Repeated Hypoglycemia May Not Cause Brain Damage

I am really glad to hear there were meaningful consequences for this nurse -- not because I'm vindictive, but because of the nature of the job. One mistake can kill.

I'm not familiar at all with the training, but I'd be absolutely shocked if it doesn't require a finger-stick check before administering any treatment to correct BG, or cover food.

Anyone know?

Of course everyone should watch for and treat hypos. I don't know what more we need to know about this condition. And some of us know way more than "very little". A ton of long timers have quite a bit of cumulative experience with hypos and hypo activity.

And there actually is published science / research / and conclusive results from the NIH and NDIC where they say from the DCCT and EDIC Follow-up Study:

"What are the risks of intensive treatment? In the DCCT, the most significant side effect of intensive treatment was an increase in the risk for hypoglycemia, also called low blood glucose, including episodes severe enough to require assistance from another person.When blood glucose falls too low, a person can become confused, behave irrationally,have seizures, lose consciousness, or even die.

The good news is that such episodes, while dangerous at the time, do not lead to a long-term loss of cognitive function—the ability to perceive, reason, and remember—as scien­tists originally feared. Researchers recently reported this finding after examining 1,144 of the original DCCT participants a mean of 18 years after enrollment in the DCCT."

I consider under 70 a low but I still would agree that I feel MUCH worse when high than when low (if I go high my anxiety gets very severe and I also get severely depressed. I only get mildly anxious with hypos as far as I can tell and it makes a major difference on how I handle things with my treatment) . I'm quite happy in the upper 70's to 80's most of the time and trying to be in a target of 7% would be silly for me. I've maintained an a1c less than 6% since November with minimal and mild hypos that I can always treat without help .

Granted my endo is proud of me and not too concerned about my a1c being where it's at as long as I'm 1. Not having multiple lows every single day 2. Not having severe lows that require assistance ...just to maintain that a1c. Which I don't. My endo understands I do not like having blood sugar that's higher than 180-200 mg/dL and that I want to keep lower than that the best I can (with understanding that perfectionism is a no go but it's possible to stay under there without anything risky to my health) .

Richard, my endo has type 1, and has had it for at least 40 years. It is a lot easier I THINK to have an endo with type 1. My endo was diagnosed at the same age as me (and his daughter was also diagnosed in her 20's with type 1, complete with a misdiagnosis similar to mine) where there's a lot of understanding between us on how it works. Granted, I do tend to find my CDE is also a great person, and she doesn't have diabetes. Her settings for my pump (when I used it) were a lot better than my endo's recommendations , though on mdi they're both pretty equal on it and what they suggest on mdi is what works pretty well for me and I've modified it very little since first going on insulin at all. It's easier to have and endo where you can ask what works for you? personally instead of what works based off studies and other patients alone. Adds another perspective into the mix.

Hi Dave:

That's the scary part. She DID test my blood glucose but still gave me my Insulin since breakfast was at the foot of my bed. She obviously had no clue about what she was doing. She was young.

I'm spiritually cutting her some slack, because it never feels good to be harsh. I gotta wonder, though, what kind of training did she have? What are nurses taught about diabetes, and diabetes management?

This seems like an awfully gross mistake to make, unless one was ignorant.

Seems I offended you. Not sure how/why, but sorry I did!

Do people die from hypoglycemia? Even today?

Sure do.

Just sayin'...

Also, while there are plenty of well-experienced diabetics on this site who certainly need no cajoling from me to manage their condition (Richard especially -- I'm not the least bit worried about him), keep in mind there are all sorts of people here -- newly diagnosed, youth, those that have ignored or neglected their disease, people in denial, etc. etc.

Unless you are claiming that hypoglycemia can not cause brain damage (which is not what the referenced article was saying), I'm really at a loss to see what you find objectionable to what I posted.

Finally, the published follow-up studies, and their conclusions, that you reference are precisely my point in saying we know very little -- in science, particularly medical science, that information is encouraging, but in terms of well-understood correlation/theory, it ain't squat.

That's the sort of thing that can lead to research to find out and develop a complete theory of metabolic behavior while hypoglycemic. The fact is, this sort of research simply hasn't been done. So, to a large extent we're operating based on personal experience, anecdote, and a small number of passive follow-up studies showing correlation.

Thin gruel for making definitive statements about the risks of hypoglycemia and neurological damage that people can rely on.

That sounds great, I wish I had that experience with a T1 endo. My endo has a lot of experience, but she kinda goes by the book, and expects all of us to follow the same pattern, without much variation. I cannot convince her that we are all different, in many ways.

Exactly the kind of doctor I wouldn't want lol. My endo seems to be pretty flexible with how I manage it, as how I manage it is what works for me.

Dr. Bernstein (and i) don't believe that tightening control leads to increase in hypoglycemic events, IF you eat low carb. I take very little insulin and hardly go low at all (and not high either, of course). A1c 5-5.3