Nighttime hypos and tongue biting

Have heard of tongue biting as a sign of serious hypos. I would advise to ALWAYS test before bed. Also need to do a 3am test to see what your levels do overnight so u can judge better your basal insulin. Sometimes there is no reason behind a change in insulin requirements but regular tests will help check I'd your basal is correct.

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I would be very concerned if you were biting your tongue at night that you were having a serious hypo. Tongue biting usually implies some form of lost or altered consciousness (it is common in epileptic fits, for example). Do you mean that you are unawares that you have bitten your tongue until you have woken up and see blood on the pillow? That definitely suggests altered consciousness. I would speak to your GP about this. Another possibility is that there are forms of epilepsy that only occur during sleep.


Type 2 on Metformin, diagnosed Jan 2013, ultra low carber, Hba1C at diagnosis 8% (11mmol), now between 5 and 6 mmol. 13kg lost so far

Had my first fit during a hypo last week. Has taken a while to get over the shock of it happening. I did not know they existed. What I have been left with is a very sore tongue after apparently biting it during the fit. I had just got up but had fell asleep for 1 hour 15 minutes after I had taken my HUMULIN M3 (which should be taken 30 minutes before breakfast) lesson learned. Have discussed with other diabetes sufferers; Unfortunately it appears common to fit and bite your tongue when having a severe hypo. It was very frightening nevertheless. I think I know why mine happened, hope you get to the bottom of what has caused yours.

I've bitten my tongue a few times over my 20 years of type 1. Usually it's at the side of the tongue for me.

It's always been hypos that's caused it and this has often been at night.

I find I go lower in the small hours of the morning and I think this is fairly common amongst people with type 1. Can I ask which basal (background)insulin you're on and what times you inject it?

Also do you inject it at the same time each day or can the time you take it vary by more than hour sometimes?

When you get hypos, does it follow any patterns? Say after exercising (including longer walks) earlier in the day or following alcohol?

All the best
Ed

I have been experiencing the same problems as below and similarly, have had Type 1 for 18 years now. This is the first time that these "night time" hypos have ever happened and they are very painful on the tongue for the few days following an episode. The incidents have, in a sense, coincided with me qualifying as a solicitor but remaining as a paralegal due to lack of "newly qualified" vacancies at the firm where I work. I wonder whether the additional worry or stress is making things worse for my insulin routine? I am reducing my lantus dose and evening short acting to see whether this helps things at all? I hope so because I too live a very active life-style and visit the gym three times a week in addition to after work running and cycling. It is interesting to read of "Rob" who describes his situation very similar to mine!

I've been waking up a lot in the past few moths having bitten my tongue (usually the sides, no bleeding, just sore) & had NO idea it could be connected to a hypo (am T2).

I think I'll be bringing this up with my DN next time I see her.

Thanks for bringing this to light! :thumbup:

Hi Rob,

I have a lot of experience with severe hypos and I find tongue biting is the most obvious symptom that I've had a seizure. For me its either at night or first thing in the morning (overdose) and I usually collapse and sometimes injure myself. I don't remember anything until about 15mins after and I've usually woke and had some sugar prior to the hypo. Other common symptoms I get are lots of pain in all my limbs and a sore dizzy head for 1-2 days.

Sorry to say but I do think its highly likely you're having severe hypos too. My advice would be to test your sugars as late as possible, every night, remembering what exercise you've done, food you've ate, then eat/adjust insulin accordingly. Since I always wake before a hypo I test my BG and sometimes I've fitted even though its been high (12+). After tests I was told I have epilepsy and I'm also on tablets to stop and further fits. After several years of severe hypos I've come to the conclusion that they may have caused my epilepsy so I'm now very strict with my diabetes control, to try and prevent any further damage. Try a few tests at night just to see what's happening with your blood glucose. If you ask, the diabetes clinic may even fit a temporary continuous blood glucose monitor to your body so they can spot and fluctuations.
Best of luck
Adrian

Rob, I agree with the other contributors that you are having overnight hypos and fits. Another symptom is a sore head the morning after.

As others have said, test late at night every night and, at least until you've sorted this out, keep your blood glucose a little high before sleep. I'd suggest checking an hour before you sleep then again just before; this will show up any oddities and give you a little more time to deal with it.

But the main issue is that your blood glucose is trending down overnight - a simple test is the comparison between late night and morning readings. You say that it needs to be 10 at night to avoid problems - that suggests you're dropping by at least 6 mmol/L overnight.

You need to adjust your insulin regimen to keep your blood glucose stable overnight (and during the day), for example by reducing the basal dose. As a matter of routine you should keep an eye on this by checking every night and morning, as any problems here can have very serious consequences.

What regimen are you on?

You ought to keep a bottle or two of Glucogel - or if not that then some easily accessible source of carbohydrate such as tablet - by your bed. Is there anyone around who can help you if you're not able to help yourself? Make sure they know what to do, and to keep an eye out for you in the morning.

Robellovich said:

Hi everyone. I'm new to the forum as I have a query about the above issue. I have been diabetic for 17 years and have had good control for this duration. However recently I have been having significant problems with hypos at night and biting my Tongue in particular. The latter issue causes me pain for up to a couple of weeks and there is usually a
lot of bleeding all over my pillow

I've tried to consider whether there has been any change to my routine which may have caused this and I cannot think of anything. I exercise very regularly and am aware now that I should reduce my insulin by more than normal when I do this. However my exercise routine has not really changed over the last year or two so I don't know why I am having problems now.

I test before bed when I can however there are occasions when I cannot do so. I find that any reading over 10 is necessary for me not to have issues at night.

So I'm wondering if anyone else has had any issues with tongue biting and if they have found any way to counteract this occurring? I have had nights hypos before, but not where I have bitten my tongue.

Thanks

Rob


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I've recently started suffering from this? Waking up with serious cuts on my tongue with blood all over my face,pillow and bed sheets. Haven't been able to eat correctly the last few days because of a serious one I had on Wednesday in my sleep.

Rob, first rule of thumb: Don't panic. I got these fits back in the 1990s. I was having grand mal seizures like a true epileptic with tongue biting and jerking really badly so the headboard on my bed was hitting the wall and waking up the others in the house. I was even told that I stopped breathing during one of the fits, but only for a couple of seconds. These fits are bought on when your blood glucose falls to really low levels and there is not enough glucose supply to the brain. It only happens if you are asleep and not conscious enough to arouse yourself to act on the low levels. If you are awake, then you are safe. I don't consider these unsafe as they are your own body's way of restoring itself back to normal. The best cure is a glucagon injection, if you have someone who could give it to you. The next best thing is Hypostop or a glucose drink. The best way to avoid them is to test your glucose before you sleep, and adjust your long-acting insulin accordingly. Whenever you take your long-acting insulin, consider that it may act 12 hours later, so start reducing your insulin little by little from injections that take place an hour to 12 hours before you estimate an attack to occur (do this with your diabetes nurse on board with you). Also, check if this is happening with short acting insulins such as Novorapid, as you may be 1-2 units over with this insulin, too. These attacks can come on as your metabolism of insulin may change, and you should get your kidney function tested, as the beginnings of this disease may alter regimes and absorbances and timings, relating to your blood glucose and insulin control. When you have your next HbA1c, if you have had attacks, you will find this lower. Also, look out for Todd's paralysis, which can also happen if you are experiencing a hypo while still waking up - you end up having odd movements and can't put a bottle of glucose drink to your mouth successfully, so go to the nearest basin in your house to fuel up or the walls will get drenched. Good luck!


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P.S. I have no brain damage or permanent deformity of my tongue, so don't worry about any such effects. Just try and plot a graph to show your troughs and peaks with your current insulin regime, so that you can start to predict trends. I had the 'dawn phenomenon' which wreaked havoc with my glucose levels, and that played a major part in my hypoglycemia onset during sleep.

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Just replying here as its sounds like me also. Was diagnosed as epileptic though what they really said was "we cant detect it,but,you do have seizures and the medication controls them so you might have it we just cant detect it yet, there are over 250 different types of epileptic conditions and we still dont really know what causes any of them"....
BUT since i had a CGM fitted for a week and this showed i suffered hypos of 2.2 evey night for two hours between 3-4am they rused my application through for a pump,now i dont have any seizures at night! Get a CGM for a week to prove you suffer from "Dawn Phenoymum" and this kicks off seizures and your PCT will give you a pump. This will end your nightmare, lol and actually give you energy in the morning too!!!!!

40years old ,Type 1 since 18months old and epileptic since 14. Lol with all the fun included, bitten tougue,zombiefied for two days after seizure,tougue pain for 2weeks every time, etc, lol...