Kittie, thanks. Don't even want to think about what would have happened if he hadn't been home. Am very grateful to still be around! EMS got to our house in less than 2 minutes. They were so nice & kind. Told me that they've been called to hypo events with some very uncooperative patients.
Oh dear, hate to hear about your seizure. So sorry. Holy cow, two glucagon shots & IV dextrose! Amazing you weren't higher than 8.9 after all that. Know what you mean about gathering your brain cells. Sure I lost quite a few from today's episode. What do you think caused your fingers & right side to be numb & weak? Hope all that will be better. Thank heaven for husbands & paramedics. I wanted to hug the three EMS guys.
Was terrifying not to be able to move or talk. I thought I was calling out for my husband, but no words came out. He came upstairs to check on me because I was taking a nap & didn't wake up. Said I was making gurgling noises. Best I could do.
Hi Robyn,
Oh no, double doses. Geesh, glad you're ok from that. Can understand how stress could do that. Hard to think straight, or think at all. How are the beautiful peepers?
I feel ok now, other than wiped out. Still high, but I don't care.
At the family reunion on the Outer Banks, they turned into space aliens and I leaped over the couch to "escape". Fortunately my cousin, who's huge and a former EMT (in the army!) tackled me before I tried dashing down the stairs!
I do hope your endo can help you. One thing I would suggest is thinking about everything in your life that may have changed. For instance, Apridra (and other insulins) do interact with other drugs (and foods). For instance, the antibiotic Gatifloxacin is contraindicated for diabetes and can have a major interaction with insulin. More than 600 drugs are listed as having moderate interactions with insulin. Many of them are things which you probably may well have in your medicine cabinet and consider "safe," like aspirin. Salicylates, in general, interact with insulin and are found in a variety of foods as well as in medicines, perfumes and preservatives. And it may not be some drug (or food) you started taking, but one you "stopped" taking.
You may also find that foods or supplements have caused some sort of disturbance, like in your electrolytes. An example is salt, sodium levels in your body actually make a huge difference in your insulin resistance. If your sodium levels jumped, that may have made you more insulin sensitive, enough to cause a hypo. And since we have had hot weather, it is possible your hydration and electrolytes may have gotten off.
But generally, none of these things would suggest why you would suddenly go hypo 7 hours afterwards. So I'll give you a couple of other things to consider. First, what about gastroparesis? We know that gastroparesis can cause food to get "stuck," but it can also cause gastric dumping syndrome and when that occurs it can trigger a set of signals which can cause a hypo. In particular, when food passes in your digestive tract, signals are sent to the liver to suppress glucose production and your basal which is supposed to offset that glucose production results in a hypo.
And finally, there are some medical conditions which can cause sudden hypos. Addison's disease (adrenal insufficiency) can cause things, and it could also be stress related and if there is something going on with your pituitary, it secretes eight important regulatory hormones that signal the pancreas, thyroid and adrenals (as well as other things).
So you might need to get your head examined. I mean that in the nicest way.
I know I have listed some scary things, and I am sorry. You are a good friend and I hope you figure this out.
Lantus does bind to fatty tissue of the skin thus it will be a problem if injected into the artery. However with Levemir this is different. It is binding to albumin of the blood. Thus is makes no difference if you hit an artery or not. This is one of the reasons why it is more reliable than Lantus.
I think bsc has made some excellent points here. I am also willing to accept the appearance of freak lows. However it is the rate and the cause that makes the difference. 1 freak low per year would be acceptable but two in a row? I had phases in my life were I hesitated to inject the insulin due to unexplained lows. I tried to focus on the mechanics of diabetes to keep the fear at bay. With more testing you will identify lows earlier. You could also ask your endo to have a CGMS for one or two weeks (pay the sensors out of your pocket if necessary). This will help to regain confidence in your actions.
The following are just some ideas for the cause of the lows:
-liver stopped releasing glucose: effect known from alcohol. Here bsc suggested that this might be due to gastroparesis = issue with orchestration of digestion. The thought of a drug interaction came also to my mind.
-kidney related: the kidney are clearing the insulin from the blood stream. If this clearance works less effective the insulin can keep its potency for longer periods of time. But to me this would happen gradually not all of a sudden.
-menopause related: hormonally induced disturbances of blood glucose.
-your meter was/is off: you just thought you are higher but in reality you had 70 before instead of the measured 120 or the like. Just some physical activity on top and you went low.
@Garry: do you have a Glucagon kit in the house?
Late to the discussion, Gerri, but thankful that you are here to share. Keep us posted as to what doc says? Take care, and thank your husband for all of us.
Glad you're okay. I've certainly been there. I've found that if you are preoccupied about something, or dealing with a new situation, your brain sponges a lot of glucose, and you can go very low, very fast from too much thinking. To make matters worse, I believe, once the brain is slightly out of gear, it is easier for a low to push you into semi or unconsciousness. Gary Scheiner makes reference to this in his book. It makes sense. I used to get low a lot if I was playing chess.
Gerri, I'm so sorry this happened and so thankful that you're ok. Please let us know how your appointment with your doctor goes. You've gotten some great advice here already but I'll add my experience anyway in the hope it helps.
I had similar fast severe lows about 6 months ago. At the time, I was taking injections of Lantus and Humalog, which I had been taking with no problems for many years. All of a sudden I began having repeated rapid drops of up to 100 points about 6 hours after I took my Lantus injections.
After one severe episode where my hubby had to give me a glucagon injection, he freaked out just like your husband. His words to me were "let's not do that again, ok?" and I was like "ok I'm right there with you on that". My husband also insisted that I talk to my endo.
My endo said the first thing that comes to mind with rapid drops in the evening/night are kidneys. So you may want to ask to be retested. My endo also said we would probably never know what caused it.
He also reduced my Lantus dosage, set higher bg targets for a while, told me to eat more carbs for a while, changed the timing on my Lantus to give the evening dose earlier and take it after dinner with carbs.
Like you, I was afraid to take insulin after these episodes and let my bg run higher and corrected less aggressively for a while. I never did figure out what caused it although I suspect it was the Lantus, perhaps in combination with female hormones.
I've since gone to a pump where I can set different basal rates and the problem immediately went away. The weird thing though is that my basal requirements at night now are *much* higher than during the day. Since I was dropping at night on Lantus, I would not have expected that.
We would all make great detectives, I think. I feel like we have to be super-sleuths to figure out what's going on with our Diabetes. Between that and the real work I do I feel like all I ever do is try to solve riddles and puzzles!
Good luck and I hope you find a solution to this. Please let us know how you're doing and take care. :)
Nothing really to add that hasn't been said except I'm SO glad you're ok, and it scares me just thinking about it! So... here's the culprit, do with him as you wish :)
Hi Gerri. If you wind up thinking that basal played a role in these lows, you could actually split your dose of Levemir into three shots. I have to do this because after almost 20 years of Type 1, I still make some insulin from about 11:00AM to 3:00PM, and have to have a minimal amount of Levemir during those hours. While taking those three doses is a real nuisance, it does fit in with the small input, small problem idea. I've been waking up low for the last few days, and just lowered my nightly dose by 1/2 unit which worked. At any rate, good luck, and I'm really glad you're OK now.
AHHHHHHHHHHHHHHH! EVERYBODY RUN!!!!!!!!!! ;)
Wow! Are you sure they're not space aliens:)
Thanks for sharing. Kidneys--how interesting. I had bad lows the entire time I used Lantus, even at lowered doses & split doses. It had consistent peaks for me. My doctor didn't believe me & it was a battle to get changed to Levemir. Hope he doesn't suggest Lantus again. Like you, I need higher basal doses at night & I must need to lower daytime basal. That's my plan for today. Can really pass on another episode like yesterday's.
We are super sleuths. Perfect description. Need some initials after our names. DPI (Diabetes Private Investigator)? DD (Diabetes Dectective)?
Get me the poison dart gun! That's great. Helps to have a picture of the demon.
Great idea, Trudy. When do you take your three doses? Thanks!
The time remains the same all year; the amounts get lower and lower over the summer. Right now: 8:00AM, 1 1/2 units; 3:00PM, 1 1/2 units; 9:00PM, 4 1/2 units. I use a Levemir pen, so I have to use syringes now rather than pen needles.
Hmmm, didn't even consider that. This is why I appreciate you all. No doctor would offer things like this. I read Gary's book some years ago & don't remember that. Need to re-read to learn what else I missed. I barreled through it hoping to learn everything at once. I definitely had a low, that wasn't even a horrific low, push me into an almost unconscious state. Less serious thinking is in order:)
I will. Hard to express to someone how you feel when they've saved your life (twice). About every 10 minutes, I'd say, "thank you, baby" with tears in my eyes. At one point he said, "Enough of the thanks. How about a bottle of 24 year old single malt Scotch instead?"
Thanks, sweetie.