Scary night time hypo

Miss90

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Hi all,

I would like a bit of advice (and reassurance) following my incredibly scary night time hypo.

I have been type 1 for 11 years, since I was 12 and had good control, never went to hospital or anything like that. Then, a couple of weeks ago I had a terrifying experience. I went to bed, became unconscious and suffered a very low hypo. My boyfriend was thankfully awake in bed and saw me fitting, with my eyes fixed on the celing and drenched in sweat and rang an ambulance. Upon arrival they gave me two different shots of glucose and after a while managed to bring me back up. My blood sugar upon their arrival was 1.1!

SInce then I am so scared to go to bed! I check my blood sugar at least 3 times before I go to sleep but now I wont sleep alone and i'm so so scared this will happen again!!

Can anyone share their experiences or just reassure me please?!?
Thank you!
 

Auckland Canary

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286
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Hi
Don’t know if I can really be of reassurance or not but I have suffered horribly from these in the past and still do have them. I’ve been Type 1 for 31 years and during bad times in my life I was suffering these sometimes twice a week. I would become conscious with either my wife or paramedics attending to me.
They are terrifying, depressing and at one point actually started to cause problems in my marriage because of the frequency they were happening.
However they are manageable, but unfortunately with some diabetics, they are a fact of life. But there are some things to remember which may help.
1) Although there is the situation of “dead in bed”, which has been covered in these forums before, this is quite a rare phenomenon. More often than not your body will manage its own way out of severe hypos. They are horrible and frightening but if happening in isolation and not repeatedly they shouldn’t cause you harm. I believe that I used to suffer from them in the past and just sleep through them before I was in a relationship. There was no one there to help me and everything was OK. But you do need to discuss them with your HCP's
2) If you haven’t been on one see if you can attend a DAFNE course. I was sceptical at first but since attending one in July I have really got on top of these. I can’t recommend them highly enough.
3) If you haven’t already got one get glucagon injections from your GP and ensure that your boyfriend knows how to use it and is also prepared to use it. They are extremely efficient in bring people round from these situations if somewhat painful in the injection site afterwards. It doesn't help if you are alone but takes away the need for ambulances in most cases.
4) If you are sleeping alone and can manage your levels well get them up a bit before bed so this can’t happen. As we all know this is easier said than done sometimes and you run the risk of overnight highs but that may be a better solution if it helps take the fear away.
5) There is also Continuous Glucose Monitoring which will alert you when your levels fall below a prescribed level. I know nothing about these but I know there are plenty of others on this forum who do so I’m sure people will be more than happy to assist you with this.
Aside from that I hope that you find a working solution and you can find some way of dealing with these, which in my opinion, are one of the most destructive yet invisible aspects of Type 1.
 
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TonyTruthful

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91
Totally agree with you Auckland. I'm pretty care free but the night time hypos bit is, like you said one of the worse things about T1. I lost a friend this way.
I always eat before bed and run my sugars high to mitigate the threat. I think this will be the only way to put your mind at ease. It's not ideal but that is the sad matter of the fact.

Also try and avoid injecting large doses of QA around you bedtime.

Peace out matey.
 

Stefano

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123
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Hi Miss90 I'm 34 years diabetic now. Almost all my life! I am sorry I know Night hypos are awful and so depressing if you faint while sleeping.
I had quite a few when I was very young.
In recent years what I did to make sure I could sleep safe was to check my blood sugar at least 4 hours after the injection of fast acting insulin. If I was already in bed I would have put an alarm to get up and check. Obviously if my sugar was below 7.5 I would have eaten something.
Now.i am using a CGM and it has changed completely my life as it wakes me up if my sugar goes below 4.2. If you can afford I suggest this. It will change your life. You'd better ask to your consultant for one and you still could get one for free. This is at least my case....at least till April. Good luck. Stefano . .



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kkkk

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Hiya,

I'm similar not much really encouraging stuff - I've been diabetic 25 years and I remember having night hypos as a child and being in this odd daze with my Mum telling me a doctor was coming and I was convinced I was dreaming - since then I've had several more and they've got worse over the last year - but that is just me - I did have a gap where I was fairly stable overnight and had nothing too bad for a year or so - I guess the encouragement in that it could just be a one off.

My tactics are:

- Don't go to bed below 6 - if I am a slice of toast normally does me very well and keeps me up enough if I am too high, then I am too high and unless it would be some really high number I wouldn't touch my insulin (I am on injections and not a pump at present hence that view). Whatever happens with me I think a snack quite helps - it is that 1am-2am period where I am incredibly unlikely to wake up and those hypos have the potential of being horrible.

- Have your bedtime/nighttime insulin at a regular time, and I try not to have my evening meal too late as otherwise the insulins overlap and that can cause that little peak in action that could cause the hypo. (I do this rather than the 4 hour wake up - it's the same principle - I sadly do a 1am wakeup each night as mine are a little to frequent for comfort at the moment and like you it really scares me)

- having talked about all the injections - it might be worth considering a pump as your insulin doses can be personalised and night time hypos make you qualify under the old NICE guidelines - definitely worth talking to your team about. (I am hoping to go on one to really just get to the bottom of it as I am fed up with night time hypos!)

- Do some blood tests in the middle of the night to see what is going on.

- Ask your team whether they could loan you a CGM (continuous glucose monitor) for a couple of days and have a look at what is going on at night and whether you have a big morning phenomenon - when your glucose rises as you wake up.

- maybe just do a note in your diary of what you did on that night, just incase if ever happens again and there is anything common - though I know it can be like a needle in a haystack - I know heat generally makes my sugars fall so on holiday I am more aware of hypos in the day as well as the night then, also alcohol, exercise all that sort of stuff can come into play too.

For me - my solution after many many hypos in the night is to go on a pump, but I am also getting CGM as I believe that should be able to wake me up before I am at that horrible stage (though I will have to fund this, as I was told NICE won't even consider funding it until you have proved that a pump cannot completely eliminate night time hypos). I can't tell you whether either of those have worked yet but I am really positive and determined that they will :) Good luck with it, sadly you are not alone and for me too it is the worst part of diabetes - if my CGM and pump to the job for me I will let you know - it does take a while to get a pump so be worth asking about one sooner than later if that is an option you want to pursue.
 
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noblehead

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A frightening experience for you Miss90 :(
 

mrman

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A very frightning experience indeed. Bad enough waking in tge 3s with symptoms, let alone passing out. Prevention would be best obviously. Do you know why this had happened as in more exercise that day, did you go to bed with any qa in you. Was your basal dose correct.
I try to go to bed with a reading of 6~7 and no qa in me, if I do hypo from my basal, they are normally less severe.
Hope u feeling better
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Frightening, the key is to establish whether it was a routine or a one-off.

If you're on a pump how old is it? Mine failed recently and now I'm stable on the replacement, my blood sugars are more consistent than they were on the d pump. Left me wondering whether the old pump had been delivering basal and bolus consistently.....


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Miss90

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Thanks guys! Nice to know it happens to others too, I don't know another type 1 diabetic to share my experiences with!

It was a one off, never in my diabetic life has that ever happened or anything as serious as that!! My GP was awful, just told me to 'take care of myself', they wont refer me to a consultant as the local nurse should 'deal with me' so i've got a new GP and an amazing consultant who is a professor in diabetes!

I've just today been diagnosed with an under-active thyroid and the doctor reckons that played a part in my hypo too. I just hope it never happens again as waking up with an oxygen mask on your face, a line in your arm and 4 paramedics around you isn't that pleasant!
 
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Before I got my pump I had a few scary hypos. I've been Type 1 for 31 years and had been on pens for most of that time.

The eventual conclusion was that a layer of fat had built up under the skin meaning the insulin was not being absorbed. It would build up and build up and eventually get released as one enormous dose with predictable consequences.
 

G2ADY

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95
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Hi Miss90,

Are you on Basal / Bolus? If so, try to reduce your Basal slightly, as others have said aim to go to bed slightly high ( 7 or 8) and record your blood sugar figure before going to bed. Try to not give yourself any bolus at least 4 hours before bedtime. In the morning check your bloods and see where they are in comparison to what they were when you went to bed. If they are lower then reduce your basal further the next night, if they are slightly higher i.e 1.5 mmols higher then I'd leave the basal units as they are. Obviously if your morning bloods are a lot higher then consider increasing your basal slightly.

Night time lows are something that all of us are worried about. The problem we have is that sometimes our endocrinology does things that mess up even our best efforts. Hope you get on top of it :)

Steve
 

Miklo

Active Member
Messages
26
Type of diabetes
Type 1
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Insulin
Hi

I think it is difficult to get back on track after a night time hypo as you tend to edge on caution but in time it soon passes and you do forget the incident. i dont have many but you can bet it is the middle of winter when I awake confused and sweating and it can be diffilcult to persuade your mind to let yourseld get out of bed that is the first difficulty as you are confused. in my case making it downstairs to the larder is the next obstacle and by this time I am soaking wet all while the wife and kids are fast asleep the lowest \i have tested in this state is 1.4 and usually I go through have a box of shreddies and half a pint of milk with pleny of sugar and when recovered try and work out the figure to inject some fast acting insulin to counteract what I have had. Then its in the bath as I am now freezing and back into bed and none of the family are any wiser and the kitchen is like a bombsite. I dont have many night time hypos itmaybe I have had a busy day rushed tea had a few drinks etc etc and then gone to sleep soon afterwards.
 

lorrainem

Member
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people who stand in doorways!
Hi all,

I would like a bit of advice (and reassurance) following my incredibly scary night time hypo.

I have been type 1 for 11 years, since I was 12 and had good control, never went to hospital or anything like that. Then, a couple of weeks ago I had a terrifying experience. I went to bed, became unconscious and suffered a very low hypo. My boyfriend was thankfully awake in bed and saw me fitting, with my eyes fixed on the celing and drenched in sweat and rang an ambulance. Upon arrival they gave me two different shots of glucose and after a while managed to bring me back up. My blood sugar upon their arrival was 1.1!

SInce then I am so scared to go to bed! I check my blood sugar at least 3 times before I go to sleep but now I wont sleep alone and i'm so so scared this will happen again!!

Can anyone share their experiences or just reassure me please?!?
Thank you!
Totally sympathise I've suffered from these fitting hypos from about 18 until just 2 yrs ago-ish! Absolutely terrifying for both the person ther,thank god for them and the diabetic when they come round-got to warn you its VERY difficult to get any medical person to help...hope you are luckier than me
 

Duncancr

Newbie
Messages
4
Type of diabetes
Type 1
I had a few of these scary episodes a number of years ago which also spooked my wife for a while. I cut back my lantus and also took 2 slices of toast before going to bed which helped sort it out. What I eventually found was I was doing to much walking of the dog after. My dinner. I am 44 and have had type 1 for 34 years so hope this helps you :)


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iHs

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4,595
When I was in my 20's (years ago now lol) I asked my dsn at hospital about night time hypos as I had just got a flat with my boyfriend and was told not to worry about them as the liver would always come to my rescue and release some glucose in response to bg levels dropping but unfortunately this never happened and my rescue was my boyfriend (now my OH) who got me out of the hypo state by using Hypostop/Glucogel (in bottle with twist up nozzle) and some lucozade.
Read half way down this link about glucogel http://micronavigation.com/forum/index.php?topic=280.msg1799#msg1799

Apparently as years go on with type 1, the alpha cells in the pancreas start to die and no longer release the hormone glucagon which makes the liver release glucose so the only way glucagon can work is by it being injected.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1021855/

There is only so much that a type 1 can do to avoid night time hypos and that is usually by eating some carb before going to bed and working out its effect by getting up in the night and testing bg levels or adjusting the basal insulin downwards and testing bg levels to make sure that bg levels are a bit higher

Many diabetics do end up getting themselves onto a pump which then sorts out the exact basal need overnight so that bg levels can stay ok but for sure what will work for everyone whether on a pump or not is to use cgm
 

kkkk

Well-Known Member
Messages
185
Type of diabetes
Type 1
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Insulin
Makes sense to me iHs - ….the bit that doesn't is why why why won't they consider funding CGM for diabetics with this issue - not only will it help prevent horrible disabling hypos that damage your confidence and can't be doing anything great for your body either. Plus CGM will help with control and the avoidance of complications as is just a huge resource on how your individual body responds to insulin and exercise and food and confidence and being able to sleep without fear….that is what frustrates me most!

Rant over :)