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Re: Scary Hypo Episode!

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Tottie, Thanks for sharing... boy! but I don't think I would have bothered

with that second insulin shot when you were at 140.. that's nothing really

to be overly concerned with after that ordeal. vegasbilly 117 degrees her

now.. I'd like to get that down to 80

Scary Hypo Episode!

> I had the most frightening hypo episode last night. I had taken my

> usual

> dosage of Humalog and eaten dinner. This is the same dinner and the

> same

> dosage I have taken many times before with great success. I tested

> before

> eating and was at 80 mg/dl. I injected my usual units of Humalog.

> Immediately after finishing eating (about 15 minutes after I'd

> started), I

> went to brush my teeth and while I was bent over the sink, started to

> get

> the strangest feeling. My vision went all " blotty " for want of a

> better

> word. It was as if there were big areas of my vision that were all

> blotted

> out. I was weak and started to sweat profusely. I somehow made it

> to the

> bed and dragged my monitor and testing stuff in with me. While

> laying down

> I tested and it came out at 44 mg/dl! A drop from 80 to 44, in 15

> minutes,

> even though I had just consumed my regular dinner with my normal

> amount of

> carbos. I have never had anything like this happen before. Sure, I

> might

> go down to the 60's once in awhile, but that's all. I felt

> absolutely no

> hypo symptoms until I hit 44. I was so scared, I started taking

> glucose

> tablets (4 grams carbs) and tested again in a couple of minutes,

> hoping

> things had started to reverse. No luck, I was still at 44. In a

> panic, I

> took more glucose tabs, and then more. I knew I was probably over

> treating,

> but I was so scared, I just didn't want the paramedics to have to

> come to my

> house. I kept testing every couple of minutes until the bed was

> littered

> with used testing strips. I couldn't sit up or move. I had to

> perform all

> these test laying on my side. Well, the tide finally started to

> turn, I

> stopped sweating, and within an hour I was up to 141. Then I had to

> take

> more insulin to get back it down. An hour after that, I was at a

> comfortable (for me) 91 mg/dl and I went to bed after shooting my

> customary

> bedtime NPH. No more problems through the night and this morning I

> was at

> 85 mg/dl. What could possibly have caused an after dinner hypo such

> as

> this? I can see having a hypo if I haven't eaten in a long time, but

> not

> one right after eating a whole bunch of carbs for dinner. Could I

> have

> injected into a vein by mistake? If I had, wouldn't it have affected

> me

> sooner than 15 minutes? There was a drop of blood at the injection

> site,

> but I often have these, and have never had this problem. I'm pretty

> nervous

> about dinner time tonight!

> Tottie

> Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

>

>

>

>

>

> ------------------------------------------------------------------------

> Find out your risk for Diabetes and win one of 40 cash prizes.

> For every test taken, we'll donate a $1 for research.

> http://click./1/5604/1/_/529507/_/961261271/

> ------------------------------------------------------------------------

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

>

>

>

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Yes, I had to think twice about taking that 2nd shot, but my FBG's had been

so good, mostly in the 80's, that I wanted to bring it down so I didn't mess

up the next mornings reading. Probably wasn't such a good idea, but it

worked out. It's kind of hot and muggy here in N.E. PA, but I'm staying in

the air conditioned bedroom all day!

Regards,

Tottie

Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

Re: Scary Hypo Episode!

> Tottie, Thanks for sharing... boy! but I don't think I would have

bothered

> with that second insulin shot when you were at 140.. that's nothing really

> to be overly concerned with after that ordeal. vegasbilly 117 degrees

her

> now.. I'd like to get that down to 80

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Vickie, thanks. Is Susie away on vacation?

Tottie

Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

Re: Scary Hypo Episode!

> Wow, Tottie, that's scary. I don't know what to advise you...wish Susie

were

> here. Vicki

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In a message dated 00-06-17 16:16:39 EDT, you write:

<< Vickie, thanks. Is Susie away on vacation?

Tottie >>

Yes, she and Rob went to N'Orleans for a conference. You must've missed her

post. I think she said she'd be gone for two weeks. Oughta be back soon.

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Hi ,

The weather has been hot but I spend all my time in the air conditioned

bedroom. I injected in the belly, so that couldn't have had any bad effect.

That's where I always inject. By the way, I had another one last night

under completely different circumstances. I'll post the details of that

today. Thanks for your thoughts.

Tottie

Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

Scary Hypo Episode!

>

>

> I had the most frightening hypo episode last night. I had taken my

> usual

> dosage of Humalog and eaten dinner. This is the same dinner and the

> same

> dosage I have taken many times before with great success. I tested

> before

> eating and was at 80 mg/dl. I injected my usual units of Humalog.

> Immediately after finishing eating (about 15 minutes after I'd

> started), I

> went to brush my teeth and while I was bent over the sink, started to

> get

> the strangest feeling. My vision went all " blotty " for want of a

> better

> word. It was as if there were big areas of my vision that were all

> blotted

> out. I was weak and started to sweat profusely. I somehow made it

> to the

> bed and dragged my monitor and testing stuff in with me. While

> laying down

> I tested and it came out at 44 mg/dl! A drop from 80 to 44, in 15

> minutes,

> even though I had just consumed my regular dinner with my normal

> amount of

> carbos. I have never had anything like this happen before. Sure, I

> might

> go down to the 60's once in awhile, but that's all. I felt

> absolutely no

> hypo symptoms until I hit 44. I was so scared, I started taking

> glucose

> tablets (4 grams carbs) and tested again in a couple of minutes,

> hoping

> things had started to reverse. No luck, I was still at 44. In a

> panic, I

> took more glucose tabs, and then more. I knew I was probably over

> treating,

> but I was so scared, I just didn't want the paramedics to have to

> come to my

> house. I kept testing every couple of minutes until the bed was

> littered

> with used testing strips. I couldn't sit up or move. I had to

> perform all

> these test laying on my side. Well, the tide finally started to

> turn, I

> stopped sweating, and within an hour I was up to 141. Then I had to

> take

> more insulin to get back it down. An hour after that, I was at a

> comfortable (for me) 91 mg/dl and I went to bed after shooting my

> customary

> bedtime NPH. No more problems through the night and this morning I

> was at

> 85 mg/dl. What could possibly have caused an after dinner hypo such

> as

> this? I can see having a hypo if I haven't eaten in a long time, but

> not

> one right after eating a whole bunch of carbs for dinner. Could I

> have

> injected into a vein by mistake? If I had, wouldn't it have affected

> me

> sooner than 15 minutes? There was a drop of blood at the injection

> site,

> but I often have these, and have never had this problem. I'm pretty

> nervous

> about dinner time tonight!

> Tottie

> Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

>

>

>

>

>

> ------------------------------------------------------------------------

> Find out your risk for Diabetes and win one of 40 cash prizes.

> For every test taken, we'll donate a $1 for research.

> http://click./1/5604/1/_/529507/_/961261271/

> ------------------------------------------------------------------------

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

>

>

>

>

> ------------------------------------------------------------------------

> 1 out of 3 have it and they don't know it.

> ARE YOU AT RISK?

> Find out and win $1500!

> http://click./1/5606/1/_/529507/_/961331649/

> ------------------------------------------------------------------------

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

>

>

>

>

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Tottie

> A drop from 80 to 44, in 15 minutes,

> even though I had just consumed my

> regular dinner with my normal amount

> of carbos. I have never had anything

> like this happen before.

Sounds to me like a bout of gastroparesis (late stomach emptying).

Your 'regular meal' was still right there in your stomach and had not

yet contributed anything to your blood glucose concentration. The

insulin, of course, gets into your blood without going through your

stomach.

> I was so scared, I started taking glucose

> tablets (4 grams carbs) and tested again

> in a couple of minutes, hoping things had

> started to reverse. No luck, I was still at

> 44. In a panic, I took more glucose tabs,

> and then more.

Yeah, and those glucose tablets probably stayed right there in your

stomach along with the rest of the stuff! It is quite acceptable to

panic the first time it happens but you won't have an excuse if you

panic the next time. The right things to do are described in Dr.

Bernstein's book on pages 290-299 (abdominal exercises, sugar-free

chewing gum, MCP syrup, etc.).

> Well, the tide finally started to turn,

> I stopped sweating, and within an hour I

> was up to 141. Then I had to take more

> insulin to get back it down.

Your stomach (the pyloric valve) had finally opened up and the whole

lot, including the glucose left for your duodenum in one big rush.

You didn't HAVE to take more insulin, however. The whole system

reacts slowly so it would not have hurt you just to wait it out,

taking readings every 15-20 minutes would be often enough if you

really need that much reassurance.

> I can see having a hypo if I haven't eaten

> in a long time, but not one right after

> eating a whole bunch of carbs for dinner.

By 'eating' your dinner, you mean getting it down into your stomach.

Your meal is then first sorted out in your stomach as it churns it

backwards and forwards. Under the control of the pylorus valve, the

carbohydrates in the meal are normally released into your duodenum

without further processing while your stomach continues to process

the fat and proteins. The glucose from the carbohydrates enters your

blood stream in your duodenum which is the other side of your

stomach. If the vagus nerve controlling the pylorus valve is damaged

by diabetes (or for a number of other reasons) then it will not open

on time and the entire meal, including the carbohydrates, will be

retained by your stomach.

> I'm pretty nervous about dinner time tonight!

There is really no need to be nervous. Why not wait with the insulin

until after you have eaten something and seen the result? Take a

reading 30-60 minutes after you start to eat and if all is normal you

should see that your BG has risen. If it hasn't, do the exercises,

chew the gum, take the MCP. Take readings every hour (in bad cases,

the meal can take 5-12 hours to leave the stomach!). When you see

that your BG has risen, take the insulin.

I understand that in really bad cases it may be necessary to give

yourself (or, if you are unconscious, have somebody you trust give

you) intramuscular or subcutaneous injections of Glucagon. It is

worth reading Chapters 19 and 21 of Dr. Bernstein's book for more

details.

Gastroparesis can be caused by disorders other than diabetes (e.g.

gastric or duodenal ulcers, gastritis, hernia) and there are quite a

number of diagnostic measures available. This is a case for your

physician to look into without unnecessary delay. It is a common

mistake, possibly a fatal one, for diabetics to believe that

everything that goes wrong with them must be attributable to their

diabetes.

Regards

Thornton

Pforzheim, Germany

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Hi, Tottie,

I know you must have been scared. I think perhaps you may have partially

injected a vein in order to see such an episode. As has mentioned,

gastroparesis may be another cause, but I'm not really sure about that.

> Immediately after finishing eating (about 15 minutes after I'd started)

Perhaps you should let your sugars ride a little high for the next couple of

weeks, especially considering the fact that you've had two spells in less

than a week. 120 - 140 may sound bad to those of us that believe in tight

control, but for now it will give you an extra cushion while you and your

doctor figure out what happened. Another thing you may want to consider is

the use of a log to keep exact tabs on what you eat, what quantity, when,

and with how much insulin or medication. It sounds hard, and stifles some

of the enjoyment of eating, but otherwise you really have to rely on

memory--which may or may not serve you well when you try to recall exactly

what went wrong with your food/medication schedule.

Go with God, Esther

t2, diet, exercise, insulin, etc.

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Hi Esther,

Yes, I think I must have injected into a vein or large capillary to have

such a severe hypo 15 minutes after taking the shot. I appreciate your

suggestions. I know it would probably help prevent hypos if I could let my

BG go somewhat higher, but I have been striving for tight control for so

long, it's hard to see it go up. I do think that I may have to do that.

For now, I'm experimenting with the H dosage. Got my HbA1c back today and

it's 5.5%. That's down from the 8.2% it was last time, and the 12%+ it was

many months ago. My next one should be even better as I've only been in

tight control for almost 2 months. Thanks for your thoughts.

Tottie

Type 2, Dx Oct 98, Avandia, Glucophage, Lopid, Prinivil, MDI H & NPH

Re: Scary Hypo Episode!

> Hi, Tottie,

>

> I know you must have been scared. I think perhaps you may have partially

> injected a vein in order to see such an episode. As has mentioned,

> gastroparesis may be another cause, but I'm not really sure about that.

>

> > Immediately after finishing eating (about 15 minutes after I'd started)

>

> Perhaps you should let your sugars ride a little high for the next couple

of

> weeks, especially considering the fact that you've had two spells in less

> than a week. 120 - 140 may sound bad to those of us that believe in tight

> control, but for now it will give you an extra cushion while you and your

> doctor figure out what happened. Another thing you may want to consider

is

> the use of a log to keep exact tabs on what you eat, what quantity, when,

> and with how much insulin or medication. It sounds hard, and stifles some

> of the enjoyment of eating, but otherwise you really have to rely on

> memory--which may or may not serve you well when you try to recall exactly

> what went wrong with your food/medication schedule.

>

> Go with God, Esther

> t2, diet, exercise, insulin, etc.

>

>

> ------------------------------------------------------------------------

> 1 out of 3 have it and they don't know it.

> ARE YOU AT RISK?

> Find out and win $1500!

> http://click./1/5606/1/_/529507/_/961359323/

> ------------------------------------------------------------------------

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

>

>

>

>

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