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Diabetic coma or just low blood sugar during sleep?

Discussion in 'Type 1 Diabetes' started by Mattcornford29, Apr 17, 2021.

  1. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Hi all, this is my first post on here and was just wondering if anyone can help. So I slept right through my alarm today and eventually woke up at silly time 15:00! When I woke up I was VERY disoriented and managed to test my blood and it was 2.1. Managed to fix it and I’m just lucky my body woke up. So I’m trying to understand what constitutes a diabetic coma, or if it was just a matter of my blood sugar dropping whilst asleep. Some scary stuff out there about potential brain damage and maybe even death with comas? I live alone which is an extra difficulty. I’ve had Type 1 for 18 years, and this doesn’t happen very often. Any help or advice about this would be great. Thanks all
     
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  2. miahara

    miahara Type 2 · Well-Known Member

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    Hi Matt! If you can get a Libre 2 you can set an alarm to alert you if your blood is going too low. I set mine to go off at night if my blood hits 4 so I can then take in some glucose before I go into the hypo zone.
     
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  3. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Definitely sounds like a good idea, night time lows are pretty common for me, I’ll look into the Libre 2. Thanks!
     
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  4. Maco

    Maco Type 1 · Well-Known Member

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    I’ve had a couple diabetic comas in my time, every time I’ve had one I’ve literally chewed parts of my tongue off & usually woke up in a puddle of blood off where I’ve smashed my head. Pretty impossible for us to say if you’ve had one or not really. I’m guessing you have no visible injuries?
     
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  5. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Wow that’s rough. No, no injuries, thankfully, all I know is I was out and dead until the afternoon, then I randomly woke up knowing I needed sugar ‍♂️
     
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  6. StewM

    StewM Type 1 · Well-Known Member

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    Beyond getting a Libre 2 (which is a really good option) there are options for dealing with these.

    1) This is the most makeshift one. If there’s someone you trust (significant other, family, good friend) have a “check-in” with them. Basically just give them a message saying “hey” before a set time. If they don’t hear from you they give you a call. My dad did for me for awhile when I was living on my own. Usually just a phone call was enough to get me out of unconsciousness. Though, being my dad (and having cared for my Diabetes as a child) he would turn up if he struggling to get a hold of me. This is going above beyond what most people can, though.

    2) Have a snack before bed. A small snack around 9pm helped a lot with overnight hypos when I suffered from them whilst I was still on Mixed Insulin.

    3) Basal Testing. Don’t know if you’ve Basal Tested. If you haven’t and you don’t know what I’m talking about give it a quick Google. Could just be you need to reduce your Basal rate/dose a bit.

    4) Bolus Reduction. I have found in recent years having my ratio for dinner set too high could actually lead to Hypos through the night. This isn’t common by any means but can happen depending on how your Basal and Bolus mesh together.

    5) Alcohol intake. Not going to be a prude and say don’t ever drink but making sure I had some Carbs before bed when I had alcohol in me always helped prevent nasty hypos in the middle of the night. Also just stopping drinking as long as you can before bed helps a lot to, that’s the less fun option though.
     
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  7. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Welcome to the forum.

    (No judgement here.) it happens to be a Saturday today, had you any alcohol last night? (We all have to have some "leisure time.)
    Booze can stunt the liver dumping glucose in the morning. (As it processes the alcohol.)
    Though for me liver dumps happen on a work day.
    A liver dump can buffer a low. So after dealing with the booze it may have held you in a "holding pattern" till you were able to wake & treat what was left? (Just an idea bassed on personal experince.?)
     
  8. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Thanks Jaylee. No alcohol last night, but I do like to have a drink or two no doubt about that. I think it was mainly because I’ve been hitting the gym again since things opened up Monday, and didn’t adjust my insulin enough. But thanks for the tips for alcohol, will remember that!
     
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  9. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Great ideas there, thanks. Will definitely look into basal testing, never heard of that before! To be honest when because I’ve had diabetes this long, I’ve lost touch with all the new things out there (maybe basal testing isn’t new but still). Gonna talk to my doctor about a lot of these things, as I can’t afford for this to happen on a workday
     
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  10. Jaylee

    Jaylee Type 1 · Moderator
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    Hey,

    I'm a member of a band (2 of em.) I do it sober. But after why not in moderation, relax. ;)
    Your exersise regime especially during an evening may well have caught you out?

    It's been a while, dates are reappearing in the diary for me. Though I feel one or two venues are optimistic. (Even the "day job" is picking itself up.) It's easy to loose track of how we handled things pre lockdown.

    Best wishes. :)
     
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  11. StewM

    StewM Type 1 · Well-Known Member

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    Yeah, it's not something any Doctor had ever mentioned to me before I found out about it myself using Doctor Google. It's why I never assume people know about it (It is mentioned on DAFNE, but a lot of people don't get the chance to do DAFNE).

    Not going to lie, Basal Testing isn't fun, but it does give you some invaluable information that you can't really get any other way.
     
  12. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    Hi Matt, lots of good ideas from the others. I agree that a Libre 2 and basal testing are a good idea, it gives a rough idea of whether a basal dose needs adjusting. A rough idea because there are other things that can affect nighttime, and daytime, bloods. Just out of interest which basal insulin are you using? They all have different action profiles so knowing how the one you’re using behaves will help with the fine tuning.
    Severe hypos can be very worrying. I don’t think anyone who’s not had one can really understand what it feels like to be so close to the edge and so powerless to do what’s needed to correct it. Thank goodness for liver dumps.
     
  13. Brunneria

    Brunneria Other · Guru
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  14. Jaylee

    Jaylee Type 1 · Moderator
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  15. Mattcornford29

    Mattcornford29 Type 1 · Member

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    Yeah so many factors aren’t there, but I’m using Tresiba, it’s been fine for me over the last couple of years, for some reason it’s just spiked overnight... I lowered my dose last night and ate more before bed as suggested
     
  16. Mattcornford29

    Mattcornford29 Type 1 · Member

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  17. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    Hope you were in good numbers this morning.
    T1 can occasionally throw its toys, shoes, pots and pans, wheelbarrows out of the cot; I have a link from the Libre 1 to a watch that vibrates if bloods go low, it’s a game changer. I think there’s a more expensive watch that the Libre 2 will link with but I need to do more research before the possibly inevitable change to Libre 2 happens. The other solution will be to sleep with the Libre 2 reader close by.
     
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  18. Fairygodmother

    Fairygodmother Type 1 · Well-Known Member

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    Am I the only one who wants to stay with the system I’ve set up to work well with Libre 1 (standalone watlaa watch with alarms and calibration, librelink app to send results to consultant) rather than move to a Libre 2? I don’t want to derail this thread, or put you off Libre 2 Matt, the Libre is great, it’s a game changer. Hope it works well for you when you trial your free one.
     
  19. StewM

    StewM Type 1 · Well-Known Member

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    Do those things not link up with the Libre 2? I've got Libre 2s in my cupboard waiting for me to finish my Libre 1s, and I wasn't aware of that.
     
  20. StewM

    StewM Type 1 · Well-Known Member

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    Yeah, since starting using Tresiba in 2018, twice my Tresiba requirement have suddenly, seemingly randomly, changed. So this could be just one of those "that just happens" times.
     
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