How did you manage it? Did you get sick?
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Took everything i had not to, and I didn’t manage it particularly well. I have no idea what’s happening, but it’s tough. My brain does crazy stuff… I don’t even know how to explain. I keep wanting to test my blood sugar… like over and over, and I can’t figure out to do anything else. I ripped out my pump again last night because it was the only thing I could make happen. What on earth???
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List o’ questions:
Did you lose consciousness?
Do you have any idea how low you went?
How did your bg end up coming back up…lack of insulin? sugar? glucagon?
Was this a fast drop out of nowhere?
Was this a slow persistent drop?
Did you get any CGM alert before it happened?
Was your family able to assist? Did they know about it?
How are you doing today mentally?
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I’ll start with the last… mentally blah but low and nauseous again today. 
sitting this one out
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So… frustrated… at this moment, but nausea has passed. Thank you, @T1Allison for your questions. My sugar is on the rise now, and as I start the rebound… which I hope doesn’t go through the roof… i’m just frickin overwrought with frustration and demoralization and I don’t know what. @Beacher, I THINK it may have been you back on that family thread who asked why I feel such negative feelings about my diabetes. Here you go. When things are okay, I don’t, but I can’t keep things at okay as often as I’d like. I haven’t done anything wrong, and I’m just struggling. Yes, I blame my diabetes when this happens. If there’s a healthier place to deposit all of this, I’d like to hear about it. I can tell you this doesn’t feel particularly good.
I’m going to get up and try to head off the rebound. I’m sorry for the negativity. Really.
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I personally don’t think there’s anything wrong with feeling some anger after a really bad experience with diabetes. When things are going well, you won’t feel this anger. You hit that right on the nail. Hopefully things continue to improve 
so the lows and the anger come less often.
For some weird reason, I don’t tend to feel anger about things like this. I think it’s because I was diagnosed when I was so young. There have been so many helpful gadgets that have come out since I was diagnosed that it seems so, so much easier than it did when I was younger. I think that helps me not feel angry. I think I have a ton of other really unhealthy perceptions though. Like not being afraid of dying from a low blood sugar. I obviously strongly avoid severe lows, but it’s not because I’m afraid. Maybe I’m not afraid because I never remember super severe lows, and I’ve never had a seizure. People have described this fear recently, and I just can’t really connect on that. I don’t want to die of course, but my lack of fear is super weird and probably not healthy at all. I’m scared of other things way more though.
I guess diabetes affects each of us differently. I’m totally up for hearing about your anger after a really horrible experience though. It sounds like you’ve already identified a potential cause (extended bolus), so ride out your anger and hopefully a similar experience can be avoided in the future. I think carrying camel snot (glucose gel) on your person (e.g. in your pocket) at all times might help. At least until you’ve gone awhile without an experience like this.
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TOTALLY agree.
TOTALLY agree. This disease is hard. I apologize if my questions were too soon. I trust that you haven’t done anything “wrong”. Diabetes throws a lot of scary monkey wrenches at us. You’re getting a lot of them right now and I wish I could help.
What you’re describing I remember feeling before I had kids. Everything in my perception changed once I had kids and once I went through the crazy hormone-induced blood sugar swings that were really scary. Maybe it’s my responsibility for my kids that makes me afraid of the lows now. Maybe it’s the lack of birth control stabilization that makes me afraid. But I live everyday with that fear now and I never used to. It is a pronounced difference.
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I wasn’t diagnosed until 27, and it was certainly a tough transition. You’ve figured out a lot of routines by 27, and having to abandon them all isn’t easy.
What’s funny is that I had kind of just recently gotten over that underlying fear. It wasn’t an active fear, but over the last year I had started to learn how many of my behaviors sprouted from my desire to steer clear of hypos. I was adding extra carbs here and there, doing a little less insulin than I was due, etc. etc. The end result is I was running high. I’ve learned how to change those behaviors over the last year, and that’s good, but it’s also left me being more aggressive with insulin. Hence, the extended bolus party I’ve been throwing for myself. I threw one again this morning, because I thought I could, and because now I just despise those highs… there’s something in the middle obviously. I’m going to have to find it.
In the last couple of months I’ve started experiencing a new symptom of nausea with fast drops. Or with severe lows. Or probably the combination. Whatever it is, it’s new, and i’m just kind of getting throw to the wolves… that’s how it feels. I have a newfound respect for hypoglycemia. Not a fear. A respect. Something is different, and I better learn to respect it and clean everything up. This kind of hypoglycemia is not like all of the things in my life that are mind over matter. Some things are not mind over matter, and I think maybe I need to understand that, too.
Glad you clarified. Never heard it referred to as that before. Thought you were being silly. 
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They weren’t. I appreciate you coming with questions in the middle of trying to live your own life. That was very nice, and I always appreciate questions. My comment about not having done anything wrong was just a spot of venting… because i haven’t done anything wrong, and because i was feeling bitter. I’m recovering. It’s noon, and there’s still plenty of day left to enjoy. I’m on my way to being able to get to that part. I hate that i spilled a bunch of blah before getting here. But i’m not going to be silly enough to waste time being upset with myself. Did it, done, picking up and getting onto the next stage. Now i have crying children… so i guess i’ll do that first. Then move onto trying to enjoy a little. 
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You will! I have no doubt.
Agreed. Since lows can affect how well we think, we can’t really rely on our brains to work properly (I think this is what you meant… ). It has to be super easy to fix the low or it might not get fixed. I can struggle to get out of bed to treat lows when I’m really tired. My brain can think it’s perfectly fine to go back to sleep after turning off my Dex alarm. If I’ve put a gatorade next to my bed though, the probability of me drinking that to correct the low goes up substantially.
Well, I was… 
. That’s what we called it a diabetic camp when I was younger. I also think that’s what it should be called by everybody everywhere because it’s absolutely disgusting.
I’m glad you’re feeling better The nauseous lows sounds pretty rough. I hope those pass soon!
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Okay. Completely forgot to come back.
I did not lose consciousness. I thought I was going to. I did the last time. This one was a nausea that brought me to my knees… and overwhelming desire to just go down right there.
From what I remember, I tested at a 35 and then 30… The last time I believe dropped below 20.
Before the strongest wave of nausea came on, I was able to get 3 tabs in my mouth. Maybe 4. It was right as I was waking up (3 am) and knew right away something was wrong. I was starting to get sick as I was eating them but made myself keep them down. It was enough to get me back up and in the pantry some 10 minutes later?? Eating everything inside. Also ripped out infusion set again… so at least I was able to do that.
I was sound asleep so I have no idea if this had been a fast drop or slow and steady drop. I’m starting to think the rate of drop is really important. I woke up at a 27 about 2 months ago and felt 100% fine. Had to check like 3 times because I couldn’t believe it. The other night when I woke up, I woke up in a full panic. I’m not sure why I think that answers the question at all.
My CGM alerts me all night long every single night of my life. I have absolutely no idea whether or not it caught this, but I’m sure it did. What good it does me though when I have it bundled and muted under blankets is beyond me. People don’t sleep around here because of my sensor alerts.
Family slept through this one. I didn’t call out for anyone. Seriously was way too sick to do anything of the sort. Once I was up, there was no longer a reason for getting anyone. It was pantry time.
@T1Allison, I know I’ve been saying I will try to keep an eye on the cycle stuff, and I can actually comment on that part over on the basal and hormone thread. These were two very big episodes for me, and I can at least comment about where I was in the cycle. I’ll leave it up to you all to decide whether or not that could’ve been a factor.
And thank you again for your questions. It’s good for me to think through, too.
I say this is in the “must fix” category. Highest priority. Below 40 should never happen; in the 40s should be really rare.
To achieve this you need just 2 things. Glucose, plus awareness that you are approaching the 40s so you take a suitable amount of glucose before you actually drop into the 40s. You already have the glucose close at hand, as far as I can tell. Do you know a suitable amount for your body? In my case a glucose tab raises me about 10 mg/dL. So if I look at the CGM and it says 58, I pop glucose tabs into my mouth as I count by tens: 68, 78, 88, 98. No math, just counting by 10 which I can do even when quite impaired. Let’s find an amount and technique that is suitable for you, even when impaired.
You’ve just told me that you have learned to ignore the CGM alerts because there are too many to deal with.
So let’s change the alerts. Overnight, disable enough alerts and set the thresholds of the remaining ones so that any alert means this is really serious and must be dealt with right now. And anyone else in the household knows the same thing, so if you aren’t dealing with it they know they should act because it really matters.
Maybe the only alerts are “under 60” and “over 300.” The low repeats every 15 minutes because that’s when you should look to see if you need more glucose. The high repeats every 45 minutes or every hour, because that’s enough for you to decide if you need more insulin to stay out of DKA. After the issue with extreme lows at night is fixed, you can start to tighten the high limit and maybe add back some others, but only to the extent that at night the CGM never cries wolf.
Do whatever is needed to make sure the alerts wake you up. Receiver in a jar or tin with coins in the bottom? That microphone-activated switch that turns on the lights and blaring radio? There’s something strong enough to get the job done.
I wish you could substitute the practice of looking at the CGM and taking the indicated amount of glucose, no more and nothing else, but I don’t know if you can make a rule like that for yourself. It may become easier if you can stay away from those severe lows. Anyway, that’s much less important. The focus now is staying above 55 mg/dL.
So there it is. Advice not sympathy. Because I’m a 'splainer. I do mean well…
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@Nickyghaleb, I agree with @bkh on enabling only key alerts at night and would include the alert for the rapid fall rate, too.
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I wouldn’t do that now. There’s a very big problem now with too many alerts, and the rapid fall alert will be adding false alarms (pressure lows, rapid drop after a rage bolus from 350, and so on) while only saving 5 or 10 minutes in the cases that matter, i.e., rapidly falling toward 60.
After solving the below 55 issue then it would be reasonable to think about the best ways to tighten the alerts. But for now we want every single night alert to be one that actually truly deserves treatment.
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This is such a helpful response. They’re all helpful really, but this one is getting at the root of a different problem, and I’m going to have to focus on that. Yes, I ignore alerts. I used to blind-clear everything, and I have adopted better habits, but overnight is a MESS. I wake up at a 40 many mornings, and I swear everyday I’ll work on it once I’m awake, but then I forget. My endo had me let up on my insulin a little at around 4 am, but I woke at 40 again this morning, so it obviously isn’t a big enough adjustment. Because I have that tendency, every single night, to drop, my sensor just beeps all night long, and I sleep through almost every tone of it. My family’s sleep has suffered quite a bit, but they basically just wake enough to tell me my pump is beeping, and I give it a quick glance, if that, and a clear.
I now run a relatively large Facebook group, hang out here, have 3 boys of my own, a mom who is in the throes of one medical blower after the next, dealing with my own medical/physical…things… that require more attention than what I have available, and now am sitting here looking at newborn 6 kittens. I’m hanging on by a thread. My diabetes always gets put on the back burner, but just putting it there doesn’t mean I get to pay less attention. It just means more crises. More alerts. Less sleep. More being sick. I’m making your recommended changes now. And I really, really appreciate you taking the time and putting in the thought.
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@CatLady, I do have that set now. You are right that I need to pay attention to that rapid fall, but it might also be contributing to a bigger problem as @bkh has mentioned.
Your mention of that fall rate does make me think of my Suspend settings. That might also be part of the problem. I use the 670G and have suspends available in manual mode. I actually kind of dislike them but am also afraid to sleep without them. I am currently using “suspend ON low”, and that means I’m set to suspend at a 50. I have an option to suspend BEFORE low but tend to really not like that one as it often causes too many highs unnecessarily. My Guardian leaves a lot to be desired in terms of both accuracy and lag. So I have to kind of tiptoe around it and correct a lot of suspends. However, with waking up consistently at 40, with the not terribly rare 35 or 30, and occasional <30, I just am not comfortable going without. I do wake up for lows. I obviously don’t wake up until they’re pretty significant. That has never been too big of a problem because of my ability to treat, but with this new nausea… and I just don’t think “nausea” paints the real picture… I’ve been faced with the possibility of my inability to treat. I’ve never really had that concern.
Bkh, one sugar tab, 4g of carbs, just doesn’t have a big impact. Maybe you will have some different insight on these numbers, but in general, overnight, I am at approximately a 1:10 carb ratio. My sensitivity is generally 35… And now I’m working through this in front of you hoping you’ll correct me if I’m wrong, but if I can assume one unit raises me 35, and 3 totals 12g… then I would need about 3 to raise my BG 10.
AND my blood sugar is low now, and I am attempting math and phone-responding all while my pump is crying for me to calibrate. And my kids are asking me to refill things. And I can tell you what I’d like to do is just blind clear that alert and tell myself I’ll get it to as soon as possible… just like my low. This is how I do. And it’s not a great strategy.
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Keep gradually decreasing the basal until that is fixed. Look at the CGM graph for overnight. What time does the downtrend typically start? Decrease the basal beginning 2 hours earlier. In my case I make small adjustments to basal, typically 0.025 u/hour every second day until I get to a good place.
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Also… my receiver is my pump. Attached to my body by tube do you mean for me to drop IT in one of these things? Or are you thinking I have something separate? This has been a long time problem of mine, so I’m 100% up for trying WHATEVER.
If your pump is the receiver, the best I can suggest is to clip it somewhere close to your head as close to your ear as practical, to avoid it being muffled. I can make up half-joking solutions, like clipping it inside a nightcap, or taping it across your ear, but I really don’t know what will work for you.
I vaguely recall that Medtronic was working on something as an answer to the Dexcom follow app — a way to send alerts to a phone. Maybe there’s some kind of solution there, or maybe it doesn’t exist yet.
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Sorry, but I can’t stop myself… medtronic’s a little tied up in the “solutions” department right now. Maybe next year though. Or 2020 at the latest.
- And not one day later…