another hypo fit

[vickiec]

my son who is 16 had his second hypo fit in month didnt have tea time insulin 42 units novomix, picked him up from a concert got home at 1am he said he had had food at mac donalds and small amount of alcohol alcopop so i presume full od sugar he took his 42 untils of novomix before going to bed and realised he was having hypo at 4am attempted to get glucose but started fitting once aagian on floor so bust his nose and battered his face luckily i heard him but it was difficult for me to get bm so i administered hypostop bm was 7.2 and he came round this morning bm 11.4 can anyone advise were he went wrong he is suppose to be going abroad with friend and friends parents next week and is adamant he is going.

 

[donnellysdogs]

Was bm of 7.2 before hypostop or after hypostop?

 

[vickiec]

after

 

[donnellysdogs]

Have you spoekn to HCP's about what is occurring?

What were reactions from HCP's?

He is obviously wanting to have his hols...are the people that he will be with aware of night time hypo's and how to treat him? Have you got enough hypostop to go with him for the hol...?? Makesure he takes a copy of his repeat prescription form on holiday with him, just incase of an emergency....I know you must be worried silly about his hol...but, I really do know how you feel.....I used to have really bad night hypo's...I used to go abroad by myself...and I have had help from people passing in the corridor that heard me screaming....(long story)...just make sure the people he is going with are all aware...and the hotel are made aware as well.... I always did this when taking myself off for hols by myself and leaving my hubby alone to look after our dogs!!!!!
I wouldn't really advise to stop him going....the only thing you can do is to explain to everybody concerned what can happen.

Have you considered long term whether a pump may be more suitable? I never used to recognise my horrendous night-time hypo's before going on a pump....and honestly some of them could be termed as fits, but I have always just believed they were just really bad, bad hypos. I haven't had one since going on to a pump. I recognise all my night hypo's before getting in to a mess...and a pump really does allevitate these problems....I know I can go to bed at 5.6, go up to 6.3 at max and return to 5.7 in the morning when getting up.....

Levels of horrible night hypo's vary in people...some people can react, some people can't. It may be that he is losing some of his ability to recognise them.....it may be that the alcopop or something else is affecting his ability to recognise them.

 

[vickiec]

he had a pump and was non compliant and he did recognise hypolast night but put off getting up cos he was tired then it was too late my worry is that he does drink alcohol when he goes away with us and i know he will when hes away and will he recognise hes having a hypo if hes bin drinking he dosnt always test before he goes to bed which he didnt last night he just took insulin

 

[donnellysdogs]

How about the people he is going with? Can you explain situation to them?

 

[vickiec]

yeah they know him well and sue is an epileptic so has seizure awareness, last night he had full seizure thrashing about on floor blood all ova my concern is will they hear him, and if they dont could he end up in coma and we wont be there to help but my son says we have gto stop worrying and let him live his life
cos we cant always be there to protect him.

 

[donnellysdogs]

I too have had somplete thrashing around on the floor during the night hypo's. I still for me don't count them as seizures because in my brain I have some thinking around what I am doing....although to other persons it doesn't....

I'm not an HCP but I believe that fits don't have some sort of thinking around them. Although afterwards I can't remember everything that I have done, I do know that I fall off the bed, I thrash around on the flood and I scream and shout and try to crawl to the toilet or hallway etc, but my brain is not unaware whilst I do this...I do still think about my dogs!!!!!!and try to attempt to cuddle them etc...

It is good that he is going with somebody that has some experience....can they insist that before he goes to bed that he does a test??? Somebody will hear him.....rest assured on that....I have had 2 occasions (one on holiday) and one whilst working where I have been in hotel rooms by myself..the one when I was working- I came round to find 2 policemen and my work colleague in my bedroom!!!! (the policemen were in reception when my colleague who was in the next room went to reception to get a key, and they tagged along!!!!!)....

I have been type 1 26 years and had horrific hypo's at night-time, and whether somebody has been there or not-I have survived and have NEVER gone in to a coma. I can't obviously say that the same would be with your son....but I am still here......

I hope that this gives you some reassurance...make sure insurance knows your son is type 1, and that the hotel knows as well.

 

[vickiec]

donnellysdogs, yeah my sons friend's mother has laid the law down and said he better comply when he is away with them and she will keep him right but i worry if they get drunk and cant manage to give him the care he needs and i cant expect her not to enjoy her holiday,
i am supposed to be having a good chat with her this week she sounds sensible and is an epileptic herself on medication, and i know what u mean cos i heard him roar for want of a better word but i am a staff nurse so know the signs, but having said that he was down stairs at the time obviously going for food but it was too late and i couldnt prevent him from hurting himself he was having full blown seizure and snorting on tile floor in kitchen, my husband is dead against him going now cos he worries so much and as u can imagine all our stress levels are running high but thanks for your words of reassurance.

 

[iHs]

my son who is 16 had his second hypo fit in month didnt have tea time insulin 42 units novomix, picked him up from a concert got home at 1am he said he had had food at mac donalds and small amount of alcohol alcopop so i presume full od sugar he took his 42 untils of novomix before going to bed and realised he was having hypo at 4am attempted to get glucose but started fitting once aagian on floor so bust his nose and battered his face luckily i heard him but it was difficult for me to get bm so i administered hypostop bm was 7.2 and he came round this morning bm 11.4 can anyone advise were he went wrong he is suppose to be going abroad with friend and friends parents next week and is adamant he is going.

Hello vickiec

If your son had 42u of biphasic Novomix before bed, then it's no wonder that he went into a fairly bad hypo and started fitting. Biphasic insulins do need to be spaced apart and used before breakfast and then again before evening meal. I know you said that he didn't have the tea time dose because of concert etc but what would have been much better was for him to have had a reduced dose of Novo before bed and not the full tea time dose. That's what I would have done and just get up in the middle of the night to test bg levels.

Biphasic insulins are nothing like bolus. They have a fairly long duration of action.

I hope your son is coping with diabetes a bit better now that he is using twice daily (biphasic) insulin although it has its own rules that your son will need to abide by in order to be well.

 

[vickiec]

thanks for the last response he is taking novomix 30 using flexpen i am confused do you mean he should only take novomix immediately with meal i presumed that because he had eaten he would have been right to have it later than not at all, would it have been better to do bm then take novorapid as a corrective dose, and lastly he is going on hols if he has is evening meal can he have his 42 untis at say around 8pm and if he drinks alcohol after that what should he do take bm when he gets in

 

[HLW]

I too have had somplete thrashing around on the floor during the night hypo's. I still for me don't count them as seizures because in my brain I have some thinking around what I am doing....although to other persons it doesn't....

I'm not an HCP but I believe that fits don't have some sort of thinking around them.

You can be fully conscious during an epileptic seizure (which is a seizure with abnormal brain activity, you don't need to be epileptic to experience one. I've no idea if hypoglycemia induced seizure are epileptic seizures this type or not). The symptoms can be something as little as involuntary movement such as a finger twitching, with no change in consciousness. This doesnt seem to be common knowledge, I certainly had no idea, even GPs don't seem to be aware of this fact.

 

[ebony321]

thanks for the last response he is taking novomix 30 using flexpen i am confused do you mean he should only take novomix immediately with meal i presumed that because he had eaten he would have been right to have it later than not at all, would it have been better to do bm then take novorapid as a corrective dose, and lastly he is going on hols if he has is evening meal can he have his 42 untis at say around 8pm and if he drinks alcohol after that what should he do take bm when he gets in

Hi,

If he is drinking he really should decrease the amount of insulin he takes beforehand. Alcohol will affect the body long after it's been drank, even if the alcoholic drink is quite sugary. The body is far too busy trying to get rid of the alcohol to release any glucose from it's main storage points so any extra insulin will make you hypo, which is avoidable if you reduce insulin and have something to eat before bed that will keep BG's up through the night.

There's no reason why he can't enjoy his holiday and have a few drinks, but he needs to test his BG frequently if he is drinking and DEFINATELY before bed.

The woman he's going with sounds like she is responsible, maybe you should sit down with her AND your son and lay down some ground rules. He can drink IF he is willing to accept responsibility, testing reducing insulin etc.

Twice daily insulins should be taken morning and tea time, this is because they will have some immediate effect and will peak later on to cover the next meal (morning will peak at dinner, tea time will peak at supper) so he needs to have some sort of snack before bed really.

It sounds like he may be better off on the basal/bolus regime, if he's getting to the age that he wants to be out and about it will suit him much better as he can be more flexible with his meals, like going to the concert.

Next time if he has a shift in meal, he does still need insulin. I read in a post you have novorapid?
instead of using the novomix late on at night you could cover a late meal with the novorapid instead aswell as using this insulin for correcting high BG's.

 

[vickiec]

you know i have discussed all of this with my son and he agrees then today he didnt get up until 11am i made him bacon sandwiches asked if he'd had insulin he said no not yet at 12.15 i asked him again and with a cheeky grin said yes then said i will have it now not wishing to be a pain trying to push him i retreated and went out shopping apparantly his dad asked him what his bm was and it said HI so he actually had his insulin at 15.15 , what was the point in that whhen he knows the problems he is causing himself, i wonder if he has frightened himself and is puposely running high so not to have a hypo but when i ask him he says hes fine.

 

[Levy]

Hi Vickie,

When was your son diagnosed? Many teens (including me years ago) go through a 'rebellious' phase where they don't really want to accept that they're diabetic. I used to be exactly like this when I was about 16; I have never been on Novomix but I was on Novorapid and Lantus, but I used to forget (or not bother) to take my insulin a lot then correct highs later. Not always because I didn't want to do it but because it was in the back of my mind for some reason (loads of think about when you are a teenager lol!).

Anyway, if he is on Novomix and he is making it a habit not to take them at the set times then, like Ebony mentioned, maybe it's not the right regime for him anymore? It sounds to me like he wants a bit more freedom (he likes sleeping in and going out etc.) A basal/bolus regime will give him a lot more freedom with what and when he eats, if he wants to go out or sleep in etc. Perhaps that's something you could discuss with him?

 

[vickiec]

he did actually have that rgine but with pump and that didnt work especially at night cos he used to throw it on the floor but maybe this would work if it comes in epipen, today as i said he had insulin at 15.15 but when i asked him later he said he had taken novorapid to correct his high after tea and not 42 units of novomix his bm was 7, and he was diagnosed aged 14 and if you read my othner posts you will see we have had a difficult time.