I don't know. Often tragic accidents happen through a cascade of failures. Correcting any one of which could have avoided the outcome. That is probably the case here.
Do the pumps even have "kill switches"on them? I don't recall running into owe but I have to admit I haven't looked for it?
I test before bed but I still generally go to bed after alcohol binges. I seem to have my sails trimmed enough that I haven't had "night sweats" for a while?
This JDRF add was a topic of discussion last November. Here is what I said at the time after reading the original paper:
I would urge you to actually read the literature on this matter. This advertisement is a serious distortion relying on a single paper which probably should never have gotten past the editors. The paper by Philip Cryer as I believe an editorial in Diabetes Care, it was probably not reviewed and is full of errors. For instance, Cryer claims that 6% of patients in the DCCT/EDIC study (15) died of hypos, but only 3 of the 1400 patients died (0.2%) hardly 6%. He cites a Norway study (16) and claims 10% of patients died, but my reading of the paper suggests 10 out of more than 2000 died of hypos, a paltry 0.5%.
I just don't beleive that 1 in 20 type 1s dies from hypos.
I attended a JDRF seminar with a neurologist as a guest speaker who talked about his research on the connection between hypos and sudden death and SF Pete's conclusion that some individuals are dying from a cardiac event as a result of hypo's matched this doctor's conclusions that an underlying coronary pathology leads to an induced fatal heart attack.
The "who" is greater at risk, are those individuals who suffer seizures while hypoglycemic. The percentage increase in morbidity when you combined seizures with hypoglycemia were actually very, very, scary and the area of study that he branched off to in mice as a result of his morbidity research, is to determine the effectiveness of anti-seizure drugs, on those at greater risk.
My 19 year old keeps his BG's levels really tight and he participates in some an-aerobic sports that have a tendency to cause your liver to dump glucose, so I have always been concerned to the extent that I have always done a 3 a.m. BG check. I am not aware of him ever having a seizure with a low BG, or at least, he's never been in a situation where he was too low, to help himself, but small seizures could occur with low BG's that don't impede one's cognitive ability and might not easily be detected.
If one were known to be prone to seizures I'd discuss keeping overnight BG's a little higher than typical, with the endo, particularily if you participate in an-aerobic sports. For those individuals like my son that have a fairly significant basal increase overnight (he does at 3 a.m.) you might also consider a nightly alarm to check your BG before that increase occurs if you don't routinely use a CGM.
My pump doesn't have a "kill switch" but does have an auto-off feature. It has to be enabled and then given a time, after which the pump will stop delivery of all insulin if no buttons have been pushed for that length of time. I have enabled this feature on my Animas Ping pump and set the trigger time to 14 hours. I believe the Medtronic pumps have this safety feature too.
That's pretty comforting for those of us who don't have seizures. I wonder how common that is...
I can't believe you get up at 3 am to test his sugar every night. That's amazing!
I had a scary time today, and survived.
My CGM buzzed at 5 am and I treated with glucose tabs. Tested at 70--hubby went to work, as I seemed fine (70 is kind of common for me.) I went back to sleep.
To make a long story short, I struggled (and felt like a drunk) all morning, never getting to BG above 35.. Finally got it together enough to call my hubbie at 11 (have NEVER in 36 years, had to do this before..)
Once I knew he was coming to save me, my head kind of forced itself to clear, and I began to think clear enough to treat myself. Was still not in a good place when he arrived, but asked him for juice, got my glucose up, had lunch and a shower, and have been fine. EXHAUSTED, but going to sleep soon.
If I can survive this, I will not die for low blood sugar in my sleep. Scary episodes? Oh yeah. But after 50 years,I am OK. Take heart, Rudidoux!
Yep, I'd make a 19 year old get up himself! (Or buy him a CGM)
When I was younger, about 8-15 on MDIs, I had quite a few night time seizures. Usually, my parents would give me a glucagon shot and honey or glucose gel. I'd wake up very sick, throwing up, but not remembering. A few times I woke up in the hospital on a glucose drip. I always assumed that if you go low in your sleep and no one's there to help, that's pretty much game over. I would go to sleep over 150. Sometimes I'd wake up low. Often, I'd wake up high, but attribute that to going to bed high. My liver has never kicked in to stop a hypo, to my knowledge. I'm relieved to know that it happens. Now I'm trying to go to bed around 135-140. A couple lows, but nothing major.
Not in my experience. Your liver may stop releasing glucagon at night, causing you to go low on just your basal. Also, the delayed effects from exercise. Not to mention, the bolus insulin stays in your system stays in your system long after your pump says it's gone. I've had a lot of problem with night time lows, even taking reduced basal at night. I usually test in the middle of the night and my wife wakes me up and checks on me in the morning. Hate to scare you, but I've had a lot of issues with this in the past.
Sorry to hear you have had a history of hypo-induced seizures..So glad that you have obtained some releif from them and have your wife to help you out; just in case a hypo occurs and you do not awaken on your own: What a blessing and how caring she is....
God Bless,
Brunetta
One real problem when you have multiple lows is that once your liver has kicked in with a counterregulation, it has become depleted of glycogen. It can take 24-48 hours for your liver to replenish glycogen stores. Subsequent lows can leave you at risk since your liver cannot counterregulate properly.
When you are young and active, you may also be prone to overnight lows due to what they call post exercise hypoglycemia. Many kids have this and it is a serious problem. It seems to be caused by the sudden uptake of glucose into your muscles as part of recovery and it can cause harsh lows even with seemingly normal levels of basal.
If you woke up high, it is likely that your liver kicked in to deal with a low. I'm glad things are better, but your story is very sobering.
I also think it is much safer to not eat and bolus before bedtime so that overnight all you have in your system is basal.
It does happen it seems, and it shows that unfortunately no matter how well prepared we are, no matter what kind of treatments they come up with, the fear will always exist that such accidents can happen. The only way to get rid of it for sure would be to find a cure for diabetes. A cure is what we need.
http://care.diabetesjournals.org/content/33/5/1004.full
Conclusions in the above report the highest incidence of nocturnal hypoglycemia occur in individuals in the 15 to 25 year old age range.
A CGM is not within our means financially to provide, so we do what we can without a CGM. He stays up much later than me, so he does his BG check before bed, usually around 10 to 10:30 p.m. and then I do the 3 a.m. It is the one piece of his D care that I still provide assistance with.
You wouldn't do the same for your kids? The biggest complaint from T1's throughout this forum is that they lack support from both family and friends. I am glad that our son has not had to share in that experience.
Thanks. I guess I'm lucky not to be "dead in bed". For the record, I now believe that all of these occurrences were avoidable. At the time, I was taking a ton of insulin. ~150u / day N+R. I was loosely following an ADA diet, and had no idea that there was a relationship between carbohydrates and BG. This all happened before the age of the internet. I did not know any other T1s, and considered these seizures normal. At the time, I was told by Doctors that hypo events like these were to be expected with tight control. I no longer believe this to be the case.
Why is this a mystery? Hypoglycemia is just a normal part of a diabetics life…I had this happen to me, but I’ve been diabetic for 32 years, so really it was only a matter of time. I’m actually surprised that it took this long!
Eric
Luckily, my brother found me and brought me back. Unfortunately I sustained some brain damage and now have problems forming new memories…but at least I’m alive…
Eric
I'm glad you're still with us, Eric. This is somewhat of a mystery, for example, because rubidoux says that she has had many night time hypos, but woke alive and well with only a high BG in the morning, because of glycogen from her liver. Why didn't yours do the same? Why didn't you and I have heart attacks and die, as it appears quite a few do? It seems there are people here who have had diabetes 20+ years that have never lost consciousness from hypos?
I SAID IT!
I will test before going to bed. I will raise my BG above 100 if it's below.
I will not go to bed after an alcohol binge.
I will not depend on only my glycogen stores.
The rest of the day I will keep my average BG above 100 so hypo plunges are minimized.
And I will set the pump's mechanisms to stop pumping as its default condition.
This post scared the crap out of me...
I've had hypos as a teenager where I wake up at 6am, take insulin, eat breakfast and went back to sleep at 7:30am, I didn't wake up until 1am the next morning, My family was out of town and I was alone. I managed to wake up and crawl to the fridge and get OJ, idk know if any of you have tried to walk and get sugar by yourself during a very low hypo, its horrible.I was confused on what day it was and the time. It took me a few hours to finally figure out what happened. I had no brain damage. Like someone said earlier in this post, we are all different and our bodies respond differently, I've had many of these episodes and I'm still alive. This post made me feel so uneasy as I am very Hypo unaware and I do not have a CGM.