Bg was 35

I was not wearing my pump and took too much insulin via syringe. Went to ER. Sugar was high initially but after 5hrs was i was at 35 I was given bag of dextrose water IV I think it may have been 2 bags for the next hours I went up to 47. They kept me overnight.

I was conscious and alert whole time. Is that not weird? The nurse said I should have been unconscious. Er doc says that may be the difference with overdose on Novolog and R

Wow, that sounds alarming. How much extra Novolog did you take? If you were high when you went to the ER, I wonder why they let you get down to 35? Do you have a CGM?

I would have been conscious and alert at 35. After 63 yrs of Insulin use, I have never passed out. I have been down a few times to 35 and been quite alert. Everybody is different.

What can you do differently so this never happens again?

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I’m sorry you had such a rough night, but I don’t think it’s unusual to be conscious at 35 at all. When I go hypo, I feel my worst in the 60s-50s, but find a kind of peace and clarity in the 40s where I don’t feel bad at all and can hold fully functional conversations. The brain fog clears. My fingerstick meter reads down to 20 mg/dl, and I’ve seen it read “low” while still alert. I’m not saying it’s cool to hang out that low, there’s serious potential for risk and it’s a scary thing, but I also don’t think it’s usual to be conscious there, either.

Our household rule is that my husband will leave me alone unless I ask for help (because I’m a mean hypo) so long as Dex is giving readings, but he wants to be on standby with the glucagon if it starts reading “low” (less than 40). I’ve only lost consciousness once in the last 20 years, and it was because of a fever-driven hypo when I had the flu. I just couldn’t keep any sugar down and the fever was burning up all my BG. I don’t have a lot of lows anymore, especially with the help of pump automation now, but I’ve definitely had my share of scary ones over the years with full consciousness.

I really think hypo symptoms are relevant to where you were before the hypo, too. If I was relatively flat under 100 before the hypo, I barely feel them. But I’m coming down from a high, then the hypo symptoms are really severe. And I suspect the latter type of insulin-overdose is more what the ER is used to dealing with. They don’t have experience with “normal”, so can’t really judge it, they only have experience with extreme situations.

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I’ve been alert and able to treat myself when my meter read 18. Plenty of times in the 20s. Different people can handle lower BGs better than others. When I had those numbers I was on MDI and had already lost my hypo awareness, and there were no CGMs available then. I’m not sure how low I was the times when I actually required help.
People who run their BG higher all the time might feel low and be unable to function even if their BG is in a normal range.

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It is all about the delta which is the difference between where you feel comfortable and where you feel low. If you normally run your bg at about 150, then you would most likely start feeling pretty uncomfortable below 80 but may still be able to function quite normally. I run my BG between 80-100 and will not drive, even a short distance if my BG is below 48. After extensive testing of my driving abilities, I noticed, for example, that at 48 when I try to stop right on the stop line, I always overshoot by 11-14 feet. But if my blood sugar drops into the 20’s at night my mind gets real foggy and I grab Swedish fish as a learned muscle memory reflex. Each Swedish fish brings up my bg 10 points starting 15 minutes after ingestion. We all need to know our tolerance and comfort levels, especially those of us who live or mostly live alone.

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What the what?!
Your blood sugar is 48 and you’re testing your driving abilities?
Before we get too caught up in relativity and YMMV here, no one should be driving with a blood sugar under 70 just like no one should drive with a blood alcohol level over the limit. Is it possible that some people drive better when tipsy than others? I guess, But don’t. Just don’t.

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Sorry, I guess I have picked up a few bad habits in my nearly 60 year driving career. I guess it is lucky that I don’t have a yen for alcohol.

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Some people are used to being at lower numbers, so then you feel it at lower numbers. I remember we used to have someone that hit the 30’s all the time and remained perfectly functional. I know I used to feel awful at under 80, now I can be 65 and not feel anything. I just start getting anxious somewhere under 65. Depending what I am doing can depend on what level I feel anything. Some people lose the hypo feeling altogether. I have never passed out or not been able to help myself. I have asked my husband to bring me something just because it was easier. I start to lose patience with everything and anything when I drop “too low”. And get an anxious type feeling. Sometimes I get auras.

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I have to admit that I’ve had low sugars that gave me double vision, even after my sugar corrects, it takes a while for the double vision to go away, I can remember driving a few times like that , driving with one eye. Yikes.

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I’ve had these, too. I had never heard a low could cause double vision so I wondered if something else was occurring the same time as a low! It began happening with all severe lows though. Thankfully, with the help of CGM and pump, I’m able to circumvent the worst lows.

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Wow, I am glad you are OK but sorry you had to go to the hospital. Do you know how much insulin you took??? That had to be scary. Did they give you injections of glucagon??

I grabbed the wrong pen one day ( while chatting on the phone with a friend) and took my Novolog instead of Levemir. I took 16 units and boy did I panic!!! I drank some sprite and ate way too many carbs but I was fine. My Dexcom helped me out by keeping track of my blood sugar. I actually went a little high after all those carbs. I was actually shocked that I didn’t have to go to the hospital.

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I think that every aspect of that tale is weird, but unfortunately too likely.

What’s not exactly weird to me, but a shame is that not just PWD, but medical staff don’t thoroughly understand that the organ that is the largest consumer of glucose is the brain and it is 100% dependent on an adequate suppy of glucose and insulin. Without both the first functions that degrade as BG drops are judgement and intentional reflexes.

You can can survive poor reflexes, even a coma with some damage, but if judgment isn’t sound, or you don’t know what you are doing, you are more likely to be in a dangerous situation and die of trauma.

I’ve had lows beyond my BGM’s low end of reliability and never passed out. I’ve spent enough decades living with diabetes that l’ve made many mistakes with insulin dosing, but never one that dangerous, because I’ve regarded insulin as being dangerous as an inaccurate loaded gun since my first injection. My jobs have required long hours, traveling alone and by car but most of all on my quality of thinking, so I’ve always been over-prepared to treat a low. I won’t get in a vehicle other than an ambulance unless my BG is above 100mg/dL.

Until I had what could have become a fatal experience 15 years after diagnosis, I was convinced that I knew enough about diabetes.

My A1Cs were great (in the 5’s) before I was admitted for surgery. My BG was managed by BGM and MDI. I thought I knew what I was doing, but I was there because of poor judgement. I didn’t get immediate treatment for a minor foot cut and treated it like a minor thing with first aid. When it continued to get worse I was too embarassed to admit that I’d screwed up. By the time I got past that it had become a bone infection. That took 4 days over a weekend.

I had no one to blame for what happened to me but myself. I was more than happy to have trained professionals care for me, to entirely take over BG management for a while. That was actually the biggest mistake I ever made.

My last self-BGM test before the podiatrist’s appointment was 130. He took one look and had my wife drive me directly to the hospital. They drew blood and admitted me. I was later given a sloppy fingerstick test by a technician, my last meal and insulin by hospital staff, then started on nothing- else-by-mouth. Twelve hours later as I was being prepped for surgery in my room, I started experiencing all symptoms of the hypoglycemia. I checked my BG with my meter. It was in the 40’s. It took me 20 minutes to get the attention of a nurse, and an eternity to have them find a tech with the “approved” BGM and get tested by them I had to threaten withdrawing consent to surgery to get a doctor to give them directions to adminster glucagon. As I waited for them to get it from the pharmacy I continued to test. By the time it arrived my OneTouch Ultra said I was in the 30s, my vision was greyed out, and I could barely soeak. I was terrified I’d die during surgery or wake up a vegetable.

That was a big wakeup call, the one that convinced me that not only didn’t I know enough but I could never trust hospital staff or a doctor to know more about about diabetes or to care more enough about my life than I did. That’s when I started to start seriously studying 24x7 management of T1D and risk management.

My rules of survival have become:

  1. I don’t trust “luck” or statistics. The people in a group of 1000 people don’t die “90% of the time” in a situation. 10% of them die 100% of the time.
  2. I control whatever I can to improve my own survival.
  3. I trust testing technology over feelings unless there’s a conflict. Feelings aren’t reliable.
  4. If there’s a conflict, I test again and act on the results that are more likely to be life-threatening.
  5. I utilize resources that I trust.
  6. I don’t wait unil I’m in trouble to utilize them those resources…
  7. People are imperfect. Their own lives should be more important to them than mine is. I don’t trust other people with my health or life until they’ve proven how much they can be trusted and I never trust them entirely.
  8. I don’t trust myself completely and I look to people I trust and respect for validation.
  9. I accept that I’ll never be “cured”, but I’ll never stop trying to be better.
  10. I question everything.
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imo Hoping that you won’t lose focus, judgement or reflexes while controling a moving machine weighing more than 1000 lbs surrounded by larger machines is a foolish hope.
When it comes to BG, unless you are out of control hyperglycemic, the rule for driving is: better high than die.

Since BG directly effects judgement and volunatary reflexes, low BG is more dangerous as elevated alcohol level. Alcohol can be metabolized and the level can drop over time toward normal without intervention. Low BG will drop lower and more dangerous.

Under 70 mg/dL might be safe for a person who didn’t have diabetes, but for a PWD who is dependent on insulin infusion it is foolish and dangerous to oneself and others.

I know that an hour of high stress driving can drop BG faster than moderate exercise can. So I don’t trust my ability to drive safely unless I’m above 100, stable and the trip length is under an hour. Plus, I always carry glucose tabs and provisions for longer trips with scheduled breaks - even as a passenger.

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The reason you can feel ok when your meter says your really low is because the brain and the body have different glucose values and the brain can take glucose from the blood stream to top itself up (so to speak). However if your low in the body your brain will eventually catch up so you really do want to get to topping it up with glucose (obviously).

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Did you feel it coming or did it drop you like a rock? Where were you when it happened?

I’d be conscious at 35, too.