I need educating

[WhitbyJet]

My daughter's friend came to stay with us, she has type 1 diabetes. The girls went out on the town, had fish and chips, Leann tested her bg, was 9 before bed, she was happy with that. At 3am we were woken up, Leanne was having a hypo, 1.9, she had eaten all her sweets already, she was rather aggressive, I realise it was the bg levels, she yelled for bread and jam.
She proceeded to eat bread and jam as if its going out of fashion, I have never seen anyone so hungry and eat so fast before, half an hour later her bg was 13.4, she said she now needs to have insulin to bring it down.

I am a nervous wreck this morning, can someone please tell me how to treat a hypo, how much does one have to eat so that the bg levels go up but not too high? How often should you test to see if the sugary stuff has any effect? Leanne was obviously in a panic herself.

I am type 2, diet and exercise controlled, however used to take Metformin, Gliclazide and Avandia at one time,
I have never experienced a severe hypo.

I suggested Leanne may wish to join the forum, in the meantime I would be grateful if someone could answer my queries.

Thank you.

 

[Engineer88]

coke (FULL FAT!!) or lucozade is generally the best bet and no insulin to correct after! by correcting the 13 its likely another hypo could ocour.

DAFNE states 20g of carbs test and repeat after 5mins if levels arent up. so thats a third of a bottle of lucozade a mini can of coke 5-6 dextrose tabs or jelly babies. once levels are up eat some bread or other long slow acting carb.

Understand its a steep learning curve but basically the alcohol caused the drop so low as her liver couldnt release glucogon.

 

[paul-1976]

As above...Coke,Lucozade,Jelly babies etc are all good fast acting carbs to raise levels and once levels are out of the danger zone then some long acting carbs such as a piece of bread should keep the levels sustained.

 

[Thundercat]

Lucozade is very good. Coke is now my second choice of drink. Glucose tabs are also a good option. I have a (very unscientific!) method of having 10 sips, wait a few minutes then check bg again, more sips if necessary. If my be drops very low and/or very quickly I get a ferocious and almost unstoppable urge.to eat anything I can get my hands on, which of course leads to high bg. Still, regardless of a rebound high it is not advisable to take insulin to correct as it can cause another hypo.

Sent from the Diabetes Forum App

 

[smidge]

Hi Whitbyjet!

Hypos, especially night time ones, can be distressing for all involved. However, there is no need to panic! The 'rule of thumb' that the medical profession works to is 10g rapid-acting carb immediately (Lucozade, coke etc) check every 15 minutes until the BG are safe and stable and then eat 15g longer acting carb e.g. one piece of toast.

Unfortunately, like all things with this rotten condition, it differs significantly from person to person how much and what type of carb they need. For me, the medical advice would send me very very high. All I generally need is 1 jelly baby (about 6g carb). At night, I would follow that by half a rich tea biscuit to be sure. Seriously, that would bring me back to normal. If I'd been drinking alcohol, I'd have a couple of biscuits because alcohol surpresses BG, tends to make BG drop suddenly and prevents the liver correcting.

What the girl needs will depend on her size, what she's been drinking and how much active insulin she has on board. I'm guessing that if she had fish and chips (a very high carb meal), she will have injected a large dose of bolus to cover that, so she might have had significant amounts of bolus washing around her system. A dangerous situation if she's also been drinking alcohol. Carbs are also notorious for taking the BG high and then crashing it low.

The main thing is to keep testing to make sure the BG is stabilised - taking more insulin is not sensible under the circumstances. I would occasionally do that, but I understand how my body will react - this girl clearly doesn't. Finally, when you are having a nasty hypo, you become ravenously hungry. It takes a lot of willpower to stop at a small amount of carb and wait for the next test to see if you need more. If it happens again, I would limit her to a small amount of coca cola followed by one slice of toast and see how she goes with that.

Smidge

 

[iHs]

My daughter's friend came to stay with us, she has typ1 diabetes. The girls went out on the town, had fish and chips, Leann tested her bg, was 9 before bed, she was happy with that. At 3am we were woken up, Leanne was having a hypo, 1.9, she had eaten all her sweets already, she was rather aggressive, I realise it was the bg levels, she yelled for bread and jam.
She proceeded to eat bread and jam as if its going out of fashion, I have never seen anyone so hungry and eat so fast before, half an hour later her bg was 13.4, she said she now needs to have insulin to bring it down.

I am a nervous wreck this morning, can someone please tell me how to treat a hypo, how much does one have to eat so that the bg levels go up but not too high? How often should you test to see if the sugary stuff has any effect? Leanne was obviously in a panic herself.

I am type 2, diet and exercise controlled, however used to take Metformin, Gliclazide and Avandia at one time, I .
have never experienced a severe hypo.

I suggested Leanne may wish to join the forum, in the meantime I would be grateful if someone could answer my queries.

Thank you.

Hi Whitby

Firstly.... don't be too judgemental over the way Leann coped with the hypo. The good thing was that she was able to wake up and sense that she was going low so scoffed the sweets and then because her bg levels were very still very low, that's why she asked for bread and jam. Its common for all hypo diabetics to eat quickly to make bg levels rise as fast as possible but of course it can sometimes cause bg levels to rise up by too much which is what happened and made you worry. It is probable that if the girls went out for a night on the town, they also drank alchohol? Alcohol can do wicked things to bg levels over night so a bit of forethought needs to be put into practice like get up and test about 2 - 3hrs after going to bed to make sure that the bg levels have not dropped too much and eat some carb if necessary (don't get too tired and tipsy lol).

If Lean comes and stays with you again, then make sure that you get some glucogel from a pharmacy, some lucozade, a babies drinking mug to put the lucozade in to make sure that it doesn't end up spilling on the floor, some Scottish Butter :thumbup: (1" square piece is all that will be needed to make bg levels rise from very low to being about 7mmol within 10-15mins and is gorgeous to eat (resist, resist to eat too much) and a packet of crisps (the budget crips like s'burys Basic brand is about 10g carb per pkt and tastes good too). If no crisps are about or Lean will only eat bread and jam because of her behaviour, then allow her to do so as she needs to learn as she goes along so that she doesn't keep making the same mistakes.

I might be wrong but I don't think a glucagon injection would help in the presence of alcohol (if Lean was out of it - no lights on) so its glucogel and lucozade to the rescue or 999 and glucose drip in the arm (I hope for your sake that you don't ever have to face that though).

Lastly.... be greatful that you are able to control your bg levels through diet choice. Now you know what a hard time of it all us insulin injection diabetics have in controlling bg levels, insulin and food...... come on Artificial closed loop pancreas..... come on !!! :thumbup:

 

[Sid Bonkers]

Hi WJ, I can understand your concern it must have been a disturbing night for everyone..

From what I can remember from when I was on insulin I was told to to correct a hypo was to take 100mls of Lucozade or similar and check bg again after 10/15mins to check if levels had risen sufficiently and correct as necessary, the problem with over compensating is as you have witnessed a yoyo bg effect which is not good.

I do remember over correcting myself on a couple of occasions when I was confused and took milk to correct a hypo of 2.2mmol/L, then thinking that it would be too slow I took something else. Confusion is the worst part of a hypo as I recall, so a plan is essential and you should stick to it if at all possible not think "oh i'll try this" as I did

I believe that 15g of fast acting carbs is the initial response to a hypo and then check bg after 10 to 15 mins and repeat with another 15 if still low, then regularly until levels are stable. I assume from what I recall that 100mls of Luc' is around the magic 15g carbs number...

Hope this helps and please if I have got this wrong someone correct me

 

[WhitbyJet]

THANK YOU so much for responding. I have been awake since 3am, darent go back to sleep in case Leanne has another hypo, she insisted on correcting with insulin. She only had 2 vodka shots to drink, so not over the limit, she is a sensible, responsible girl.

We are a low carb household, so normally dont even have bread and jam at home, but because we have recently had 2 beautiful children coming to live with us (currently fostering with a view to adopting) we have 'ordinary' food in the house as well. I have now also purchased a bottle of Lucozade and a bottle of full fat coke in case of any future emergencies.

Righteo, I am off for a nap before I collect the little ones from school.

Thank you again for caring x