Eating Disorder/ Severe Hypos/ Hypo Unawareness Concers.

[buckfastmonk]

Hi everyone. My name is Ryan and I am a 17 year old type 1 diabetic and have recently been diagnosed and treated for an eating disorder.

Over the past few months I have suffered from frequent hypos, mostly at night, some of which have been severe and in one case I was hospitalised due to being unconscious and seizuring in the morning.

I was wondering if anyone here could help me with a few queries and questions I have about this. First of all I have almost entirely lost all signs and awareness of hypoglycemia which concerns me a great deal. I frequently test my BG to find that I am at 3.0mmol/l or below without feeling under the weather. Before I had began to struggle with an eating disorder (around about a year ago) I felt hypos coming around 4.5 or just above which was incredibly handy as I could treat them accordingly before they had time to effect me. Recently though, the only way I have discovered I am in a hypo is testing before a meal and seeing it to be quite low, or by waking up from sleep confused, twitching violently, sweating heavily or having night terrors which leave me unable to sleep for quite some time afterwards. My first question would be about the nightmares/terrors and if they are related to the low sugar levels. I have never suffered from them before, and have only began to affect me in the last week or so. Secondly if there is any way to get my awareness back meaning I can feel a hypo well before I begin to have quite severe and scary symptoms. My insulin dosage has been cut dramatically since my hospitalisation in march, from dosages of around 16 units of Novorapid with meals and 22 units of Lantus before bed to less than 6 with meals and 4 before bed. I am still having these hypos on an almost daily basis and they are becoming more and more severe. It seems it's almost at the point where I am unable to treat these myself anymore due to the confusion and twitching (meaning I am either completely in denial about my situation or unable to actually hold anything in my mouth or hand) and my parents are having to be the ones to help me. My consultant, specialist nurse and dietician have all agreed to have me try and run my sugar levels at a much higher average (currently at around 5% the last time my HBA1C was checked) but I am having incredible difficulty maintaining this to any degree as I do not have any set meal pattern and struggle to eat any significant amount of food in any one day. Any tips or advice would be greatly appreciated.

Thanks in advance. Ryan.

 

[amberzak]

Hi Ryan.

I've been having major hypos due to overdosing on insulin for fear of highs. You are not alone.

If you run a little higher than normal. You will start to get your sense of hypos back apparently. I think it must take a couple of weeks, because I was a week hypo free and didn't feel my hypo coming on yesterday.

As for night terrors, yes I get that. It's like how you have hallucinations when you have a fever.


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[Riesenburg]

Hi Ryan,

From what you have said I suspect the hypos would be due to your lack of food but still being on insulin. The insulin you take is supposed to help with the amount of carbs you eat. If you don't actually eat the carbs you will run into a hypo. I would have a chat to your specialist about it. It's very hard to give you any advice on insulin dosages if your eating patterns are not stable. But I do know that if I took that much insulin and didn't eat properly I'd be in hypo as well. The fix to it would be to either decrease the insulin further, or better yet increase the food intake, but those need to be balanced properly (which even for those of us who are long term type 1s is a dam hard thing to get right).

The reason for the hypos getting worst and worst I suspect is that you are wearing down your body's ability to deal with them, the more frequent they are the more difficult it will be to recover from them.

I would say don't worry too much about your HbA1c for now and try to get your eating back in order even if it is one small step at a time. Don't despair this is something you can fix, just see if you should maybe get the insulin reduced a bit (specially the night one) and work on the eating

Running the levels a bit higher should make the hypo signs return.

Do let us know how you get along.
Frankie