One month ago we got the minimed pump and it was fairly straightforward.
A scary learning curve but manageable. Our guy (16) has done well so far,
bearing with us as we forgot to take the needle out (silhouette type, once only). there were several bent needles, so getting the correct angle with the spring loaded
device was difficult. He is very lean. My wife thought: a bigger angle and I thought: closer to twenty degrees Wife was right, closer to 40 degreed gives straight insertion- who would have thought. The shallow angle not only gave bent needles but poor performance, that is, no insulin flow.This is the one year anniversary of diagnosis T1.
Item and question: the low blood sugars. Does anyone actually know how
bad for the system these are? We have discussed seizures and loss of
control in a car or falling, But our trainer said that the body restores
a low blood sugar spontaneously after a certain period, much like
glucagon injection. What is the worse we should normally expect for our
guy? Does anyone have their stories? I will use good judgment regarding
what I read. All information is deeply appreciated, as sharing an
experience can give so very much.
I know now that highs seem more dangerous, especially after reading
about the socialite’s tragic death.
Well, I again thank you for letting me sign up. I and my wife will share
our experiences as time unfolds. Rjm (Robert)
Low blood sugars have to be treated with food, they don’t fix themselves, if that is what your trainer meant. I’ve had diabetes 31 years, starting at age 15, and sometimes I think I’ve lost brain cells due to low blood sugars, over time, but all my friends my age complain about the same thing, so maybe its just the female 40’s. As long as he has symptoms and pays attention to them, he should be fine. I’m pretty sure the socialite was a party girl with at least alchohol involved, and nobody checked on her for days. Who knows how many days she went without insulin.
Thanks Carol, sorry, I was inaccurate in my question. I wanted to know what actually has happened to people who had experienced low blood sugars. Our son is always treated for the lows, as we were taught in the hospital. My question is what are the health consequences in the real world to those (with T1) who have experienced low blood sugar. What happens to one individual is no guarantee that it is going to happen to another. Still it was intriguing that our trainer noted the body eventually gets the system out of a low. Are seizures common? Carol said, in passing, ‘loss of brain cells.’ Has there been a loss of some capacity in intelligence that is noticeable? These questions are meant with deep respect. Robert
An untreated low can cause seizures (a very real possibility) and ultimately death if left untreated.
I’ve asked that same question. I even asked my Dr. once, which was worse high’s or low’s. He couldn’t really answer I think because they each have different effects on the body. I have never been able to find an answer to this question and I’ve been looking a long time, Is it better to have more lows or more highs?? I also think it’s probably the constant up and downs that can take it’s toll. I’ve probably had at least one “severe” low a year for 36 years. That’s when I don’t remember anything and I “come to” in the hospital or on the floor with my husband shoving OJ down my throat. Problem is, my BS can go to the 30’s and I am functioning and even arguing that I’m FINE! So is that considered severe? I’ve heard that your liver (I think it’s your liver!) will kick in and start producing enough insulin to pull you out of a low at least enough to get some help and I know it has happened to me but I wouldn’t count on it.
I’ve come to my own conclusion, lows effect the brain and highs effect the body, that’s just my opinion based on how I feel with each. (Although, like Carol said, it could just be me getting old!) Would love to hear from anyone who has a more precise answer!! 
My doc told me blood sugars under 40 damage the brain because it has to have glucose to function. thus the reason people seize or faint or just act drunk.
As you work with the pump you should work to get rid of both highs AND lows.
I want to balance your feeling about highs with information about lows.
The liver provides glucose when one gets low, but it comes in such an amount that it requires correction with insulin later.
It also comes too late to prevent a person’s getting into trouble when driving. Furthermore, the more lows over a period of a half-day or day or week, the less the liver reacts again for a day or so. This is especially important when settling in on initial doses - and reductions with pumping.
The best way to avoid a bounce down is to avoid hovering at 60-70.
Correct with the number of glucose tabs that will bring up that glucose to 85-100 every time.
Glucose tabs do not require digestion to work. They work quickly in the mouth. I can count to 8 and I am already getting glucose in my brain.
You will find lots of stories on here about lows - go backwards on the site for type 1s.
The most important for a guy of 16:
One should test when one gets in a car to drive. When learning to drive, test when one enters the car. (reiterate the need in front of a friend)
One should not “think” one feels high or low. One must know and that’s by testing. CGM is 15 minutes behind.
If one stays low (60 over even a four hour period a few days in a row), one starts to lose hypoglycemia awareness. When one has lost that taste or shakiness, one gets into trouble: one’s ability to steer, to brake, to recognize events transpiring in front of one and react become impaired. It takes awhile to get hypoglycemia awareness back, but it can be restored by remaining higher for awhile.
Lows are deadly.
So now I’ll say “cheers”, glad you’re on this site, and use it for all you’re worth to help your guy initially, and so he can learn for himself on the site.
ok, here’s an experience or two, depending on what happens to pull me away from here next. These are from years ago.
- I was shredding old taxes in the basement where I have a good size shredder. Filling one big black bag after another. The next thing I knew my husband was hitting me with a straw and OJ. I hate OJ. I was lying on one of my big bags of paper shred. I told him I don’t need that. But I did. I had given myself unavoidably probably a unit more than I needed for lunch (sometimes you just can’t be exactly right on estimating grams of carbs) - on top of which, it was 2 pm, the witching hour that my morning lantus dose was hitting its peak. Oh, no one thinks it peaks. Ha. I’m here as Evidence 1. It takes me about a unit to a half a unit to go low. I’m out of it in the 30s. I had no idea I was going out. Hypoglycemia unawareness.
- I was watching a DVD in the evening with my husband. The DVD came to its end with a flourish of band music which apparently stimulated me enough & woke me up. I could not remember (to myself) how the movie ended. If I couldn’t remember that, I knew there was something wrong. I grabbed two halves of my glucose tabs - because I learned I would rather be up 13 mm/dl than sorry later. I said to myself I’ll bet I was low. I finished removing the DVD and set the TV on for my husband.
Then I tested - about 20 min. had gone on. I was 230. 230 means for me that I was low. My liver did that, but it didn’t prevent the low. I corrected immediately for the high and went to bed, actually. In the morning I was my usual 91. I could correct because i know exactly how far down one unit of short acting insulin will take me. It’s the math one needs to know. It’s delightful and it’s awe inspiring that bodies work that way.
These kinds of instances made me a believer in low carb, low insulin. In never giving more 1 unit for my 7 grams (cause that’s what works with me), In correcting immediately if I go to 70, and in periodically checking that my basal is keeping me in the 85-100 range all day and all night long. I didn’t get down to that range for a couple years. One settles the body down. One has to eliminate swings first. One goes for the jugular of standard deviations first.
Thank you all for your replies, they make a difference. Leo2, thanks for the info on the liver’s extravagant response to lows, it explains the yo-yo effect. I will let you know how it works for him. He is just getting used to some of the essentials of diabetic self care. He is also autistic which means self care comes more slowly, however, he never cheats on his meals which is a blessing.
The liver will start to produce insulin to pull us out of a low? You mean the liver will release glucose, right?
I think the safety function of the liver to release glucose should not be taken as granted. It will react to late and the amount depends on the depot that the liver has left. In my opinion a diabetes trainer should think of this mechanism as non existent for diabetics on insulin.
Lows will happen and they should be taken seriously. This means the reason should be identified and the next similar situation should be better dealt with. This is easier said than done. It is an ongoing learning process. I would not waste thoughts on the possible outcome of a low. It is our daily risk and it should be reduced with the same attention that must be paid on our highs.
Report this trainer before they kill someone.
Lows are fast in doing harm, highs are slow. That is the reality of T1D. The body may or may not recover from the lows and the continued lows experienced can really damage brain cells.
The liver may or may not be able to provide glucose, because continued exercise or low BG will deplete the ability of the liver to release glucose. Also, the more lows are experience, the less apt the liver will respond by secreting glucose. The seizure that may be a more typical response to extreme lows will not be avoided by glucose from the liver.
Get Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin for comprehensive information on what Diabetes really is and all the challenges, aspects and experiences that come with having T1D.
The socialite you spoke of killed herself with multiple drugs and not taking enough insulin to normalize here BG for a long period of time and then followed DKA which I understand killed her. This was not a quick process…pretty. She could have done it much quicker with a high dose of insulin, which can cause a heart attack.
I agree with everything Holger & S Woodward have said.
The books can help you more than a trainer. You and your 16 year old must feel in charge. You must read and continue to ask questions.
Here’s another couple experiences since you asked for them:
I was playing Scrabble, and I’m normally the winner of any game. About half way through, about 2 hours after supper, he said I had a thousand yard stare. I had misjudged a pile of veggies and given about a half unit too much insulin. (I had had a snack a couple hours before supper and the insulin from that was still working when I took supper’s insulin, and I had not given it its due diligence.) Thousand yard stares became the description he passed on to our children and grandchildren to watch for!
Another time I was reading a book. I noticed a yellow ringed dark circle that both my eyes could see when I closed my eyes. I grabbed a glucose tablet and watched as the circle receded and disappeared. It took a count of 8.
thank you Holger,Mr Woodward and Leo2 and everyone who sent us information. Our son is going through a series of lows. We are taking his BG sometimes every twenty minutes. We have noticed that bacon and other fatty and protein foods keep him more even. We are starting to see that he is becoming more aware of his lows and what he needs to prevent them. We (his parents) are not panicking but as it is apparent we are climbing the learning curve. What is rewarding is our guy is learning also. What is nice is there are three voices and his is starting to become the more knowledgeable. Everyone on this site echoes the growth of knowledge. Maybe we have a long way to go, but this site and its giving members are good to have along the way.Thanks again.
I’m sure you know this, but the most critical advice I can add is to make sure that he ALWAYS carrys some candy (lifesavers, glocose tabs) with him to treat a low. It’s a lesson we all learn.
After a couple of lows, about three or four months after dx, he wanted to bring his glucose meter (in addition to carrying glucose tabs). He is doing a mature job of assessing his needs. Curiously, he usually goes low while at the Mall. We think it is because of the strain of being social which is a big stressor for an autistic individual.
Walking a mall is a sure way for me to go low. I have learned to pop 2 ever available halves of glucose tabs at the beginning; then I test an hour - 2 hours later. It’s exercise and what it does to an individual’s body. That, too, is individual.
Oops, right.
I would support this decision of his if you haven’t already. I found a pocket-sized case to hold my meter, syringes, two bottles of insulin and test strips (obviously you just need the meter and strips since he’s pumping) and I never leave the house without it, whether I’m walking to the post office or flying to Japan. It’s always in one pocket, lifesavers in another, wallet in another.
Could also be all the walking in the mall that causes the lows - stress tends to make me go high but this is different for everyone.