I have been married to a T1 husband for over 40years and in that time I've sorted out a few hypos. Last Saturday morning was something new.
He woke me at 0415 sweating profusely and not really aware of his surroundings [we were at my mother's about 90 miles from home. I checked his blood glucose 1.1mmol [19.8mg/dl]!!!
I didn't know what emergency supplies he'd packed or where. Iknew we had some in the car, but my mother [95 years old] locks up the house like Fort Knox, so I raided her pantry. I found some jelly sweets [candy] and some jam, which was mouldy and I threw out. I gave T1 about 5 sweets, which he swallowed. Checked bg after 15 minutes and no change. Also his meter is hopeless with a non-cooperative patient.
I went back to the pantry and found some powdered glucose. Dissolved some in water and gave him that. After 15 minutes no change. Tried it again and still no good. Eventually after an hour, I called the paramedics. It took them an hour with Glucagon and IV glucose to get things right. Of course I had to wake my mother to warn her not to panic if she heard voices.
T1 insists it shouldn't have happened. He'd had ssome wine, but not too much and no insulin since about 8:30. He's on basal and bolus.
Anyway my vet brother told me laer to get a syringe from the pharmacy and some powdered gglucose and if i have any more incidents like this, to make up a STRong solution of glucose and squirt it into the mouth. Ensuring the swallow r3eflex is still working.
Any ideas on what went wrong guys?
Yes. I did have to unlock to let paramedics in. I didn't get to go back to bed, by thye time they left, it was time to take the dogs out.
Hana
I always keep some emergency supplies on hand. I get little ziplock bags at the hobby store (probably intended for beads or something like that...) and keep about 30G in my pocket, just in case. Looking in someone else's pantry can be dicey as you never know what they'll have. I agree drinking things is easier and I like the powdered Gatorade (which is dextrose, also working a shade faster...) as I can make it as strong as I want. Accidents happen and I'm glad that you found what you needed to get him fixed!! Perhaps there's some extra basal or bolus or activity in the visit to mom's house or something. I run into that sometimes as both of my last two assisted hypos were at family events, one a reunion and one Mother's day. I think MrsAcidRock had them in hand but other folks are quicker on the 911 trigger. Ugh.
With 1.1 mmol/l I would eat at least 25g of carbs. In sweets this is a lot to eat. With my glucose tabs it will be around 5 tabs (5g per tab).
I would recommend to get a glucagon kit. This is a small injection kit. You just dissolve the powder into the solution. Then you inject a tiny needle anywhere into the skin. The glucagon will force the liver to release its deposits and the glucose level will rise quickly. This is safer than squirting something into the mouth. In case he passes out something in his mouth might block his air way. Another point is that glucose tabs should be always on the bed table - that is his responsibility in my opinion.
Wine has the potential to prevent the liver from releasing glucose. The basal insulin is there to cover this constant stream of glucose coming from the liver. With the liver being blocked the basal just worked against the blood glucose and this might have lead to the low. But perhaps he just miscalulated his bolus for dinner. To have more peace of mind you two should try to identify the cause. It is always better to be on top of the development and to prevent mistakes the next time.
Don't know how big your husband is but 5 jelly sweets won't do much to raise my bg when I'm hypo and heading further down.
Alcohol in the evening can have a profound effect suppressing the body's natural liver action to raise bg in the early morning. Others here swear at the liver dumps but when alcohol is suppressing liver action, the hypos can be deep and profound. Glucagon (which depends on the liver to release its glucose stores to work) may not work well, and IV glucose may be the only choice: This describes my first trip to the ER with a hypo.
It's always dificult when not in your own home Plus T1 rarely has hypos. That was the first in ages and last time he needed medical help was years ago. He usually has very good control.
Hana
If you squeeze a thin layer of cake gel onto the gums and rub it in, the gums will absorb a lot of the sugar. This works on the inside of the cheeks, too, but the gums are easier, in my opinion.
I drink, uh more than one, and it doesn't seem to crash out my BG that much on it's own. I've experimented with lots of different varieties and usually keep a range of beer around (to do more experiments with...heh heh heh...) and, as long as I cover the carbs, I do ok. I am sort of inclined to eat a lot while I'm "beering" it but I am sort of disinclined to blame a lone glass of wine for any wild metabolic excursions. Maybe bolusing for the wine inaccurately would do it but I don't bolus for wine that much anyway.
Thanks for all the sugestions guys! It seems the incident remains a mystery. Taking advice from my veterinarian brother, I now have a 10ml syringe [without needle] and some powdered glucose. This I will take charge of, so I know where it's packed. We are due to go on a short trip next month , just to explore East Anglia. I want to see the curvature of the Earth and it's one of the few places in the world it can be proven.
Hana
I am with Holger re the glucagon kit obtained at my local Pharmacy ...the kit does have an expiry date for the times I will not be able to swallow the Dex4 pills and hubby will have to assist .My kit always has been outdated and had to be discarded. I don't bolus for my dry red wine , but drink with food .I am glad you called the paramedics ! Did Hubby have to deal with a High BG after this scary episode ??