Severe Hypo & Fit

[Dido]

Hey everyone,
I am a regular visitor to the forum but have never posted anything until now.
Just looking for some advice, after what feels like the most frightening thing that has ever happened to me......
I'm 34, female, type 1 taking 13 units of Lantus (evening) and Novorapid for meals. Last HBA1C was 7.9, which was a great improvement after 9.9 & 8.9.
Hypo warning signs are usually pretty good, or so I thought.
On Saturday night after my usual bath I went to meditate which I do 2-3 times a week. Whilst listening to it, I felt a bit panicky (which is not unusual) so continued with my deep breathing. The last thing I remember is the voice I was listening to seeming really fast then fading.
I then remember the paramedics at the bottom of my bed and screaming out, it felt like my hands were bleeding, and I was asking if I was dying, I was so scared. They told me I'd had a hypo and were asking me if I knew where I was etc. I told them I'd been to Thailand! (Must have been whilst I was unconcious).
Anyway, I went to A&E, had glucose injection & was sent home a few hours later.
I feel so guilty for not recognising my symptoms, it frightened my husband so much as he did not know what was happening to me. He's been really upset and I think he's had as much a shock as I have. My family too are also very upset and scared.
I feel ok now (took today and Tues off work to get myself right). But my sugars are running high because I am scared of taking too much insulin.
Off to see my GP tonight too about getting some hypo stop, so that if it happens again, I can be treated quickly.
Has this happened to anyone else? I read that if you are "out of it" for too long, it can cause brain damage. My confidence has took a real knock I thought I was getting things on an even keel,
Dido

 

[sugarless sue]

Welcome to the forum ,Dido. Poor thing that must have been really frightening for you.I'm hoping that a knowledgeable type 1 will come along and answer your questions for you.

 

[sandymaynard]

Hi Dido,
my mum is insulin diabettic, must admit i was scare when i saw her have a hypo for the first time! I can fully understand that you must be very shaken and upset!
There can be times where they are no warning signs what so ever my mum has had a few! Until she got Chummy, her collie dog that can pick up on a hypo!
My mum says it starts different ways with her a warning sign can be feeling shaky or panic! Dido for your husband and family this would of been worrying for all of them!
Thing is you need to keep them in the loop and explain too them and try to find out what the wwarning sign's are you! Then let them know how to be able to help you!
I feel for you! I hope that you don't stop your medication as that can be as dangerous as taking too much medication!
See your doctor, could be that if you are on a low cal diet that your blood sugars are coming down! Then the medication drops it too low! See your doctor and ask for expert advice, I am no expert there are lots of people who are experts on here! who could help you!

 

[hanadr]

Lucozade shoud be enough for most hypos Dido
Make sure you have a supply.

 

[farmerfudge]

I find having a hot bath drops my BS quite quickly, maybe this was a contributory factor?

 

[Dido]

Yes perhaps the bath didn't help...what I don't understand is, at 4.30PM BS was 11 prior to mowing the lawn. My "Episode" was at about 7.30PM, admittedly I still hadn't eaten but surely BS should not have dropped to 0.6?
Got the local nurse coming to see me tomorrow, she thinks perhaps my insulin needs reviewing.
Fingers crossed I'll be sorted.
Thanks for all your replies.
Dido

 

[Trinkwasser]

I've known this happen on occasion because someone inadvertently injected into a vein, or used bolus in place of their basal.

 

[skotish]

hope you are fine after that episode dido :!: i usually notice sweats and kinds of shaking when i hypo and have some locozade as its absorbed very quick

 

[hails]

Hi Dido,

Sorry to hear of that experience. If anything would help maybe just going a bit OTT on testing your sugars for the meantime might help until you get your confidence back?!?!

I tend to find the panicky, uneasy feeling related to a hypo with me then I get the sweats, so look out for that one. I dont always get the pnaicky feeling but i know when I do its hypo related.

Hope this helps a little

x

 

[kegstore]

Dido

Reading your post reminded me of the first time this happened to me. Very upsetting and confusing for all involved. I have lived with hypo unawareness for 10 years now, but I think I'm a lot further along the road than you are if this is the first time for you. I can sometimes get down to around 2.5 mmol/l without really being aware of any problem. Have to ask a few questions first: how old are you, what's your control like (be honest!), how long since diagnosis, do you manage proactively or just tolerate? There's nothing wrong with running higher for a few days to get your confidence back, and to hopefully reset your warning signs.

With me this was the first sign (that I completely failed to do anything about initially) of autonomic neuropathy. But you can mitigate the onset if you act early, and there are usually other symptoms too - talk to your specialist. Have you thought about pump therapy?

Jo

 

[Dido]

Hi Jo,

Thanks so much for your reply. It's comforting to know I am not the only one.....it's left me so confused, worried, especially the "not remembering anything" part, and the thought of the distress my hubby must have felt.
My last HBA1C was 7.9 - same as yours! This is a personal best for me so far.
I'm 34, 5 ft tall and weigh around 7 st 10 lbs. I was diagnosed in 2003, but shortly "honeymooned" for about 18 months. I then started getting symptoms again, so really have been injecting for about three years now.
My control has improved in the last four months - I cut bread out of my diet (except for weekends), so have been eating lots of salads for lunch, hence not needing as much or very little insulin.
The worrying thing about what happened was, although I had not eaten since around 1PM, I checked BG at 4PM and it was 11. The incident took place about 7.15PM and paramedics took my reading at 0.6. Admittedly, I had not eaten, and had done a bit of gardening, but had no insulin since lunchtime.
I took my Lantus around 6.30PM, but I noticed straight away that a little lump popped up in my tummy once I'd done it. This has only happened once before. The nurse says it's possible that I injected close to an existing recent site of novorapid, which could have dramatically sped up the reaction of the Lantus.
I've now only just been told that Basal & Bolus sites should be on 2 separate areas of my body - is this true? Sorry to ramble on, but hopefully this gives a clearer picture of what happened.
Dido :?

 

[kegstore]

Hey Dido

You certainly sound like you have more of a hold on things then I ever had so don't get overly worried! I will comment on the Novorapid which is VERY fast acting, and I've never liked it for that very reason. Same with Humalog which I used to be on, but this type of insulin is a requirement for pump therapy so I have no choice. Something to be aware of when you inject it though.

The 2 separate sites sounds like a good plan to me, and when I did inject I always did this as a matter of course. I'm cagey about giving such advice however as this hails from a time when I didn't really bother with my diabetes at all, and am now paying the price... Perhaps another T1 could comment? Your nurse seems to be on the ball though which is good.

It might turn out that this was just one of those one-off hypos that we all have every now and then, and defy explanation. It's worth rechecking everything, and asking the appropriate questions which you're doing.

Jo

 

[yipster29]

Hi

I'm newly diagnosed and can confirm was told to use Novorapid and Levirmir (Lantus equiv) in 2 separate sites as if still got any Novorapid in the site it will affect the other.
It was suggested I use tummy for daytime rapid injections and leg for evening slow release.
Hope this helps, all scary stuff xx

 

[Dido]

Thanks Jo & Yipster....I have started doing the Lantus in my legs now. Sorry to hear you've had a tough time of it Jo. This forum really is great for supporting one and other, I can't thank you enough.
xx

 

[Kash2001]

Hi Dido

Couple of thoughts on this, my system of insulin is similar to yours although my quantities are larger, however, I have found that on this system you can get store ups of insulin in the body which can for no reason release into the body, giving a massive hypo.

I train most days and my fat content is relatively low, so I think the insulin is going more into muscle than fat areas, it is worth regularly changing the injection sites in a rota, I only do legs for Nova rapid and the levemir in the backside, I will not inject into stomach areas due to my job, so looking at this area may be worth while. as said Lucozade or one of the small cans of coke, are as good as the Glucogel and taste better too.

We are all different and there are many reason why we get lows, checking sugar levels after training is no good for me as mine go way up but come down V quick. so you need to understand how exercise affects your sugar levels and administer insulin according to your requirements. But do watch out for the storage of insulin in one area as the body will become resistant to the absorption of insulin and the you can, large amounts suddenly hit your system, 1.2 - 1.4 can happen to me even with me noticing the effect of them as I'm getting Hypo unaware. So watch out for this long term.

ATB

 

[Aadrgon]

Hi Dido

I'm a T2 but as a thought - is there any possiblity that your earlier reading of 11 might have been wrong? would you normally expect that sort of reading at that time of day based on your previous experiences?

 

[secrettheatre]

Hi Dido,

One word (and it's been mentioned a few times already) - Lucozade. Make sure you have a regular supply.

Chris

 

[lilibet]

Hi
Hope you feeling a bit better since you first wrote this

First I can think of is that the excercise' you did earlier in the day has had some impact, combined with a hot bath and then taking lantus.
Although Lantus is meant to have a relatively flat profile, and keep you steady, I do believe it has a 'kick in' bit to it, and maybe all combined have given you the bad hypo

In terms of the hypo unawareness all suggestions so far are good - keep the bg a bit higher until you reset it. It might be however that you are not unaware but just misinterpreted the symptoms. You did report feeling panicky ( I too get that , along with floaty light head, and then trembling and a feeling of heat as the bg continues to drop) and that was likely the start of your symptoms. In future, test when you feel ANYTHING until you begin to reinterpret whats being happening

If you find you are truly unaware -change of basal insulin could be considered.

As for brain damage - it can happen with severe hypos but if I recall correctly, anything Ive read has suggested you have to be out of it for a while. Jury is out on whether hypos effect your cognitive abilities.

L