Calling All Diabetic Experts

[Mobi]

Last night I had a massive hypo.

i went to bed late - about 2.a.m (no alcohol,) and took my overnight insulin without checking my blood sugars.

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

I struggled downstairs and grabbed 2 cans of coke (the last 2!!) some glucose tabs and some Kit kat chocolate biscuits. By this time I was nearly out of it. My heart was pounding so hard I thought it would break through my chest.

I managed to swallow all my stuff in double quick time, but still felt awful. Usually this amount of stuff would be enough to raise my sugar levels within minutes, but when I finally took a test, it was still under 50 (that's 2.7 in UK measurement). I've had hypos this low before - but that's at the start - before I've taken all this sugar - not after I've taken it. I found some more sugar, and the next reading was finally a bit better.

I reckon my blood sugars must have been very close to 18 (or 1). If I hadn't woken I would surely have passed out and died.

After a while I fell back to sleep, only to be continually woken with cramps in my calf muscles, which were excruciatingly painful and made me jump out of bed.

Today I don't feel great.

My diabetic specialist is out of the country.

Do you reckon I should see a doctor for a check up, or just be more careful with testing my sugars and adjusting the insulin. I was at the hospital last week and everything was fine.

Does anyone know if a really low blood sugar level can do any permanent harm?

Any advice would be appreciated.

thanks

Mobi

[johnb]

Mobi

I'm no expert and only have type 2 but I would strongly recommend that you have a blood test that will show youre average levels over the last three months.

Hopefully it was just that you injected more insulin than was necessary

Best of luck

Johnb

[Who, me ?]

Last night I had a massive hypo.

i went to bed late - about 2.a.m (no alcohol,) and took my overnight insulin without checking my blood sugars.

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

I struggled downstairs and grabbed 2 cans of coke (the last 2!!) some glucose tabs and some Kit kat chocolate biscuits. By this time I was nearly out of it. My heart was pounding so hard I thought it would break through my chest.

I managed to swallow all my stuff in double quick time, but still felt awful. Usually this amount of stuff would be enough to raise my sugar levels within minutes, but when I finally took a test, it was still under 50 (that's 2.7 in UK measurement). I've had hypos this low before - but that's at the start - before I've taken all this sugar - not after I've taken it. I found some more sugar, and the next reading was finally a bit better.

I reckon my blood sugars must have been very close to 18 (or 1). If I hadn't woken I would surely have passed out and died.

After a while I fell back to sleep, only to be continually woken with cramps in my calf muscles, which were excruciatingly painful and made me jump out of bed.

Today I don't feel great.

My diabetic specialist is out of the country.

Do you reckon I should see a doctor for a check up, or just be more careful with testing my sugars and adjusting the insulin. I was at the hospital last week and everything was fine.

Does anyone know if a really low blood sugar level can do any permanent harm?

Any advice would be appreciated.

thanks

Mobi

I feel really sorry for you, and wish you feel better quite soon.......

One point caught my attention......you talk about cramps in the calf.......I suffer same things quite often, either during day or night, without warning.....Is it a symptom of Diabete ?

Thanks

[Tywais]

I feel really sorry for you, and wish you feel better quite soon.......

One point caught my attention......you talk about cramps in the calf.......I suffer same things quite often, either during day or night, without warning.....Is it a symptom of Diabete ?

Thanks

As above, hope you get it sorted out soon. As for calf cramps, I get them occasionally and sometimes quite painful. I figure it's too much sugar intake before going to bed, at least for me - non-diabetic. There was a topic on this a long time ago (foot/leg cramps) so not uncommon here it would appear.

[Mobi]

I feel really sorry for you, and wish you feel better quite soon.......

One point caught my attention......you talk about cramps in the calf.......I suffer same things quite often, either during day or night, without warning.....Is it a symptom of Diabete ?

Thanks

I'm not sure _ was hoping someone might know. I used to get leg cramps sometimes when I drank too much, but I haven't touched alcohol for 8 months. It's too much coincidence that I got them after a massive hypo.

Hi John,

Thanks for your concern

I do blood test several times a day and have up to date, downloaded records of my averages etc. As I said I was at the specialist last week and all was fine.

Maybe it was just a one off and I need to be more careful. I'm just worried about permanent damage - maybe to my brain?

[Who, me ?]

I feel really sorry for you, and wish you feel better quite soon.......

One point caught my attention......you talk about cramps in the calf.......I suffer same things quite often, either during day or night, without warning.....Is it a symptom of Diabete ?

Thanks

As above, hope you get it sorted out soon. As for calf cramps, I get them occasionally and sometimes quite painful. I figure it's too much sugar intake before going to bed, at least for me - non-diabetic. There was a topic on this a long time ago (foot/leg cramps) so not uncommon here it would appear.

Thanks for the comment. Will do my homeworks and see what has been said then

Cheers

[Tywais]

Found this about diabetes and cramping.

"A problem with muscle cramps can sometimes be a problem with the muscle not being able to function properly due to a lack of proper electrolite balance. Potassium (K), Calcium (Ca), and Magnesium (Mg) are absolutely essential for a muscle to be able to properly fire....and to properly relax. If there is a lack of these minerals in the body, the muscle can temporarily lose the ability to relax and, therefore, cramps. Try taking K, Ca, and Mg suppliments regularly and see if that doesn't make a huge difference.

This could also be the effect of insulin resistance. I'm not sure of your weight or sugar intake, but if you have too much sugar or processed crap in your diet for a prolonged period of time, the body goes into what is called insulin resistance. Insulin is an anabolic hormone that also serves to store calcium and magnesium. Insulin resistance, by these means, can be a cause of not only muscle cramps, but osteoporosis and hypertension as well.

(If you think about it, the middle wall of your blood vessels is a muscle. If it can't relax, it becomes constricted. If the blood vessels become constricted, then the same amount of blood has to travel through an all around smaller maze of vessels. The result is hypertension or high blood pressure.) "

Source: WiKi - leg cramps

[johnb]

I feel really sorry for you, and wish you feel better quite soon.......

One point caught my attention......you talk about cramps in the calf.......I suffer same things quite often, either during day or night, without warning.....Is it a symptom of Diabete ?

Thanks

I'm not sure _ was hoping someone might know. I used to get leg cramps sometimes when I drank too much, but I haven't touched alcohol for 8 months. It's too much coincidence that I got them after a massive hypo.

Hi John,

Thanks for your concern

I do blood test several times a day and have up to date, downloaded records of my averages etc. As I said I was at the specialist last week and all was fine.

Maybe it was just a one off and I need to be more careful. I'm just worried about permanent damage - maybe to my brain?

Mobi

Thanks - I hope as you said its just a one off especially as youve just seen the specialist

All the best

Johnb

[Pattayatony]

Last night I had a massive hypo.

i went to bed late - about 2.a.m (no alcohol,) and took my overnight insulin without checking my blood sugars.

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

I struggled downstairs and grabbed 2 cans of coke (the last 2!!) some glucose tabs and some Kit kat chocolate biscuits. By this time I was nearly out of it. My heart was pounding so hard I thought it would break through my chest.

I managed to swallow all my stuff in double quick time, but still felt awful. Usually this amount of stuff would be enough to raise my sugar levels within minutes, but when I finally took a test, it was still under 50 (that's 2.7 in UK measurement). I've had hypos this low before - but that's at the start - before I've taken all this sugar - not after I've taken it. I found some more sugar, and the next reading was finally a bit better.

I reckon my blood sugars must have been very close to 18 (or 1). If I hadn't woken I would surely have passed out and died.

After a while I fell back to sleep, only to be continually woken with cramps in my calf muscles, which were excruciatingly painful and made me jump out of bed.

Today I don't feel great.

My diabetic specialist is out of the country.

Do you reckon I should see a doctor for a check up, or just be more careful with testing my sugars and adjusting the insulin. I was at the hospital last week and everything was fine.

Does anyone know if a really low blood sugar level can do any permanent harm?

Any advice would be appreciated.

thanks

Mobi

Mobi,

I hope you had a better night last night and your journey today will be full of surprises

Cheers Tony

[tropo]

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

Mobi, is everything alright between you and your wife. She wasn't around at 4 am and there were no glucose tablets in your bedroom.

[Mobi]

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

Mobi, is everything alright between you and your wife. She wasn't around at 4 am and there were no glucose tablets in your bedroom.

Since you ask - No.

But that's another story.....

[zzdocxx]

Sure Mobi you need to see a competent physician and get the bugs worked out of whatever routine you have going.

While it is important to control your blood sugar, you can die alot quicker from too low blood sugar than you can if it gets somewhat high.

When did you take your "overnight insulin"? Was it at 2am?

You have got to be careful.

A "Hemoglobin A1c" blood test will give an idea as to whether control of your blood sugar has been good over a month or two period. Usually a lower number is considered desirable. Your main concern at this time, however, is to make sure you don't bump yourself off (via self-induced hypoglycemia).

I am gonna go out on a limb here about the leg cramps and guess that they could be caused by the combination of the blood glucose (from what you ate) combined with the action of the insulin, which causes potassium to be transported (along with the glucose) from the blood, into the inside of cells, thereby causing low potassium levels in the blood.

Good luck.

Edited August 17, 2007 by zzdocxx

[Mobi]

Sure Mobi you need to see a competent physician and get the bugs worked out of whatever routine you have going.

While it is important to control your blood sugar, you can die alot quicker from too low blood sugar than you can if it gets somewhat high.

When did you take your "overnight insulin"? Was it at 2am?

You have got to be careful.

A "Hemoglobin A1c" blood test will give an idea as to whether control of your blood sugar has been good over a month or two period. Usually a lower number is considered desirable. Your main concern at this time, however, is to make sure you don't bump yourself off (via self-induced hypoglycemia).

I am gonna go out on a limb here about the leg cramps and guess that they could be caused by the combination of the blood glucose (from what you ate) combined with the action of the insulin, which causes potassium to be transported (along with the glucose) from the blood, into the inside of cells, thereby causing low potassium levels in the blood.

Good luck.

Thanks for that.

Yes, as I haven't had any cramps for ages , and then I get a whole load of them in both legs, immediately following a severe hypo and imbibing loads of sugar, even my feeble mind concurs that it must all be connected.

I do try to be careful and I am for 99% of the time. It's that 1% when I get careless that things go wrong, and it's sods law that on those occasions, there's no one around to help.

PS _ yes, My insulin was taken at 2 a.m. This is the slow acting type. Then I take fast acting insulin (Humalog) with each meal. My blood sugars were obviously very low before I took the overnight shot. I usually check, but at 2 a.m. I was too tired so didn't bother!!!

Edited August 17, 2007 by Mobi

[tutsiwarrior]

always recommended to check the BG before injecting...I always do and then think about what I'm about to injest in the way of glucose producing alimentation then measure the units accordingly...

I've only had one perilous low BG episode that was when I just got outta the hosp. after discovering diabetes and being treated for ketoacidosis ( )...I took the doctor's recommended insulin dosage without checking BG and started to feel weird out on a power station construction site...good thing I wasn't up onna scaffold! Managed to leg it back to the office where I had stashed sugary stuff for that purpose...

now...I do lie sometimes...where I live in Suphanburi I can't find test strips for my BG meter anywhere so I often go for days, sometimes weeks without any BG measurement. As I keep a daily record I average previous BG readings and then inject myself with the average dosage when no strips are available...what else is a beat, diabetic falang to do?

[Sheryl]

Mobi,

Sorry for late reply, Tony had alerted me to your post but I weas caught up in a work presentation and forgot to check til now...

Anyhow: the severity of this hypo is such that unless there is an obvious explanation (such as having skipped dinner or eaten unusually little..or had a bit to drink) then yes, you had better see a doc ASAP.

And yes, hypoglycemic episodes can cause permanent brain damage, including coma/persistent vegetative states, as well as death.

NEVER ever ever again take insulin at night without checking your blood sugar!! When you are awake you'll detect signs of a hypo early on but as you found out, during sleep you won't.

But there remains the mystery of why your sugar was apparently so low before you took the insulin, so as I said, unless there is a clear reason why that you know, best see a doctor at once.

Stress affects both blood sugar and insulin requirements, also stress can disrupt normal eating patterns. Your insulin (esp the nightime dose) may need adjusting

Alcohol use will also play havoc with it, sending sugar skyrocketing first and then plummeting downward, had you been drinking befiore this happened?

take care

Sheryl

Edited August 17, 2007 by Sheryl

[Mobi]

Mobi,

Sorry for late reply, Tony had alerted me to your post but I weas caught up in a work presentation and forgot to check til now...

Anyhow: the severity of this hypo is such that unless there is an obvious explanation (such as having skipped dinner or eaten unusually little..or had a bit to drink) then yes, you had better see a doc ASAP.

And yes, hypoglycemic episodes can cause permanent brain damage, including coma/persistent

vegetative states, as well as death.

NEVER ever ever again take insulin at night without checking your blood sugar!! When you are awake you'll detect signs of a hypo early on but as you found out, during sleep you won't.

But there remains the mystery of why your sugar was apparently so low before you took the insulin, so as I said, unless there is a clear reason why that you know, best see a doctor at once.

Stress affects both blood sugar and insulin requirements, also stress can disrupt normal eating patterns. Your insulin (esp the nightime dose) may need adjusting

Alcohol use will also play havoc with it, sending sugar skyrocketing first and then plummeting downward, had you been drinking befiore this happened?

take care

Sheryl

Hi Sheryl,

Thanks for your reply, and please don't aspologise for the delay. You are a very busy lady saving all those sickies out there.

To answer your questions.

I haven't drunk any alcohol for 6 months (192 days today)

I guess I have been under stress lately, and my appetite is not so good. On the evening in question I had a small evening meal, some ground beef, and a small portion of rice, and I probably took my usual dose of insulin with it. Obviously too much, and by 2 a.m. my BG was probably already quite low.

I have had these early morning hypos several times in the past few months, but this one was the worst by far. Scared the living shit out of me.

I promise I will be more careful. I reckon I'm good for a few more years yet, and have no wish to go ahead of time

[Sheryl]

Mobi, If you've had several early morning hypos then I think your evening/night time insulin doses need some adjustment. If your regular doc isn't coming back soon you might do well to consult someone else. If he/she will be back soon, make an appointment to see them as soon as they are back.

And since stress plays havoc with both appetite and insulin levels, be extra vigilant about monitoring your sugars during this time.

[khunmarc]

Last night I had a massive hypo.

i went to bed late - about 2.a.m (no alcohol,) and took my overnight insulin without checking my blood sugars.

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

I struggled downstairs and grabbed 2 cans of coke (the last 2!!) some glucose tabs and some Kit kat chocolate biscuits. By this time I was nearly out of it. My heart was pounding so hard I thought it would break through my chest.

I managed to swallow all my stuff in double quick time, but still felt awful. Usually this amount of stuff would be enough to raise my sugar levels within minutes, but when I finally took a test, it was still under 50 (that's 2.7 in UK measurement). I've had hypos this low before - but that's at the start - before I've taken all this sugar - not after I've taken it. I found some more sugar, and the next reading was finally a bit better.

I reckon my blood sugars must have been very close to 18 (or 1). If I hadn't woken I would surely have passed out and died.

After a while I fell back to sleep, only to be continually woken with cramps in my calf muscles, which were excruciatingly painful and made me jump out of bed.

Today I don't feel great.

My diabetic specialist is out of the country.

Do you reckon I should see a doctor for a check up, or just be more careful with testing my sugars and adjusting the insulin. I was at the hospital last week and everything was fine.

Does anyone know if a really low blood sugar level can do any permanent harm?

Any advice would be appreciated.

thanks

Mobi

reading your post here Im a medic by trade not a doc LOL

but about the cramping its related to the hypo attack causing dehydration /depletion of the salt/ mineral balance in your body Id say use stuff like gatorade instead of coke for a quick fix if anythung your specialist must have stress diet to help control the symptoms ... if not get another doc !!!!!!!!!!!!!

and your drinking days are over... unless you like to be comatose!!!!!!!!!!!! good luck

[zzdocxx]

Update please?

[Mobi]

Update please?

Well I haven't seen a Doc yet.

I've been very careful about my overnight insulin - i.e. checking my BG

No more cramps

Several day time hypos, which were a bit distressing.

That's about it.

[Sheryl]

Mobi, clearly your insulin schedule needs a downward adjustment. See your doctor!

[Mobi]

Mobi, clearly your insulin schedule needs a downward adjustment. See your doctor!

I honestly would if I felt there was a specialist out there who I had any confidence in.

Even my current doc - who is out of the country, doesn't exactly inspire me with confidence - just a very quick, superficial examination of my records etc. and very little time to investigate hypos and the like.

It's never been the same since I had to leave my Harley Street Doc back in the UK.

Ah well the joys of living in LOS.

I'll just plug away trying to make my own insulin adjustments.

Trouble is, one minute my BG's are too high and the next I'm having hypos.

[zzdocxx]

OK sorry but I don't know where you are located.

In what specialty does your regular physician practice?

It may be worthwhile to look for an(other?) endocrinologist in your area.

Good luck.

Edited August 26, 2007 by zzdocxx

[Mobi]

OK sorry but I don't know where you are located.

In what specialty does your regular physician practice?

It may be worthwhile to look for an(other?) endocrinologist in your area.

Good luck.

I live near Pattaya, but I attend one of the top specialists at Bumrungrad ,so I don't think I can do muchg better in Thailand.

Somehow, I just don't think the endocrinologists are geared up to gve the sort of personal attention I seek. They tend to treat all Thai patients as children and adopt a 'we know best' attitude, and are reluctant to discuss specific treatments or changes in medication at any great length. Maybe they're just too busy.

[Sheryl]

Mobi,

1. Are your eating habits regular and consistent? If you are skipping meals or eating at odd times this would account for the yo-yo effect. No insulin regimen is going to work unless matched by a regular eating pattern...and avoidance of highly processed carbs.

2. You really need to keep looking for a doctor. There are good ones out there. Suggest you try:

Bumrungrad:

Dr. Apichati Vichayanrat. 30 years experience, he is a Professor of Medicine at Mahidol University and U.S. board certified in endocrinology. Hours: Sat 16:00 - 18:00. His hours are limited due to his teaching responsibilities.

Bangkok Hospital:

Dr. Chaicharn Deerochanawong. About 20 years experience. Did a fellowship in diabetes and endocrinology in the U.K. Hours: Mon & Thurs 16:30 - 18:30

Dr. Sithiphol Chinnapongse. US trained, board certified in the US in both Internal Medicine and Endocrinology. Younger, about 12 years experience. Hours: Mon-Fri 7 AM - 1 PM

(Note: I have no personal experience with any of the above, just going by qualifications)

Edited August 26, 2007 by Sheryl

[Mobi]

I know you're all goping to say "I told you so", but last night it happened again. This time, it was even worse.

I went to bed about 12.30 am. and checked my BG - about 130 - not too bad, and should have been a high enough to 'support' my overnight slow acting insulin. I injected 24 units.

The next thing I knew it was 1.30 a.m. and my heart was pounding so hard I was sure it was going to burst through my chest. I couldn't move, but I moaned. The wife - who was home this time- woke up, rushed to get me some sweet drinks and literally poured them down my throat and force fed a load of chocolate. I could never have done this if I had been alone. In fact I thought I wouldn't get out of this one, and it was a good half hour before my heart slowed and my senses started to return to normal. I eventually felt well enough to test my BG, and even then it was only 45 - so God knows what it was before. I was still in a hypo and took a load more sugary stuff and drinks and after another hour it climbed to about 80.

Now, I had a small evening meal at around 7 p.m. - probably less than normal, but I downwardly adjusted my fast acting insulin to take this into account.

I really don't understand what's going on and why my BG should have plummeted so quickly and violently.

The last time I saw my specialistic she told me to increase my overnight insulin as my morning BG readings were too high!

Beats the H..ll out of me

[mikethevigoman]

Mobi go and see someone, dont take any chances with this, something in you may have changed, its for peace of mind if nothing else,.

[mikethevigoman]

Around 4 a.m woke feeling terrible and knew I had a hypo coming on. There were no glucose tablets in my bedroom - nor any Coke, which is usually kept there for such emergencies. The wife had buggered off and no one around to help.

Mobi, is everything alright between you and your wife. She wasn't around at 4 am and there were no glucose tablets in your bedroom.

Since you ask - No.

But that's another story.....

Some of us remembered that, you really arent having a good time are you,. get some friends around you Mobi,. Edited August 28, 2007 by mikethevigoman

[Nienke]

Mobi, can you please please please take action! Especially follow Sheryl's advice!!!!!!

You've got a major warning before, and now this second one which was even worse than the first one, according to your own saying. You really want to risk a third one?

GO TO A DOCTOR TODAY!!!!!! before it's too late.

Nienke

[thaigerd]

I know you're all goping to say "I told you so", but last night it happened again. This time, it was even worse.

I went to bed about 12.30 am. and checked my BG - about 130 - not too bad, and should have been a high enough to 'support' my overnight slow acting insulin. I injected 24 units.

The next thing I knew it was 1.30 a.m. and my heart was pounding so hard I was sure it was going to burst through my chest. I couldn't move, but I moaned. The wife - who was home this time- woke up, rushed to get me some sweet drinks and literally poured them down my throat and force fed a load of chocolate. I could never have done this if I had been alone. In fact I thought I wouldn't get out of this one, and it was a good half hour before my heart slowed and my senses started to return to normal. I eventually felt well enough to test my BG, and even then it was only 45 - so God knows what it was before. I was still in a hypo and took a load more sugary stuff and drinks and after another hour it climbed to about 80.

Now, I had a small evening meal at around 7 p.m. - probably less than normal, but I downwardly adjusted my fast acting insulin to take this into account.

I really don't understand what's going on and why my BG should have plummeted so quickly and violently.

The last time I saw my specialistic she told me to increase my overnight insulin as my morning BG readings were too high!

Beats the H..ll out of me

Dear Mobi,

I am a diabetic and it looks we are using the same kind of insulin.

When my BG would be 130 at night the maximum of insulin would have been 10 units, may be a bit less.

I keep a record in an Excel sheet on my computer, updating my sugar level 2 times a day. So I can always compare.

My experience with the "specialists" in my hospital here in Phuket is very sad. He suggested me to injekt always 30 units, no matter what the results of my sugar level is.

Another reason for your results could be a faulty equipment from your side,same happened to a good friend of mine in BKK cause he has had the same problem like you.

Go to a hospital and let them test your sugar level, than you use your personal "machine" to check your blood. When there's a big difference something must be wrong.

I am using Mixtard 30, from Novo Nordisk and it works very good with me, using a pen.

Gerd