of the risk of choking . http://www.nhs.uk/Conditions/Hypoglycae ... tment.aspx

I really don't know whether it is certain that everyone would lick their lips whilst unconscious though it obviously seems to have worked for you.
It used to be thought that sugar/glucose would be absorbed through the oral mucosa so it used to be taught as a method . However, when they experimented to see how much was actually absorbed (back in 1978) they found it was ineffective . Almost no glucose was found to be absorbed via that route. The conclusion:
" Instant glucose appears to be of therapeutic value only if swallowed by fully conscious, hypoglycemic patients. It should not benefit unconscious patients because of its poor absorption through the buccal mucosa"
http://www.ncbi.nlm.nih.gov/pubmed/691147
If someone is fitting as in this case trying to put sugar in their mouths could be problematic .
 

michaeldavid

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Okay, Phoenix, I acknowledge that my last question was posed AS IF I were addressing the authors of the kind of document you first gave a link to. (Of course, those authors are not reading this.) And now you're just referring me to more of the same.

But the point of my last question remains the same. For this is the initial part of the relevant passage of my first posting in this thread: "If I began to have a hypo during the night, my mother would hear this. She would quickly grab some granulated sugar and a cup of water. And she'd dip her fingers into the water, and then into the sugar. She would then brush that sugar across my lips." (And I've just been speaking to my now 92-year-old mother about the occasions on which she did this, incidentally. She emphasises that she'd have to be careful not to get her fingers bitten.)

Please note the first few words: "If I began to have a hypo during the night, ....". But the first document referred to in your last posting uses these words: "If a person is already unconscious due to a SEVERE hypo, they need to be put into the recovery position. ... Never try to put food into the mouth [etc.]". (The emphasis is my own.)

I was expressly only talking about the ONSET of a hypo whilst asleep. (I was certainly unconscious on these occasions, however.) But the article you referred to MAKES NO ALLOWANCE for any such onset. The standard advice seems to be all just black and white.

Accordingly, either the authors are stupid, or they effectively believe that anyone who reads it must be taken to be stupid, and should not be encouraged to use their common sense.

So the point of the question I asked at the end of my last posting was really to highlight that severe shortcoming of the standard advice.

As for the people who use this website, are they to be discouraged from using their common sense?
 

rochari

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Hey Darren

Not much I can offer here because you’ve had some great advice from the regulars. I would like to say though that these episodes can be difficult and very distressing on partners, friends etc especially seeing them for the first time.

I’ve had them and they still scare the daylights out of me. The first time my partner saw me in one had a huge effect on him, much in line with what you’ve written about how you felt. Since then we have kept the small glucagon kit with us, at home and when we travel. Thankfully, it has never been used (we renew it every few years) but he says just having it there relaxes him more than anything else. When we first got the kit our GP was great and talked him through how to administer it which he says gave him a lot of confidence should it happen again.

Bill
 

Thundercat

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A few years ago after falling asleep in front of tv I woke with a hypo. Went and sat at kitchen table to treat it. My partner came to find me slumped over the table unconscious. He put me lying on the ground and administered Glucagon injection. Just over 10 minutes later I was conscious. I've never had a seizure but if my bs plummeted low enough to trigger one I would prefer the injection, maybe its because I know it works and how long it takes. I'd be a bit miffed if he did the sugar and water thing as it sounds very slow. How long would it take to injest even one teaspoon of sugar this way. I appreciate that it worked for you and your mother sounds like a very resilient person (my partner, always cool in a crises, had a mini panic!) but I guess it's horses for courses. To my mind the glucagon is as simple a solution as any.

Sent from the Diabetes Forum App
 

michaeldavid

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A glucagon pen may be fine, if you have one handy, and if it isn't out of date, and if the patient has recently eaten significantly. (For glucagon to be effective, I have been given to understand that it's necessary for the patient to have eaten significantly in the recent past.)

Moreover, my previous query remains completely untouched.

IF IT IS CAUGHT EARLY ENOUGH, hypoglycaemic unconsciousness can quickly and safely be remedied by repeatedly wiping wetted sugar across the lips of the patient.

So why does that elementary recourse not feature in the standard advice? (If an ambulance has been called, the above recourse can be followed whilst one waits for the ambulance to arrive.)

No-one has so far given a good reason why it doesn't feature in the standard advice. (In my last post, I suggested an explanation.)

Indeed it appears that the standard advice is flawed.