Lost significant amounts of weight (10 to 12 stone) about 2 years ago, put on around 1 stone since first admission (around 25 days ago)
No bowel issues, a little bit of diarrhoea about three days ago.
No gastric issues.
If you have one hypo, you are more at risk of more. Especially if your hypo was treated with glucagon. Because this tells the liver to release its glucose stores. Once you start eating again your body prioritises restocking the liver glucose stores. So food you eat won't raise blood sugar, it will be funnelled into the liver's glucose stores. Restocking takes time. After a hypo treated with glucagon you should eat some complex carbs, with a reduced bolus.
Why is your friend treating hypos with 7 sandwiches, 6 packets of crisps? These are complex carbohydrates that won't work quickly to raise blood sugar. He should be treating hypos with dextrose tablets, glucojuice, hypostop gel, lucozade, jelly babies, Coke, fruit juice. Once he takes on 15g of carbs (in these simple carb forms) he should wait 10-15 minutes and then test again. If blood sugar is under 4 he should repeat. If blood sugar is over 4 he should have a complex carb snack like a digestive biscuit or oat cakes and then consider having a complex carb meal with a reduced bolus.
If he is not currently taking any insulin and still having multiple severe hypos has he had type 1 diabetes confirmed? When was he diagnosed with type 1 diabetes? Has he had cpeptide and GAD testing? Has he had investigations for Addisons? This is an autoimmune disorder that kills your corticosteroid production, corticosteroids usually keep blood sugars up. Addisons in a honeymooning type 1 could cause the kind of severe hypos your friend is experiencing without insulin.
@WheelyFun - has your friend been losing weight, or gaining weight, or does he have any other gastric issues, like lose bowels?
Does your friend have any other conditions like over active thyroid gland or Coeliac disease?
How old is your friend, and how old was he when diagnosed?
Has the insulin he takes been changed since he lost all his weight? The reason I ask is some people carrying spare weight have insulin resistance (IR), meaning insulin (natural or injected) doesn't work as efficiently as it might for someone without IR.
Has your friend ever been treated Bynum other means than injected insulin? Did he go through a period on. Tablets at all?
If I am honest everyone, I first thought he must be taking way too much insulin, but he is barely taking any, and eating the way he has been, his levels should be sky high.
Also; 10 units of Levermir once a day.
Can I ask, and I mean no offence, is the guy being straight to you about his insulin usage? No undeclared correction doses to counter upward swings or anything?
Sorry to ask that, and I hope you get to the bottom of the problem.
Yes they are currently in the hospital under supervision.
Although he is being discharged today, from what he has been told it is because his hypos are “better” (only down to 2.6 mmol/l instead of 1.2 mmol/l) and he can manage at home.
The issue is, the only reason that is happening is because he is eating literally over 400g of carbs a day. (I am basing that on 25g per sandwich he is eating, he ate 7 sandwiches in the space of 5 hours yesterday, as well as hot meal, two bowls of porridge, a sausage bap, 4 slices of wholemeal toast, and three 1.5l bottles of lucozade. After all that he had a hypo of 3.2
Hi again WheelyFun,
This is where it all gets a bit tricky...
You're in hospital with this chap you recently met & get on with. He's also relatively a new'ish T1.
To be quite frank. We can only surmise from the info you tell us.
This guy's HCPs are in a far better position than we are..
I take it he's had a diabetic specialist bedside visit..
They’ve seen him and told him that he is basically must be doing this to himself, because they can’t see how else it would be happening.
That’s why I’ve reached out here. The HCPs are really unsure as to what is going on.
They are also concentrating on the symptom and not really looking at the cause or potential causes. Generally I agree that HCPs know best, but this time around something is not right, they are not doing anything at all. The guy has been struggling with this for a while, has been inside the hospital for 20 out of the last 23 days with this, and there hasn’t been anything other than the most basic of blood tests, no other investigations at all.
His concern is, he is at home, either on his own or with his kids, and a hypo happens. It’s not even going down slowly, he has been tested 15 minutes before a hypo by the hospital BM machine and been at 11, and then after 15 minutes he is at 1.2. That should be impossible from everything I understand.
That is why I have reached out here. Not because I don’t trust or don’t believe the HCPs.
Good, and thanksYep, completely sure. I spent literally 72 hours never more than 2’ away from him and he never took anything extra.
I also have asked him as I thought the same thing, and he has been on 1 to 1 monitoring.
No offence taken at all.
How long has this chap been using insulin?
Good, and thanks
I brought 2 kids up on my own from 4 & 5 yr old and I think the first thing I taught them was the 999 number, the 4 year old moved out 2 years back aged 22 having only hit me with glucagon the once in 18 yearsso good luck to him.
Around a year.
Checking back through the thread. Your friend was diagnosed two years back, age 30. Put on metformin for a while which didn't work. Then insulin for about a year.
How long was he on met?
Hi again WheelyFun,
This is where it all gets a bit tricky...
You're in hospital with this chap you recently met & get on with. He's also relatively a new'ish T1.
To be quite frank. We can only surmise from the info you tell us.
This guy's HCPs are in a far better position than we are..
I take it he's had a diabetic specialist bedside visit..
Jaylee,
What info do you need to make things more accurate? He is very open to trying to find a solution to this issue, especially as it has nearly put him inside a coma twice in three days.
He is still having trouble coping with the diagnosis, and has admitted to me that he is struggling to cope with everything that is going on. He seems to not be receiving anywhere near the level of support I received when I was diagnosed, which is a real shame, considering he has a lot more to deal with day to day than I do.
Any information you want which may give some clue as to what is going on, ask, and I will talk to him and see if it can be both obtained and more importantly if he is okay with sharing it, but to be honest I don’t think he’ll have an issue sharing it, given how desperate he is to try and stop these hypos.
25 units of bolus insulin seems an awful lot if i took this many at every meal id be constantly in a hypo stateHis insulin was changed from 25 novorapid at mealtimes and 30 levernir daily when he was admitted to the doses I mentioned before.
He did try tablets (metformin) but was taken off them after two months as they were not working.
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