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Hypo nighttime fits...

L

L1984

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2
Hi there,

Apologies if I am posting on the wrong board, but I just have a few questions...

My boyfriend is an insulin dependant diabetic - he has been diabetic for 23 years - since he was 3.

Back in February, he had a really bad hypo fit in the night, luckily enough, I was there to call an ambulance and get him seen to. Needless to say, I was very shaken and worried about him.

I bought him a hypo watch for him to wear at night, and overall, it has been really helpful, it wakes him up in the middle of the night if he is going low, and so he's able to do something about it before it gets too bad.

However, he had another hypo fit on Saturday morning, the watch didn't wake him up (we don't rely on the watch to wake up him all the time if he has a hypo, as we know it's not foolproof) He was shaking, his body completely tensed up, everything was clenched, he had bitten his tongue quite badly, he stopped breathing, went blue, and it was the nightmare all over again.

I don't know what to do about it, he is adamant that he doesn't want to get an insulin pump (which I thought would be a good idea for him to have). I also thought that maybe reducing his insulin slightly might help, especially during the Summer months as it's so hot, but he doesn't want to do anything. I know I am no expert, and he knows his body and his reactions better than I do, and I am aware that my suggestions may not help at all, in fact, I worry it could make him worse, which is why I'm sending this post!

He takes 25 units of Lantis at night, and 10 units of his other fast-acting insulin before every meal. Is this too much? Should he be taking the insulin BEFORE meals or AFTER meals? Should he be taking this much insulin? I know it depends on what he eats, but he eats fairly healthily, usually has a good amount of Carbohydrates in his evening meals and not massive portions either.

I also wanted to know whether these hypo-fits he has during the night could cause any long term problems? And what if he has one when I'm not there, then what happens? Could he die? Or will he come round eventually? I am so scared about it happening again when i'm not there.

Sorry this is such a long post with so many questions! Just want to put my mind at ease and help my boyfriend as much as I can.

L x
 
Hi L1984,

He could try splitting his dose of Lantus 50/50 and injecting it AM/PM. This tends to give the
Lantus a more even action throughout the day (and night). The heat of summer may well be affecting the absorption of a single large dose.

Good luck,
timo.
 
hya and welcome,
i would also see if he will start carb counting as a fixed amount of bolus can cause hypos if u are eating less carbs than u are injecting for,
i used to have awfull night hypos till i started carb counting, i know if i took 10 units bolus it would probably finish me off as ive never taken more than 3 units per meal
if u need to know anything else plz ask
 
Night time hypos are the worst for obvious reasons, if he is regularly having them then the obvious solution is to look at his insulin dosage and also to set an alarm to wake up and do blood tests so that he can improve the situation.

When does he take the Lantus? I take mine at 8:00 pm or thereabouts, I would say it's peak hits at about 8 hours later and it stops working after about 16 hours (needless to say I'm going to change to another insulin at my next appointment as that isn't very helpful).

He needs to be aware of how much carbohydrate and what type he is eating and inject short acting (at varying levels) to counter it. Just sticking rigidly to one dose isn't going to work unless all the other factors, such as exercise, diet etc., etc., are rigidly maintained as well.

It's difficult to say what multiple treated hypos can do; things are pretty unclear. It seems that answers range from nothing very much to (mild) brain damage, an untreated hypo is of course a different matter, especially if glycogen stores have been used up. Have a look through the site though as there are quite a few threads about this. I have had in the past a number of night hypos and have either woken up and been able to eat glucose tablets or have woken up my partner who then gives me fruit juice or glucose.

Good luck though - the key thing is that this is not something that can be ingnored; it needs to be dealt with. A head in the sand approach won't cut it here alas.

Dillinger
 
Hi Li984
Get yourself a tube of "Hypostop" It's a thick sugar solution. If there should be another incident, you need only to get this onto his tongue.
 
Hi,

Thanks to everyone who has replied to my thread, you have all been really helpful!

Dillinger; he takes Lantus just before he goes to bed, so that could be anytime between 9pm and 11pm. I hadn't actually thought about setting an alarm to check his sugar levels during the night, I will definitely get him to start doing that. Haha, he's going to love me!!

Timo; I have mentioned to him about splitting his Lantus 50/50, this sounds like a good idea, as 25 units just seems so much in one hit. He is going to consider doing this once he's spoken to his doctor about it. Thankyou :)

He's got some shots of glucagon in his fridge, so i'm going to learn how to administer those if, god forbid, it ever happens again.

Thankyou all for your responses, I'm always happy to hear what anyone else has to say on this matter, as it's always good to know what other people have experienced :)
 
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