# severe hypos whilst asleep



## CarolK (Apr 29, 2010)

hi, hope this doesnt sound like a stupid question but on reading everything i could about hypos, it seems like the majority are saying that you should wake up when your BGs drop. My son, although only had 2 severe hypos in 4 years, (the last one being a couple of weeks ago) has had 2 seizures, both while he was asleep. Fortunately, both times I have been there to get help. Now I am terrified every night and am becoming obsessive about testing etc, and I know that I am getting on his nerves. Has anyone got any advice for me. He is 21 and has been type 1 for 7 years.


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## bev (Apr 29, 2010)

Carol, you are right to worry. Although we are all told at clinic that everyone will wake up if they have a hypo - there are a few who dont and left untreated - well you know what I mean.
I never tested through the night when my son was on MDI - unless he had an active day etc.. But when he started on the pump I tested a couple of times a night and found him hypo - unexpectedly - and he was still asleep.

Of course, my son is only 12 - so not sure what he would think if he was 21 and I was still testing him through the night. Are you sure you have the basals right? Is your son waking on a good level - does he always dip around 3am?Bev


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## Northerner (Apr 29, 2010)

Hi Carol, not wishing to add to your worries, but not everyone is woken by hypos, although I think it is more common in young children not to wake. The important thing is the nighttime/before bed check and a good knowledge of basal (slow-acting) insulin and how it affects your son. He needs to find a BG level that he can comfortably go to bed on with little fear of dropping too low, and also to know if his basal insulin dose is not too high. I used to have fairly frequent lows in the night, although I usually woke from them. Eventually, I managed to reduce my insulin so that this no longer occurs.

There are two strategies - you can have him test at around 3 am as this is usually the time that blood glucose is at its lowest. Or, you can ask his DSN/clinic for use of a CGMS (continuous glucose monitoring system) which will show his BG profile over a period of time and they will be able to spot any possible problems. I was considering a CGMS but managed to get things sorted without it.

Unfortunately, there will always be a danger of having a night hypo and not waking. However, what often happens is that when levels do fall low the liver responds by relesing some of its own stores of glucose and levels rise again (bear in mind that this won't happen if a person has been drinking, so a snack before bed after alcohol is highly recommended.


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## CarolK (Apr 29, 2010)

You know I always feel that Im being such an overprotective mother and nag, and it does wear me down as he is old enough to take responsibility himself,. But you cant switch off from being a mother and when you have to deal with seizures it is terrifying. He has never been good at testing (prob a lot of denial in the teenage years) so I am making sure he tests before bed and making sure his levels are reasonable then, and really fingers crossed. I suppose the frustrating thing is we cant think of a reason why the last one happened. His last hb1c was 7 and the doc seemed to think he may have had too tight a control? and reduced his lantus.  Hopefully this will help. Prob go too high now! such a frustrating illness!


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## Lauren (Apr 29, 2010)

Hi.
I have had severe hypos (fits) while asleep.Obviously they are extremely frightening and a big worry but even if you fit, you can't die from one and your liver will kick in and your blood will shoot up again.
I go low every night in my sleep (because of hormones) and I get a rebound where my blood shoots up very high - obviously a bad thing but just pointing out that it does go back up.
This really worried me when I first found out, but my DSN said that she has never heard of a case of someone dying only because of a hypo.
I hope this reassures you a bit but I can understand your anxiety x


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## CarolK (Apr 29, 2010)

Thanks Lauren,it does reassure me a bit! I wonder if I will ever lose that anxiety.


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## bev (Apr 29, 2010)

Lauren said:


> Hi.
> I have had severe hypos (fits) while asleep.Obviously they are extremely frightening and a big worry but even if you fit, you can't die from one and your liver will kick in and your blood will shoot up again.
> I go low every night in my sleep (because of hormones) and I get a rebound where my blood shoots up very high - obviously a bad thing but just pointing out that it does go back up.
> This really worried me when I first found out, but my DSN said that she has never heard of a case of someone dying only because of a hypo.
> I hope this reassures you a bit but I can understand your anxiety x



Hi Lauren,
I am not wishing to worry you at all, but what you have said just simply isnt true.
There have been countless cases of people dying in their sleep (from DIB syndrome). Some of these can be attributed to heart problems, some to fits, and some to severe hypos that have been left untreated.

I have personally heard of 3 deaths from DIB or DKA that have happened when a person has been asleep, in the last 5 weeks. All of these people were under the age of 20 and in otherwise good health.

I understand your need to feel 'safe' when this is happening to you, but it really is so serious that I felt the need to put the other side of the coin.

I think your DSN is trying to re-assure you that these things dont happen - but I personally feel that night-time hypos are often overlooked by the medical profession because they feel it is preferable to put forward the case that these things dont happen - for peace of mind. But this is clearly not good advice.

I have read many reports that prove that some people dont wake when hypo. They have used CGM's and left it until a person is very low - and there has been no response - and no intention to wake up or treat. Obviously they woke them up and treated them - but - this proves to me that not all people will wake when hypo and the liver does not kick in every time.

I went to a JDRF conference and asked the Professor if people wake up every time they are hypo. He said that if they are newly diagnosed, then their liver will kick in for up to a year - but if it keeps happening - the liver gets tired of it and simply stops responding. I understood from what he was saying that you can 'get away' with it a few times - but dont push it so to speak.

If you are having constant hypo's through the night - perhaps you should decrease your background insulin? Are you on a split background insulin? When you say hormone problems - have your team offered you any advice on how to sort things out?Bev


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## CarolK (Apr 29, 2010)

I went to a JDRF conference and asked the Professor if people wake up every time they are hypo. He said that if they are newly diagnosed, then their liver will kick in for up to a year - but if it keeps happening - the liver gets tired of it and simply stops responding. I understood from what he was saying that you can 'get away' with it a few times - but dont push it so to speak.


Hi Bev, this seems to sound realistic to me. I know going back to when first diagnosed the info I was givenwas that you would wake if having hypo but obviously its not true. I have also thought about dangers like  somebody choking while fitting etc,  you have given some good advice.


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## bev (Apr 29, 2010)

CarolK said:


> I went to a JDRF conference and asked the Professor if people wake up every time they are hypo. He said that if they are newly diagnosed, then their liver will kick in for up to a year - but if it keeps happening - the liver gets tired of it and simply stops responding. I understood from what he was saying that you can 'get away' with it a few times - but dont push it so to speak.
> 
> 
> Hi Bev, this seems to sound realistic to me. I know going back to when first diagnosed the info I was givenwas that you would wake if having hypo but obviously its not true. I have also thought about dangers like  somebody choking while fitting etc,  you have given some good advice.



Hi Carol,
I hope I am not worrying anyone with my views, its just that I have heard so many times that their team say that they will wake when hypo and dont worry etc etc etc and to be honest with you - it makes me a bit angry. I do understand why clinics say this to people - but I prefer to know the 'real' risks - not the fairytales.Somebody I know asked their team whether they could 'guarantee' whether their child would always wake when hypo in the night and they said no. This is good enough for me to know that testing through the night is essential for parents and carers. I do hate all this doom and gloom talk - but there is no way of ignoring it unfortunately.
By the way, I see your from Liverpool. I was born in Wallasey and lived there for 34 years.Bev


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## CarolK (Apr 29, 2010)

Thanks Bev, I think you have to be realistic, the stakes are very high. I think thats why I do worry so much. I have always wanted to know everything I could, the more info the better to enable me to deal with things. Thats why I was so confused. Even when my son was in hospital once, the nurse told me not to worry and that you normally wake up. This site will be invaluable to me for getting answers from people living with diabetes. 
 I live about 20 miles outside city towards Ormskirk, dont know whether you heard of that, but lovely to talk to you.


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## Lauren (May 1, 2010)

bev said:


> Hi Lauren,
> I am not wishing to worry you at all, but what you have said just simply isnt true.
> There have been countless cases of people dying in their sleep (from DIB syndrome). Some of these can be attributed to heart problems, some to fits, and some to severe hypos that have been left untreated.
> 
> ...



Hiya again 

I've heard from a few others that you can die from being hypo at night, maybe you're right that my DSN is just being reassuring? However I really think it must only be the odd few.
I am extremely worried about what my blood sugars do but they have been like it since I went on MDI 6 years ago - they really do go low and high by themselves every night! My DSN reduced my Lantus from 38 (old clinic recommended I keep my Lantus as high as possible,which was not helping!!!) to 14. This has significantly improved the lows! Apparantly its my hormones that are causing it and I am becoming resistant to long acting insulin too. They are going to put me on a pump thank goodness,this should break the cycle!


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## Lauren (May 1, 2010)

Also I should point out that I have been Diabetic since I was 6 and people didn't do night time testing and suchlike back then, and I woke up every time I was low - and am still alive at the age of 22! 

Obviously night time testing IS definitely a good thing, just to quantify!


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## Lizzzie (May 1, 2010)

Just a quick note - I have no experience of this field at all - but I wondered if some kind of alarm existed to alert parents that a sleeping child is fitting? The epilepsy people might have something up their sleeves.....


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## Northerner (May 1, 2010)

Lizzzie said:


> Just a quick note - I have no experience of this field at all - but I wondered if some kind of alarm existed to alert parents that a sleeping child is fitting? The epilepsy people might have something up their sleeves.....



There are hypo alarms, although I don't think they are particularly reliable so not widely in use. There is also the possibility of training animals to detect hypos - read Moddey's blog at http://mmollymoddey.blogspot.com/


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## CarolK (May 1, 2010)

I did buy a gluco watch a while ago, but it reacts to sweat apparantly and was constantly waking him up for no reason. What are the CGM and do you have to  have a pump with these?


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## Northerner (May 1, 2010)

CarolK said:


> I did buy a gluco watch a while ago, but it reacts to sweat apparantly and was constantly waking him up for no reason. What are the CGM and do you have to  have a pump with these?



Hospitals should have a Continuous Glucose Monitor (CGM) available for use - they record the BG level every few minutes and this can be downloaded and analysed on a computer (usually at the hospital, rather than at home). They show the trends that you wouldn't be able to see without an awful lot of fingerpricks!

A lot of people in the US are now using CGMs all the time - Dexcom seems to be a popular brand and they do have an on screen display. I doubt you could get such a thing on the NHS though.  http://www.dexcom.com/


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## CarolK (May 1, 2010)

Just checked out the CGM at Dexcom. How wonderful if everybody could have one! I know thats a long way off, everything is about money, but it would take a lot of the worry away, epecially for chiildren with type 1.


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## Northerner (May 1, 2010)

CarolK said:


> Just checked out the CGM at Dexcom. How wonderful if everybody could have one! I know thats a long way off, everything is about money, but it would take a lot of the worry away, epecially for chiildren with type 1.



It will happen one day, I'm sure. This is what we are currently waiting for: http://www.jdrf.org.uk/page.asp?section=174&sectionTitle=Artificial+Pancreas+Project


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## glodee (May 2, 2010)

God, this thread scares me so much. x


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## ruthelliot (May 2, 2010)

Hi, I just wanted to reiterate what Bev has said. We were told not to test our son after he went to bed but on the back of advice from people like Bev and Adrienne we started testing him at midnight (and sometimes at other points) and have found him below 2 still out for the count and still 7hrs until he would be due to wake - while I know the liver can kick in to some extent how far can you push it! We have found due to his frequent hypos at the moment during the day he is taking much longer to come up and needs more agressive treatment, presumably because his liver reserves have been depleted. I guess how well the body copes at night prob reflects how good overall control is so getting everything else as good as poss should hopefully give you a little peace of mind for nightime. Must be difficult though for you asa the mother of an adult in this position - dont know how I'll ever be able to step back and I'm sure like you the worry never lessens.


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## Lauren (May 2, 2010)

Hi

Quizzed my DSN again as this thread was starting to worry me.

My DSN has never heard of anyone dying only because of a hypo but there HAVE been cases of teens dying of hypos because they gone to bed drunk - these are probably the odd few mentioned in this thread. 

The 'liver reserve' is adrenaline - which is replenished as it is used - so it does not run out. Unless you go hypo several times in one day and your body hasn't had the time or energy to replenish it.

I know this is a very scary subject but lots of people have been diagnosed as kids and are still alive today as adults. My mum never checked me at nights and to a certain extent let me be quite independant with my Diabetes - while my control is not perfect at the moment I can honestly say that I have grown up very aware that good Diabetes control is key.

I guess what I am trying to say is, although it is natural to be worried, I  think realistically that dying of a hypo because you haven't woken up is very unlikely.

Also I hope I haven't offended anyone, and obviously people are still free to have different opinions!


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## Northerner (May 2, 2010)

Lauren said:


> ...The 'liver reserve' is adrenaline - which is replenished as it is used - so it does not run out. Unless you go hypo several times in one day and your body hasn't had the time or energy to replenish it.
> ...



Not quite correct there Lauren. The liver reserve is something called glycogen, which is a method of storing glucose until needed. Our muscles also store glycogen, and this is what gives them their energy when we do things like running (I've known all this for years before my diabetes as a marathon runner!). One of the reasons why glucagon injections will only work once in about 24 hours is that the glucagon makes the liver release its stores of glycogen and as you say, these then need to be replenished. Glucagon won't work when you are drunk either, as the liver can't multitask and will be processing the alcohol.

I think that cases of dying from hypo are probably very rare, but it can happen.


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## SilentAssassin1642 (May 2, 2010)

Lauren said:


> Hi
> 
> Quizzed my DSN again as this thread was starting to worry me.
> 
> ...



Hi lauren, hate to say it but i really think your DSN needs to go back to her text books.

It is possible. And it is scary. Fair play about going to bed drunk, but even if not drunk and you hypo in your sleep and don't notice (happened to me on MANY an occasion, I almost died from one and would have if my parents hadn't found me fitting on the floor!) then well...it is possible.

Rare yes, but still likely.

and its glucogen (glycogen? something like that) in your liver, not adrenaline


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## Lauren (May 2, 2010)

Ok I stand corrected... maybe I need to find a new DSN?! She was so sure it can''t happen...

I'm glad I  know now that it can happen, its never too late to start being more careful. As my sugars go low most nights I think I am going to go for the Medtronic pump with the CGM, then I can monitor my blood sugars more carefully and it has the alarm too for when I go hypo.

Thanks guys for your invaluable knowledge and support!


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## SilentAssassin1642 (May 2, 2010)

Lauren said:


> Ok I stand corrected... maybe I need to find a new DSN?! She was so sure it can''t happen...
> 
> I'm glad I  know now that it can happen, its never too late to start being more careful. As my sugars go low most nights I think I am going to go for the Medtronic pump with the CGM, then I can monitor my blood sugars more carefully and it has the alarm too for when I go hypo.
> 
> Thanks guys for your invaluable knowledge and support!



thats the one ill be going foe too. however, realise that its very rare to get a funded CGM at the moment, a lot of PCTs refuse flat out to give them!!


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## Lauren (May 2, 2010)

I thought I would just buy the sensors. My DSN said they're only ?3.50 each. However I have heard that they can cost much more so maybe she's wrong about that too?!


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## shiv (May 2, 2010)

they're ?30 each...


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## Lauren (May 3, 2010)

ok maybe I won't self-fund!!!


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## shiv (May 3, 2010)

lol, i know right. ?30 a go, and they last 3 or 6 days. even so you're looking at what, ?150 minimum a month?? if you managed to get 6 days out of each one!


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## CarolK (May 3, 2010)

I think that after reading everything I am right to worry, but also realise that as my son is 21, he is an adult and I am not always around. What do other T1's living alone do to safeguard themselves? I guess that it is just to make sure you are at a reasonalble level before going to  bed. I think that to be offered a pump and CGM where I live you have to meet certain critria, that is to have really poor control of your diabetes, and probably suffer lots of disabling hypos. I looked at CGMs on internet and they can cost anything up to ?1000, and then sensors only last  a week, so pretty expensive. Hopefully one day soon they will be within reach of all diabetics!!


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## scotty (May 3, 2010)

I have just woken up, tested and was 1.8 , Thank god. I had my tea a bit late tonite 9pm, and had my levimer at my usuall 10pm, think i had them to close together.I nodded off just after ten without testing so i suppose it is my own fault, This is the first time my body has woke me up due to a hypo, it does worry me as i do live on my own i wouldint like to think when i have had drink of alcohol though.


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## Northerner (May 3, 2010)

scotty said:


> I have just woken up, tested and was 1.8 , Thank god. I had my tea a bit late tonite 9pm, and had my levimer at my usuall 10pm, think i had them to close together. This is the first time my body has woke me up due to a hypo, it does worry me as i do live on my own i wouldint like to think when i have had drink of alcohol though.



Wow Scotty, 1.8 is pretty low  From the timings I suspect that your Novorapid dose may have been a bit too high - if I'm going to hypo after getting the meal dose a bit wrong, it's usually at around 4 hours. I usually try and avoid eating late so I can be sure the NR has left my system before bed. 

Hope you manage to get some sleep and don't have a hypo hangover in the morning.


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## Steff (May 3, 2010)

Hi Scotty hope you had a good nights sleep after you hypo x


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## aymes (May 3, 2010)

CarolK said:


> What do other T1's living alone do to safeguard themselves?



I'm type 1, I live with 4 housemates but obviously they're not around when it comes to sleeping hypos. I was diagnosed at the age of 21 and was living away from home by then so have always managed my diabetes myself, my family know very little about managing diabetes, other than what to do in emergencies.
I guess my philosophy with it is to be as careful as I can in avoiding problems overnight, but remembering that is very rare (although it can happen) for a diabetic to die from an undetected night time hypo. So for me that would be confidence that my basal rate is ok, and when it goes off then comitting myself to 3am readings until it's right again. At the moment I'm happy that my basal is fine and confident about sleeping on anything 5+, at times when my basal has been less sure I'd have made sure I had a higher starting level before bed.
The biggest risk for adults seems to be after drinking. I've come to know what alcohol does to me overnight, and so treat accordingly, usually snacking before bed. I'm also careful never to go too ott so that I'm sure I'll still be taking care.
I do find that I wake up when I have night hypos, usually before it gets too low. Now I know that's not a guaranteed thing, but it's not something I tend to think about. To some that might seem like I'm burying my head in the sand but to me that's not the case. I think it's just where you decide to draw your line in a kind of life/diabetes balance. In a similar way, If I really thought hard about it I would probably spend most of my time worrying about complications, so I try to give the prospect the respect it deserves but not let it take over, so if my control needs to be compromised occasionally because I want to do a certain activity or eat that piece of cake then so be it. It's totally a personal thing though in what 'risks' you decide are acceptable, and I wild guess that's so much harder as a carer of someone with diabetes as they're not solely your decisions to make.
Carolk, has your son had an opportunity to do a course such as dafne, or a local equivalent. It could be really usful in giving him the tools to fine tune his basal rates to lower the risk of hypos. Of course the courses would also give him knowledge of a lot of other aspects too.


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## Smit (May 3, 2010)

Hi Carol, 
I can totally understand where you are coming from. I was diagnosed at 3, i am now 27 and married. But even now my parents still worry. They always have and always will. I tend to check my blood just before bed, if under 5.5 i always eat a biscuit to see me through the night. No reason for the 5.5 and under, it's just what i feel safe at. I always keep snacks by my bed and near by incase i wake up and need something. When my husband is away working my mum panics if she has not heard from me and starts calling. Claims it's just for a chat but i know the real reason. You will always worry and it's good you are there for him. I think i'd try and let him try and take some responsibility from now on and just be there to support him. My diabetes was crazy at his age, but i eventually got fed up been ill and was very grateful for my parents support when i finally admitted i couldn't control it myself. x x Hope this helps and i didn't gab on for to long. x


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## bev (May 3, 2010)

http://www.dundeeforum.co.uk/ubbthreads.php/topics/27411/Dundee_student_dies_after_week.html

This story is so sad and brings it all home. Lauren I do think your DSN is slightly out of touch with things if she is giving you this advice. Obviously these things dont happen often, but this is the 4th death I have heard about this year. The other 3 were all youngsters age 12, 14, and 18 (I think) and none of them were drinkers. One boy died of DKA within 4 hours of speaking to his mum on the phone as he had gone home from school and his mum was at work. He said he was fine - but when she came home she found he had passed away. I am not trying to worry anyone unnecessesarily here - but I do wish that DSN's would stop telling people that they will be fine if they hypo through the night - because sometimes they are not fine.Bev


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## HelenM (May 3, 2010)

This is a worrying subject and  sometimes it seems that we should steer well away because of the anxiety such subjects cause. I can well understand the fears of parents.
I've been trying to find out  numbers involved to try to put the problem into perspective.  I couldn't find any useful UK figures:
In Norway between 1981 and 1990 there were 240 deaths of under 40yr olds with diabetes (from all causes) of these 16 could be classified as 'dead in bed' 
In Sweden  there was a study of all children diagnosed between 1977-2000 and followed up until 2000  By 2000 , 10200 children were on the register. A total of 78 died  (81,600 person-years of the observation.) Of these  17 cases were classified as 'dead in bed.' (in the same study 33 deaths happened for reasons  nothing to do with diabetes)
So the risk is there and everyone is right to be aware of it but it is thankfully not a frequent occurence.


 a fairly recent article on the syndrome with a few practical suggestions (though they're all common sense)on avoiding nightime hypos.

http://www.diabetesmonitor.com/learning-center/other-complications/dead-in-bed-syndrome.htm

Someone earlier on said their nurse mentioned alcohol, I know of cases where this has been involved, and is something we all have to take into account  but these wouldn't be classified in the same way.


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## Northerner (May 3, 2010)

Thanks Helen, it does help to put it into perspective - rare but not unheard of. Night hypos used to worry me a lot in the first few months after diagnosis (I live alone), as I had them quite frequently. Eventually, I got a good feel for the right dose for my basal insulin and ended up reducing it from 20 units to 6! I'm pretty confident about it now - I did a basal test yesterday, 5.3 before and 5.4 six hours later  I'm similar to Aymes and have my lower 'limit' at 5.5 before bed - below this and I will have a snack.


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## Lauren (May 4, 2010)

That is so sad. I am a bit frightened now.

I am moving clinics so will get a new DSN but my application for a pump will probably be cancelled, I hope not because I think a pump is the only way forward for me 

I'm glad that you guys have told me all this info, it is important to know and I believed my DSN before.


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## CarolK (May 4, 2010)

Thanks for your replies, its good to hear from other young adults and it does help me a lot to deal with this. I totally understand what youre saying Aymes, and I think I need to try an put things into perspective and stop worrying as much, I think it has been dealing with the seizures that has frightened me so much.
He is going on a carb counting course next week, so I hope that does some good, as we havent really got a clue where thats concerned. His DSN did advise to reduce his lantus by 2 units but that has sent his sugars quite high(its amazing the difference 2 units makes!). Hopefully after this course he can get back on track. I know running sugars high isnt good either.


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## Northerner (May 4, 2010)

CarolK said:


> Thanks for your replies, its good to hear from other young adults and it does help me a lot to deal with this. I totally understand what youre saying Aymes, and I think I need to try an put things into perspective and stop worrying as much, I think it has been dealing with the seizures that has frightened me so much.
> He is going on a carb counting course next week, so I hope that does some good, as we havent really got a clue where thats concerned. His DSN did advise to reduce his lantus by 2 units but that has sent his sugars quite high(its amazing the difference 2 units makes!). Hopefully after this course he can get back on track. I know running sugars high isnt good either.



Hi Carole, he should ask the DSN for a single unit lantus pen so he has finer control over the doses. I needed one when my lantus needs started dropping from 20 units to 6 - I needed to be able to do doses of 7, 9 etc.


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## CarolK (May 4, 2010)

Thaks for that, didnt know you could get them. I think hes had the same pens for the last 7 Years. We have just changed hospitals though and new one seems to be better, so will do that.


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## bev (May 4, 2010)

CarolK said:


> Thaks for that, didnt know you could get them. I think hes had the same pens for the last 7 Years. We have just changed hospitals though and new one seems to be better, so will do that.



You can also get pens that do half a unit if you need it.Bev


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## sofaraway (May 5, 2010)

bev said:


> You can also get pens that do half a unit if you need it.Bev



But you would have to change to levemir, you can't get a pen for lantus that does half units. 
The 1 unit lantus pen is the green autopen24, I use it as I am insulin sensitive


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## accountremoved001 (Feb 28, 2017)

Northerner said:


> Thanks Helen, it does help to put it into perspective - rare but not unheard of. Night hypos used to worry me a lot in the first few months after diagnosis (I live alone), as I had them quite frequently. Eventually, I got a good feel for the right dose for my basal insulin and ended up reducing it from 20 units to 6! I'm pretty confident about it now - I did a basal test yesterday, 5.3 before and 5.4 six hours later  I'm similar to Aymes and have my lower 'limit' at 5.5 before bed - below this and I will have a snack.


I can understand how hard it is on your own with it and to deal with it, I get bad hypos at night too and cannot stop them from happening, one min I get the blood readings good and then the next it changes even though I have had the same food, exercise and insulin, I get really frustrated why it does it with me. any clues why? I also have tablets at the side of the bed but the brain does not think to get them!  so annoying to 999 too!


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## accountremoved001 (Feb 28, 2017)

bev said:


> http://www.dundeeforum.co.uk/ubbthreads.php/topics/27411/Dundee_student_dies_after_week.html
> 
> This story is so sad and brings it all home. Lauren I do think your DSN is slightly out of touch with things if she is giving you this advice. Obviously these things dont happen often, but this is the 4th death I have heard about this year. The other 3 were all youngsters age 12, 14, and 18 (I think) and none of them were drinkers. One boy died of DKA within 4 hours of speaking to his mum on the phone as he had gone home from school and his mum was at work. He said he was fine - but when she came home she found he had passed away. I am not trying to worry anyone unnecessesarily here - but I do wish that DSN's would stop telling people that they will be fine if they hypo through the night - because sometimes they are not fine.Bev


I wish my specialists would listen to me too! Even though they can't listen to me now I got  away from them as they don't listen, but still left to have hypos in the night! or high readings but a pump would fix all this! or would it?


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## mikeyB (Feb 28, 2017)

My switch from Lantus to Levemir almost eliminated night time hypos, though recent diet changes to lose weight, successfully, (9Kg in three months) have altered my insulin needs which I am still playing with. It was the split dose, two thirds in in the morning and one third at bedtime of the total daily dose. You can do that with Levemir, but not Lantus, which I am glad to be rid of in truth. And this is all in preparation for a pump in a couple of months, because the answer to your question, Dibbles, is yes, a pump would solve your problems. Its a postcode lottery whether you get one. Whereabouts in Lancashire are you? You don't have to answer that, of course, if you don't want to.


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## accountremoved001 (Feb 28, 2017)

Your looking well MikeyB !    ! I'm on Levemir too and have hypos in the night, not as bad as lantus id agree!  but they still get you! can I ask you what U of Levemir are you taking MikeyB as I've changed mine a little and I think less in the morning than the night one but need to see how others are with this and as I see you said less then this might help me a little better understand too! Gabapentin is not helping the nerve pain at all!


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## trophywench (Mar 1, 2017)

Dibbles - you urgently need to do Basal testing to see what your BG is doing 24/7, however if you are not already setting  your alarm several times throughout the night to check your BG and correct lows before you become badly Hypo, do that, and asap.

What happens if you knock a unit off your night-time dose? - cos all insulins have peaks and troughs and the idea is to get whatever insulin you use, to work as near as you can in unison with your own body's needs.  You can only work this out by basal testing.

It doesn't matter what the hell dose anyone else needs since every single one of us is different - the only thing that matters is the correct amount for you.  However - I needed far far less for my evening dose (less than a third of my morning one) than I did for my morning one of Levemir - neither were they 12 hours apart - about 14 or 15 hours - but that was me, then - and I wouldn't need the same now anyway and would just have to take a guess to start with - and then test and adjust until I sorted it out once more.  Which is what you need to do.

Get fasting and testing.


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## accountremoved001 (Mar 1, 2017)

I tried to reduce levemir at night , and that just gave my high's in the morning, now I'm trying to reduce just Novo at night, instead before bed and rise the levemir, so far its looking good getting 5.5 on wake up and so far no hypos in the night, I also reduced Levemir in the morning, but still getting it going a little too high in the mornings, but sometimes it's spot on, I cannot fig why this is! Has I weigh my breakfast meal to make sure I get the same Carbs each time. I've never tried to wake myself up to test sugar levels, never been advised too!  so now I can try this, as I'm sure I was getting hypo's and not knowing it! Very difficult also on my own! I have no fall back or somone to kick at night! lol when the hypos start, 18+ now!  Thank you Trophywench for the help here! Not too sure what you fully mean basal testing here,I prefer long acting and short acting phrase.


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## trophywench (Mar 1, 2017)

Dibbles - basal is the long acting one - Levemir in your case, and bolus is the short-acting one - Novorapid.

Please read this whole page and as you get down the page there's an explanation of how to do 'Basal testing'  - very very useful thing for any Insulin dependent diabetic to do.  http://www.diabetes-support.org.uk/info/?page_id=120

You get really useful info about your own body, what insulin it needs and when it actually needs it !  Those of us who demonstrate that no insulin currently on the market can adequately match what our body needs - usually decide to opt for a pump!  But there are usually a number of different things we can try before we can safely come to that point - so get testing and tell us the results if you'd like to, and we can have a look at them and see if we can suggest doing this or that, which might help?


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## trophywench (Mar 1, 2017)

Pumps in some ways, are much harder work than just having a few jabs a day - they do not do ANYTHING AT ALL on their own - we still have to tell them to do it! - a lot more testing, reviewing and adjusting - all manually, not automatically - and it never stops!


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## accountremoved001 (Mar 2, 2017)

Thank you Trophy for the link! reading up on it to have a go and see what happens. Pump or no pump we never get a rest!


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## novorapidboi26 (Mar 2, 2017)

How much control does he have of his diabetes at 21?


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## Robin (Mar 2, 2017)

novorapidboi26 said:


> How much control does he have of his diabetes at 21?


Er, this thread started in 2010, I expect the 21 yr old is 28 by now!


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## novorapidboi26 (Mar 3, 2017)

Robin said:


> Er, this thread started in 2010, I expect the 21 yr old is 28 by now!



and still getting his bum wiped do you think...


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