Hi, first post so forgive me if it's in the wrong place or whatever, I've had a pretty good look around but need some more specific advice please. My wife (60) has been diabetic for many years. Most of the time she's fine and controls her levels well. Once in a while she'll have a mild hypo and I can handle it and get her back pretty well but then again there are the bad ones, eg in the middle of the night on holiday in a strange hotel when she tries to get out of the room (obviously to find some food) and punches me when I try to stop her (it's OK I can put up with bruises) I might be able to get some hypostop into her mouth but she often just spits it out, very messy but generally with some patient coaxing things are fine. These events are frightening but rare. Last week though was not good - I came home, all the lights were out and I thought that maybe she was shopping, after 10 minutes I found her in the sitting room, lights out and deeply into a hypo .... as it happens, for once, she ate a banana (all I could grab quickly) and then a biscuit or two and a mouthful of lucozade ... my point (at last I hear you say) ... that last incident worried me the most, what would have happened had I not come home for another hour or two, or more .... it's possible .... and no one would know that she was ill and she's on her way to a coma ? Any comments welcome Regards Roger
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Husband of type 1 needs some advice
- Thread starter rogertb
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hanadr
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As your wife iws over 60, could she have one of those wrist alarms? My Mum, who doesn't have diabetes, but is 90, has one. If she were to have a fall, she can just press the thing and help will come.
Thanks for that, yes it's a good idea but these hypos normally come on 'cause she's not getting the signs of low sugar levels, I'd be concerned that if she's not getting the signs she won't know that she should press the button ie if she were aware enough she'd go get something to eat ! Good of you to take the time ... Roger
Dennis
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Hi Roger,
For your wife to be having hypos and loss of hypo-sensitivity it rather sounds like your wife's insulin intake is not balancing her carbohydrate intake. If you could give us some idea of what her insulin regime is then perhaps one of our type-1s might be able to come up with some suggestions?
For your wife to be having hypos and loss of hypo-sensitivity it rather sounds like your wife's insulin intake is not balancing her carbohydrate intake. If you could give us some idea of what her insulin regime is then perhaps one of our type-1s might be able to come up with some suggestions?
Hello Roger
I too have had hypo times like your wife and I always feel awful for my partner who has had to come to my aid.
Is your wife using insulin twice a day?
From reading your message, I would suggest that your wife starts to do a bg test mid morning and mid afternoon in addition to the existing tests that she is already doing. By doing this, she will be able to spot midway if her bg levels are on the way down and eat something to ward off a hypo before it hits. As a general guide, any bg above 8 will most likely mean that a snack doesnt have to be eaten, but of course below 8 will mean that something does.
I
I too have had hypo times like your wife and I always feel awful for my partner who has had to come to my aid.
Is your wife using insulin twice a day?
From reading your message, I would suggest that your wife starts to do a bg test mid morning and mid afternoon in addition to the existing tests that she is already doing. By doing this, she will be able to spot midway if her bg levels are on the way down and eat something to ward off a hypo before it hits. As a general guide, any bg above 8 will most likely mean that a snack doesnt have to be eaten, but of course below 8 will mean that something does.
I
lilibet
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Hi Roger
In a worst case scenario and her hypos become very serious, maybe speak to GP/Consultant about the use or need for glucagon injections which can be given intramuscularly when people are unconsious through hypo? This is of course if you feel comfortable with this idea.
Also, Ive read that some people try running sugars a bit higher for a period of time in order to regain some awareness of hypos but to be honest this idea has always troubled me, for obvious reasons. However not at that point so can only speak for myself.
The idea about testing through the day (and recording it) is good cause this will give you some idea of how her insulin is affecting her at particular times of day. EG, i tend to be hypo before lunch or tea time and have cut morning dose as a result. You can also check insulin profiles on the internet if you know what she has and maybe see if the peaks and troughs of this match her hypos and take action this way either by cutting dose or by changing when and what she eats.
SOrry nothing definitive, but am new to the 'game' and these are just things that spring to mind
Lilibet
In a worst case scenario and her hypos become very serious, maybe speak to GP/Consultant about the use or need for glucagon injections which can be given intramuscularly when people are unconsious through hypo? This is of course if you feel comfortable with this idea.
Also, Ive read that some people try running sugars a bit higher for a period of time in order to regain some awareness of hypos but to be honest this idea has always troubled me, for obvious reasons. However not at that point so can only speak for myself.
The idea about testing through the day (and recording it) is good cause this will give you some idea of how her insulin is affecting her at particular times of day. EG, i tend to be hypo before lunch or tea time and have cut morning dose as a result. You can also check insulin profiles on the internet if you know what she has and maybe see if the peaks and troughs of this match her hypos and take action this way either by cutting dose or by changing when and what she eats.
SOrry nothing definitive, but am new to the 'game' and these are just things that spring to mind
Lilibet
lionrampant
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lilibet said:
I always thought Glucagon was like... "required reading", as it were for type 1?
There are a few things you can do with the cooperation of your wife but the glucagon injection is the only thing you can realistically do if she is not cooperating with you. This is available on prescription for insulin users.
I have glucagon available but have not needed to use it so far. All our family members are trained in how to give it and we had a dummy run again last week when the old one expired and my youngest son Dave injected it into a tomato. It would have been the orange but my husband said he fancied eating it.
It has been shown that if you keep the bs level above 4 for two weeks you should see an improvement in hypo awareness. What you do is check the bs every 2.5 hours and correct any lows immediately with glucose. Through the night I would just test once at 2-4am during this time. Sort out the insulin doses so these hypos are not occurring.
Users of continuous glucose monitors have found that they often have lows during sleep and correcting these improves hypo awareness. Realistically the way to test for this do one bs every night sequentially and move the time of the test so that over a week all the times are reasonably covered. Again, if you spot hypos you reduce the night basal or alter the bedtime snack/insulin ratio.
Some insulin users get better hypo awareness with animal insulins such as pork or beef. You can learn more about this at the IDDT site.
Giving 7 units maximum for each insulin injection (but you can have more than one shot at a time) ensures insulin timing predictability.
You may need to think about how exercise, hot baths, seasonal variations are impacting on things.
Once someone has adapted to a low carb diet and is using much less insulin the number and severity of hypos usually reduces considerably. The process of carb/insulin reduction needs to be managed carefully to ensure that more hypos don't occur in the run in phase. You can learn about how to do this at http://www.dsolve.com
Insulin pumps can be used for hypo sufferers. These are hard to obtain and priority seems to be given to children and adolescents.
I hope this information helps.
I have glucagon available but have not needed to use it so far. All our family members are trained in how to give it and we had a dummy run again last week when the old one expired and my youngest son Dave injected it into a tomato. It would have been the orange but my husband said he fancied eating it.
It has been shown that if you keep the bs level above 4 for two weeks you should see an improvement in hypo awareness. What you do is check the bs every 2.5 hours and correct any lows immediately with glucose. Through the night I would just test once at 2-4am during this time. Sort out the insulin doses so these hypos are not occurring.
Users of continuous glucose monitors have found that they often have lows during sleep and correcting these improves hypo awareness. Realistically the way to test for this do one bs every night sequentially and move the time of the test so that over a week all the times are reasonably covered. Again, if you spot hypos you reduce the night basal or alter the bedtime snack/insulin ratio.
Some insulin users get better hypo awareness with animal insulins such as pork or beef. You can learn more about this at the IDDT site.
Giving 7 units maximum for each insulin injection (but you can have more than one shot at a time) ensures insulin timing predictability.
You may need to think about how exercise, hot baths, seasonal variations are impacting on things.
Once someone has adapted to a low carb diet and is using much less insulin the number and severity of hypos usually reduces considerably. The process of carb/insulin reduction needs to be managed carefully to ensure that more hypos don't occur in the run in phase. You can learn about how to do this at http://www.dsolve.com
Insulin pumps can be used for hypo sufferers. These are hard to obtain and priority seems to be given to children and adolescents.
I hope this information helps.
LittleSue
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lilibet said:
Usually only need to run higher for 2 or 3 weeks to get awareness back (not long-term). One could run higher that long whilst struggling with a virus or adjusting a new insulin. So on balance running higher temporarily is probably safer than continuing with hypo unawareness.
Roger
If your wife is a driver, she must not drive until she regains hypo awareness.
lilibet
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God, I hope not cause I've not got any.Maybe too new to dx? No one has put it on repeat script though have extra pen, keytone strips etc. Will ask methinks now.
My other half would pass out if he had to inject me. Ive already warned him that maybe at some point in the future if I lose awareness he is going to have to try and notice for me and help out with some sugar and this made him anxious. Or maybe it was the comment that people can get belligerent (prob thinking, Christ belligerence unawareness in her would be a nightmare LOL)
Thanks to all for the very helpful advice and comments, I may ask Maggie to jump in with some comments on the details of her regime, (Sue ... she's not driven for many years) ... again good of you all to take the time and it's certainly given us more information to help out at the next meeting with the consultant. Best Roger
