Last Night Was Hard

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#1

I went the lowest I have yet to go, last night. Number 32 snuck up on me out of nowhere. I had eaten a balanced and healthy meal, of which I measured the carbs for and taken my normal dose of Novolog. I take 1 unit for every 20 carbs. and I took 2 units at dinner. I also enjoyed 2 glasses of red wine with my dinner, but up until now, have not suffered any symptoms from my minimal alcohol consumption. I took my regular dose of 15 units of Lantus and went to bed around 11:50, with a healthy night time blood sugar of 116. I was tired and feel asleep quickly. Literally one hour later, I woke startled and tossed and turned. I thought it wasn’t possible that I could be having a bout of hypoglycemia, so I waited it out for 5 minutes. When I checked, I was at 32! I broke into a cold sweat, heart beating fast, utterly exhausted and went downstairs to have some sugar. Even though I ate a bowl of yogurt with maple syrup, a 4 oz juice box, one glucose tab, 1/4 of an apple-my blood sugar had only risen to 52 after 20 minutes. I had a small glass of chocolate milk and a couple crackers (I was feeling sick from all the sugar at once). I checked again and was at 110 so I went back to sleep at 1:10 am. Sure enough, at 3:20 am, I woke again with 60. Worried about sinking lower at an alarming rate, I went downstairs again to have some sugar. This time I was able to bring my blood sugar up high enough to sleep through the night. It was 174 when I woke at 8:16. I sure don’t feel like having breakfast after that double midnight snackathon.

It is these occasions that render me fearful of the time when I am living on my own. I currently am staying with my family, but am probably moving out again in 1-2 months. It has felt like a safe zone, but being alone last night (my mo works nights and my little sister was sleeping), I felt what it would be like to have to take care of this without anyone’s assistance. I know that I can do it, that many do, but I feel scared. All I could do after that first low last night was collapse on the couch, I felt useless, immobile.

Waking up this morning, I feel depressed angry at an unknowable force-why was I robbed of my peaceful nights sleep? Why was I forced to consume 400 extra calories that I didn’t want to eat? Why do I have diabetes?

#2

Oh Frankie! I had a night like that when I was first diagnosed. It is so very scary. I hope you’re feeling better now. I just wanted to chime in and say something encouraging: Diabetes will not limit your independence! It takes more care and thought and planning, yes, but you can live alone with it and be safe. (BTW I believe, based on the sequence you described, that it indeed was the wine that messed you up!) Just keep your mind open and continue learning. You’re doing great!

#3

Hey Frankie - just something to discuss with your CDE - but I used to have lows with my Lantus shot - when I took it just in the evening before bedtime (I was taking 16 units). I felt like you do - and started to get fed up. I questioned my endo about it - and we split my dose to a smaller amount at bed time - then abit larger in the day time. It worked fine for me. I also learned abit later - after taking a break from my pump - and went back onto Lantus - I’d been giving too much Lantus - so juggled it around abit - and things went great. Diabetes is fickle - you’re always having to tweak things from time to time - but hang in there - I have been for 43 years - and just happy that I’m alive and kicking here on our big blue marble with all the great advancements that are available to us today.

#4

Alcohol consumption can be confusing. It tends to lower the action of the liver for many hours, and suppresses the liver from doing it’s glucagon stuff, meaning your bg can end up lower than you’d otherwise expect.

It’s these nonlinear effects, the effects that foods and drinks have on bg’s that go beyond the carb count, that are the real tricks to learn.

How do I know? All courtesy of a trip to the ER as a result of a extreme hypo brought on by alcohol consumption… and which I wasn’t expecting at the time.

#5

It will get better. You’re still pry honeymooning. I had TONS of trouble right away when I was honeymooning because of still having beta cells. Randomly they would kick in and dump insulin and I would drop. Or they wouldn’t do anything I and I would spike from not enough. It gets better. I was DX in May 2010, so I know what you’re going through. Just take it one day at a time and you’ll get through it. If you’re digging a hole like that at night, you might be on the upswing of a honeymoon and may need to adjust your lantus. If you’re dividing your lantus, try taking more in the morning and less at night. 15/15 is the same total dose (30) as 16/14, but you’ll have a little less active at night. It’s what I had to do to keep from falling at night. Talk with your endo about it. I don’t drink anymore, so I can’t help you with that. I haven’t been brave enough to take that step.

#6

I am in a similar situation. I am moving away to school in the fall, and a few months ago I had a bad episode. I woke up with the worst headache I have ever experienced in my life. I did not feel low, but felt that I should get up anyway (this was at about 7 am). By the time I got to the kitchen I felt low. I got out some bread, but for the life of me (litteraly. lol.) could not figure out what to do with it, I was so disoriented and confused, nothing made sense, so in that state I figured it would be a good idea to sit down on the floor. About 10 min later my dad found me sitting on the floor unable to speak or understand him. He managed to get a full glass of orange juice into me, before trying to test my sugar. It was so low that my meter could not get a reading. My parents called 911, and an ambulance came to my house and brought me to the hospital, I spent the rest of the morning and part of the afternoon throwing up, and still experiencing the head pain. I was terrified and confused. For weeks after I felt horrible, physically and emotionaly. I tested every 30 min because I was so afraid of dipping again. It has not happened since, but the fact of not having help there when I need it when I move away scares me, especialy when I have to sleep. The fact is diabetes sucks! and things in our lives are going to be changed by out disease, but “different” doesn’t have to mean “worse”. Think of it this way, if your sugar is going to be a jerk and cause random lows, there is only so much you can do, stressing and letting your moods affect your sugar is not going to make you feel any better or give you better readings, in the end I just had to accept that if “diabetes” were a person they would be a GIANT AS* HOLE, and sometimes you just have to deal with them and get on with your day.

#7

Oh poor you! I do know the feelings well! You have described some of my night times perfectly!

I wonder what you were doing during the day? Quite often the lows we have are reactions not to the last meal that we had, but the lunch or breakfast even, and sometimes from what happened a couple of days ago? Don’t ask me why, it just does.

This might not happen again! Or it might set a pattern for a few nights. Best thing I can do is to make sure my sugars are quite high at bed time and have a snack and my insulin. Then also have sugary snacks or drinks near my bed so that I do not have to tackle the stairs (not a good idea when one is hypo!) and can deal with it immediately! And keep your mobile phone on next to your bed! You might be disturbed by the odd early morning call, but you would be safer.

I have had LOs and like you will eat whatever is available! Not a problem. You will probably wake up with a bit of a high sugar level but you can deal with it. It is vital that you get it up as quickly as possible.

Another thing I have been taught is that anything that is higher in fat, namely yoghurt, milk, chocolate etc is no good for the hypos since it takes too long to digest!

Bless you. You will get through this. I used to be on Lantus and found that it was too strong for me, and 15 is quite high. You might need to lower it a bit!

#8

I have just read Rebecca’s comment and I too have been in the same state where I found food but had not got a clue what to do with it! Weird! I live alone too.

#9

When I was on lantus I would have severe lows over night and extreme highs after dinner. After splitting my lantus shot to a shot at 6:00 a.m. and one at 6:00 p.m. things really evened out for me.

#10

I take my Lantus in the morning. I don’t drink alcohol but heard it can cause some bad lows. Hope you’re feeling better.

#11

Oh, gosh. I really feel for you, Frankie. That sounds so scary. I live alone and share your fear of hypos while no one is around. I try to deal with the fear by keeping glucose shots everywhere: car, purse, desk, kitchen, bedroom right by my bed, etc.

My doctor just switched my Lantus to the morning (between 6 and 7) for the same reason.

I had a few night-time hypos (including one where I awoke from a sound sleep sweating, cramping and heart pounding) and now I keep four emergency glucose shots next to my bed (15 gm each). If I wake up feeling super funky, I just TAKE ONE and then test. I don’t wait.

As Rebecca found out, she had the energy to get up and go to the kitchen but then she went too low to function. If she’d just treated immediately with something at her bedside, she might have headed it off, right? This is not a criticism, just an observation – something that I learned from someone else on this site: it’s easier to correct for 15 gm of carbs that you didn’t need than to deal with passing out from an untreated hypo. I had the same experience as Rebecca last summer where I went to 36 or lower (?) I had the consciousness to dial 911 and ask for help because I was too confused to know what else to do (this was my first really bad hypo ever) but by the time the paramedics arrived I couldn’t move my arms or legs – I was a dishrag on the couch slipping in and out of awareness. Now I know to just TREAT anything that feels hinky and deal with the extra 15 grams of carbs if it turns out I didn’t need it; that’s what I do now to compensate for living alone and not having a guardian watching over me.

The yogurt may have slowed down your recovery and complicated things right at the beginning of your hypo treatment. If you’d treated immediately with the glucose tab and the apple juice (things with sugar but no fat and no protein) they would have been absorbed more quickly without the yogurt in the way. Then if you’d waited until your BG was up to a good level j

#12

Yes, definitely should not have eaten the yogurt! I was reaching for anything and everything that I knew had some sugar in it. I strongly dislike the glucose tabs but I need to at least keep a lot of juice around. I don’t drink a lot, but I am going to try not drinking at all to see if there are any changes.

#13

While all our bodies are different, I and most people, find 2 glasses of wine will drop your blood sugar significantly. When I have two glasses I’m best to keep my blood sugar around 140 before bed so I don’t drop as you did. The other lifesaver I’ve found is Extend Bars. If my blood sugar is around 100 before bed I have a few bites of the bar and it does what it says - keeps my blood sugar level overnight.

When you’re low and you still have several hours to go before eating a meal, eat glucose tabs to get your blood sugar up and some carb/protein snack to keep it more level. Also when you’re really low you’ll feel like you’re starving. Don’t give in, that will definitely get your eating too many unnecessary calories.

I’ve lived 39 years with type 1 diabetes and had a few bad lows, they happen and you learn. There may also have been something going on with your body like a cold coming on, it really is hard to tell. You might want to experiment moving your Lantus to the morning and having a glucagon kit.