Low BG seizure

Type 1 & LADA
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So my wife and I had a new experience Friday night. We attended a fundraiser gala which included dinner, auction, drinks, dancing, etc. It was fun, and ended too quickly for my tastes, but that’s always the case.

At 1 am, I tested BG, which was about 275, so I took humalog and my normal Levemir bedtime basal dose. At 3:30, my wife woke to me convulsing in the bed, unresponsive. She had a bit of panic, looking for glucagon and glucose gel, both of which she couldn’t locate. Instead, she carefully fed smarties to me, monitoring swallowing, etc. (She’s an occupational therapist, so knows a bit about this kind of thing). I think she fed me 5 rolls.

After about 20 minutes, she sat me up in bed and began asking me basic questions: what are our kids’ names, etc. A minute or two into this, I regained sight, and cognition…“what’s going on?”.

I thank God for my wife, but not nearly often enough.

So, in hindsight, I am sure I took too much humalog, and also should have cut my basal dose due to alcohol consumption (I probably had two drinks in my system yet at bedtime… Past experience suggests overnight low for me in these conditions). Also, if I tested at 10 PM, I would have taken care of the high BG by bedtime… All hindsight.

I’ve requested a prescription for libre 2 for monitoring BG overnight- I’ve put off a CGM for too long.

Does this happen to all type ones? Should I go see my physician for a checkup?

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I have seizures when my BG goes low. They’ve occured when the BG was mid 70s and lower. For me, it’s completely random at which level the BG triggers these things. Definitely see a doctor.

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That sounds terrifying! Sending both you and your wife hugs and healing thoughts!

The nasal glucagon Baqsimi or the new no-mix Gvoke might be just right for treating extreme lows!

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Really scary, and how awesome of your wife to handle the situation so well! The CGM should help a lot!

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I don’t know if it happens to all of them, but if you have it long enough there is a high likelihood that you will have something like this happen.

I don’t think there is a need to get checked for this event unless you have some lingering symptoms.

This is hindsight too, but put the glucagon in a place that she knows and make sure it is always there.

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well that’s really scary, since I’ve been diagnosed I’ve never really had any incidents, not even DKA while I was being diagnosed. I’ve been living alone since I was diagnosed last year around october.
I’ve also been doing my own thing instead when it came to prescription because what the docs prescibed didn’t work and also never felt right after I did some research.
I was originally on premixed insulin so had to force my docs to move me to bolus/basal which they reluctantly did and even said I’m on my own if things go wrong.
A few months later I bet they were eagerly waiting to see how bad my controll was but were surprised when my a1c came back 6.9% from 14%+ when I was diagnosed.
I can’t really say i’ve been doing perfectly, I’ve been as low as 1.9 and am normally around 3.9 when I get home from work (walk 6km back and fro), infact I can hardly tell when I’m low since I’m used to it.
When I was at 1.9 I noticed because I was watching a clip and couldn’t understand anything that was being spoken and yet it was okay just a few minutes ago, I had to drag myself out of bed and mix some sugar and water since I didn’t have anything.
Actually I don’t think diabetes has been a real issue to me, it’s just that life is so unfair considering all that’s happened in the last few months.
Diabetes was just the nail in the coffin.

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Here is a good article.

I found this comment interesting.
Beer and sweet wine contain carbohydrates and may raise blood sugar. People may overeat when drinking alcohol which also can increase your BG. Always wear a medical alert piece of jewelry that says you have diabetes. And in an emergency glucagon may not work so tell people to call 911 (your liver is busy filtering alcohol so the glucagon may not work).

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@MM2 , yep that tidbit about glucagon was the other thing I told my wife a day later… Probably a good thing she couldn’t find the glucagon, my liver was probably still processing ethanol.

That episode also violated my practice of never having active bolus as I sleep. (Or, at least setting an alarm to wake me 2 hrs post bolus).

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Glad you are OK, glad your wife is a hero and glad you’re deciding to get on a CGM!

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Yes, I agree, please get a CGM!

I think if you drink alcohol, and maybe are not used to drinking frequently, it can reduce your BGs unexpectedly. I think this may have happened to you, and thank goodness your wife was there to help you recover.

I have experienced this as well. I once woke up on the floor of the bathroom in my hotel room. I have no idea how I got there but thank goodness I woke up, and was able to make it back to the room to eat a snack. The previous evening I had drinks with a client, and several hours later I was barely cognitive.

Thank goodness all turned out well for you, and for me, too, but for those T1s that may not be know, alcohol can really, really cause dangerously low hypo BGs. For those who drink infrequently, it could have have an unexpected impact, and drastically reduce your BG from what you normally experience.

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Hi Mike. Glad to see you’re finally getting a CGM. That made all the difference for me. Haven’t had episodes at night since I’m now able to test much more often. The best part is the graphs, which tell me how to anticipate my lows (which are common between 3am-5:30am) and when a low is dangerous. Best part is getting to know how much bolus to give myself as a correction.

I keep a glucose tablet right by my bedside if needed. Alternatively, I also suggest a small juice box.

In terms of low blood sugars besides nighttime low episodes, I have also experienced those when my breakfast bolus is bringing my BG down while my lunch bolus had just started to crank up. (Happened when I gave myself too much insulin at breakfast or my lunch was still being metabolized.) Again avoid those with the CGM.

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Last night, I visited with a friend, a family physician who happens to be a T1D. He didn’t think there’d be any lingering effect. We discussed the CGM and also glucose gel as good ideas.

Thanks everyone for the thoughts and concern. This is a great community!

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image

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My understanding is that the active ingredient in the Transcend glucose packets is D-glucose. Googling about I found the assertion that “Formally known as Dextrose Monohydrate or D-Glucose, dextrose is the most common type of glucose.”

Dextrose is also the main ingredient in your common cellophane wrapped roll of SweeTarts which is about 4g of fast acting carb. My very, very quick comparison was that you may pay about 9 time more to get a package that has “Raise Low Blood Sugar” printed on it, but is functionally the same thing.

I grew up around people who lived through the Great Depression of the 1930s. Maybe that’s why I look at this differently? They also would never leave the lights on in an empty room, but then they also didn’t have LED light bulbs. :confused:

https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/treating-hypoglycemia/

Dextrose is the form of carbohydrate that raises blood glucose levels the fastest. Glucose tablets, gels, and drinks are made with dextrose, as are several candies, including Smarties, SweeTarts, Nerds, Runts, AirHeads, Spree, and Pixy Stix. Check the ingredient labels on candies to see if dextrose is the first item listed.

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John - the point of having the gel available is so caregivers (if you have them) can squeeze it into an unconscious person’s mouth. That doesn’t work well with solids, which are more likely to be choked on.

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@Jim_YYC, I’m planning to get a few packs of transcend, just for emergencies. Should be a bit easier to administer than smarties. However, I’m glad she didn’t use glucose tabs, those things take a while to dissolve and aren’t fully glucose, with maltodextrin, cellulose, etc adding bulk.

@irrational_John , you’re correct about sweetarts.
I prefer smarties…wayy cheaper and easier to dissolve than glucose tabs…that’s why I keep them around.

I also hear where you’re coming from on frugal living. I grew up on a farm. My grandparents lived 100 yards away. They got married and began farming on their own during the depression, so I heard many stories about that era, and saw how it influenced them. The lessons they learned were not soon forgotten.

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Yes, if you have to deal with someone with a hypo who is either unconscious or not rational, I can see that the gel might be easier to use. That’s still one heck of a mark up over apparent cost. :man_shrugging:

I live alone so the question of how a caregiver might cope tends to not be at the top of my mind.

Except that I think they are being lost. Perhaps some people are still frugal, but I recall a different outlook on life from my elders back when I was (much) younger. I didn’t consider it at the time, but as those people pass away, apparently so does that outlook.

Insert the emoticon for nostalgia.

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The speed and convenience of the gels is not for the person getting it, it’s for the person giving it. Easy to open and easier to administer.

Being unconscious with a hypo sucks for your spouse/parent/significant other. You don’t care because you are out. But it’s totally horrifying for them.

Spending a few extra bucks to make the ordeal easier for them is money well spent.

+1 for the Transcends.

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I’ve had T1D for 22 years now and I have had 1 seizure in that time. It was back in the day when I was taking protophane, which I haven’t used in 15 years, in fact I switched shortly afterwards.
I was in bed and headbutted the bedside table and got one hell of a black eye.
I’m glad that I haven’t had one since. Was scary!
I was staying with my mum at the time and she heard me bashing my head and tried to give me my glucagon, but was panicking and injected me with the water :woman_facepalming:t3: fortunately she had already called an ambulance.

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That’s why the newly developed nasal glucagon sprays and auto-injectors are so great. I can see so many people messing up that clumsy mixing procedure with the old glucagon kits.

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