Late night low

So this is what happened. I have been having troubles with highs and lows lately, although to my knowledge, I haven’t changed any of my practises in the last month or so. I have often been awakened lately buy lows, in the area of 3 -4 mmol/l in the last 3 weeks or so. I usually get out of bed and drink about 250 ml. (8oz) of orange juice, sit quietly for a while and then go back to bed.

By the way, I’m going to get professional advice on this, so don’t give me any non-professional advice about going gluten-free or vegan, or anything else.

Anyway, last night I got up with a low about 3AM. I didn’t realize at first how low I was, but I knew I didn’t have time to take a bg. I went to the kitchen, got a juice box of OJ, and as things got worse, I tried to get a glass of OJ. I got it poured, just barely as my hands were shaking and my eyes were doing funny things. I thought of calling for help, but I’m English, and we don’t call for help, it’s just not done. At this point I was unable to think clearly, and was afraid of falling on the floor and not getting up. I worked a slice of Wonder Bread out of the bag, and reached for something to put on it, so I got a jar of powdered chicken stock out of the cupboard, opened it, and tried to figure out what the hell it was, and what to do with it. That’s how disoriented I was.

At this point, my wife came in, and asked me if I was OK. I could not get any words out, but I remember shaking my head. When she assessed how bad I was she got a chair and made me sit in it. Then she asked if I needed anything. At this point, I was able to say, “I know what I want but I can’t articulate it.” (That is how I talk, OK?) Then she asked if I could use an orange juice, and I said, “That would be a good start.” She got me the drink, and I sat for a while as the symptoms abated. I had about 22oz of OJ in me at this point, so she helped me to bed, and this morning my bg was at 15.6. Too high, but livable.

I really think if my wife had not come to me, I would have fallen on the floor and died. I am sending this information to my endo, and I am going to try taking my long-acting insulin in the morning, so that if it is driving my bg down, I will feel it coming and be able to deal with it before it takes off on me. I don’t know what you may take from this, but I am now convinced I cannot live alone. Perhaps I should have thought to deal with this earlier. Who knows what lurks in the insulin bottle? Only the Endo knows.

God bless, and may all your bgs be on target.

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I’m sorry to read about your overnight hypo trouble. I do live alone and have had to deal with these kind of events by myself. One thing I will say is that the human body is resilient when it comes to low blood glucose. I’ve passed out when I’ve taken a full meal dose, when I used Regular and longer pre-bolus times, and then didn’t eat. I remember waking up, hours later, and being able to figure out that I needed glucose. My counter-regulatory systems worked and protected me from the worst effects of the low.

I know there are no guarantees but don’t sell your built-in biologic defenses short. Humans are tough.

What I’m trying to say is I understand how vulnerable you feel. It’s the worst. It undermines your self-confidence and threatens your autonomy.

You didn’t ask for any specific suggestions, so I’ll hold back here. I’ve learned some things that help me in this regard but I don’t want to give unsolicited advice.

I’m glad you survived and that you have a wife who cares about your welfare and is willing to help you. I’m also glad you’ve told your story here. You will help many people. Good luck to you!

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I know Brits are polite. I am Canadian and many of us have inherited that. When it comes to your diabetes you need not be so polite. Don’t be afraid to ask for help.
I have lived alone for many years. I agree with @Terry4 . Over the years I have had more episodes of extreme hypoglycemia than I wish to recall. Eventually I end up getting carbs into myself and I live to see another day.
I ALWAYS have Dex tabs or some other type of fast glucose next to my bed. I also carry them everywhere I go when I am awake. Whether I am at home or travelling the Dex tabs are packed in my carry on and always beside me when I sleep. If I wake up and can’t figure out why I am confused I take some tablets. Opening a bottle can be hard if you are very low. So the lid is barely closed on my bedside bottle.
You should have complex carbs after a severe hypo. Keep yogurt or cheese in the fridge. After you have Dex tabs have a slice of cheese or a few spoonfuls of yogurt to stabilize your blood sugar.
You are married. Let your wife know that she must watch you until you are able to carry a normal conversation. I have told my friends that if I end up confused and unable to carry a normal conversation they must tell me to have some sugar and watch me and chat with me until I can answer simple questions easily. There is a one questions quiz that works well very well. “What did you do yesterday?” If I can answer that question in a way that makes sense my blood sugar is not dangerously low. If I can’t answer that question my friends know that I can’t look after myself.

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That was definitely disconcerting.

Is it possible that you have been doing a few more chores around the house or had some unforeseen activity the last few days? Sometimes exercise can cause you to go low much later.

Sorry you went through that. I remember one time that I woke up very low and couldn’t figure out how to take a blood sugar. I want to second the recommendation that you keep glucose tablets by your bed. Being able to treat without getting out of bed can be a big plus.

I understand. I have survived a few low BS that make me wonder how I survived. One thing it does is make you respect the disease and the medications we need to survive. Hope you and the doc can get it figured out.

Your experience has often affected me as well. If I emailed endocrinologists about every critical low like that, their mailboxes would soon be overloaded. Once, when I was taken to the hospital for hypoglycemia, I was talking with the EMTs and they said there is one fellow in the city (population, 900,000) who has to be taken to the emergency ward three times a week on average for severe diabetic hypoglycemia.

When I started university in 1970, the dean of housing said the university did not want to let me have a room of my own, since they thought that the risks of lows occurring with no one to help would be too great. I think they probably are if you maintain strict blood sugar control, and getting married or becoming rich enough to afford a servant are good solutions for this.

omg thats very scary thank god your still alive it could be the insulin or it could be the meter giving you rong numbers be sure to have your endo check your meter to make sure its not massing up on you

Shelly: The real problem for me is that the spontaneous variation in the body’s need for insulin from day to day is so great that if I come anything close to good control my blood sugar level will often fall far below normal. One day dinner can require 10 units of Humalog, and the very next day it can suddenly require 4 units, even though it is exactly the same dinner with the same portions served at the same time of day, after I have expended the exact same amount of calories that day. So what is happening?

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I made 2 significant changes:

  1. CGM helped me determine that my basal dose was too high (I am MDI and take 1 shot of Lantus at bedtime).
  2. I let my blood sugars ride higher than I used to. I am very happy between 5 and 8 (85ish - 145ish). I hate going below 5. I don’t like going above 8 but it doesn’t bother be too much unless I get to 10 or more (>180).
    The number of hypos I have now are a small fraction of what they were a few years ago. And my last a1c was 5.9

Thank you all for the kind comments. Here’s what actually happened. I had finished taking my dose of slow acting insulin, or so I thought, this morning, when I noticed the thread on the vial was orange, not green. The vial had about two doses left in it, which means I had been taking 32u of Novorapid at night, instead of Levemir. I had accidentally put a vial of Novorapid in the pen I use for Levemir. This explains a lot, as I must have taken seven doses of the wrong insulin over a weekI had consulted with my endo, who had approved my decision to try injecting the Levemir in the morning instead of the evening, and given me some other advice. Now I shall have to humbly acknowledge my mistake. I think it’s time for a pump and a CGM.

I hang my head in shame. :frowning:

Oh, I have replenished my supply of Dex4 tablets.

No need to feel shame! Anyone who uses MDI have all made that mistake. But it is a dangerous mistake. I was transported to the ER once when I did this.

May I make a suggestion? Make your place where you inject your long acting insulin entirely different from where you inject your short acting insulin. Your nightstand table next to your bed is a good place for injecting long acting insulin since most people usually do this at bedtime or upon rising. Keep your long acting insulin and everything you need to do the injection nearby and don’t store any short acting insulin or supplies in the same place. Maybe keep the short acting insulin and supplies in the kitchen.

Maintaining different delivery places for the different insulins can be a good reminder of the different nature of these two insulins.

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Oh my. :scream_cat:

I did that once but realized it right after I injected. Glad you figured out the issue but no need for shame (we’re only human, right).

I would mark Short acting with a BIG S on the vial (in permanent marker or with tape… some way you with always know which vial is Short and which is Long) and keep the 2 vials in separate locations.

Once in my dorm as an undergraduate I woke up in a panic to find it was 9:40 and I had a class I did not want to miss at 10:00. I quickly took my daily insulin dose (in those days everyone took it once a day) and grabbed something out of the refrigerator to eat en route. In my last step before leaving, I pulled open the window curtains, and then to my amazement saw that it was dark. “Aha,” I thought, “it’s not 10 AM but 10 PM,”, and then the whole day came back to me. Needless to say, enormous corrections were required, since the dining halls were already closed for the day.

So sorry Roger 212, you had to deal with an extreme incident but thankful you’re wife was there with you. I use to deal with those all to often in fact our Cardiologist told my husband he could not leave me alone for an overnight trip. One important event has made all the difference for me, for us is my new pump. Is that something you would consider? My saving grace has been the Medtronic 670G with a CGM. It is a close loop system that will suspend or lower your dosage as needed. This has saved me from having to get up & treat. I believe in your neck of the woods it has a different #, but please check it out. Good luck :heart:

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