low sugar in combination with a traumatic shock event

[erich]

I am 50, and type1 for 35 years, in perfect health, not even micro aneurysms or any detectable kidney function lose. This all on two injections per day and two BG tests.

The only dangerous situations I have ever found myself in were when I have had low sugar in combination with a traumatic shock event. Twice this has happened in 35 years. The combination of hypoglycemia with a fainting event will send me into an unconscious state which takes hours to recover from.



My hint to simplify things comes from my grand father who did some of the original testing on insulin at the FDA. He told me that insulin kept at room temperatures over a year only loses 5% potency, and doesn't sting when at room temps.



What really gets my goat is the continued misrepresentation of diabetic conditions in the story line of movies over the years. Like we would die within hours without insulin or low sugar. I just want to stand up in the theater and give an impromptu lecture to set the record strait.

Let us all pray for the Hot Pepper Cure, I believe 4 months in a mouse is 15-20 years in humans. Diabetes breakthrough (http://www.canada.com/nationalpost/news/story.html?id=a042812e-492c-4f07-8245-8a598ab5d1bf&k=63970)

I found this wonderful forum because of the thread you all have on this discovery, I love those GOOGLE alerts .

Erich J. Knight

[Dad-of-Elias]

What really gets my goat is the continued misrepresentation of diabetic conditions in the story line of movies over the years. Like we would die within hours without insulin or low sugar. I just want to stand up in the theater and give an impromptu lecture to set the record strait.


So you're telling me that our son's doctors (I'll say it again, doctors with an "s" at the end) are lying to us when the tell us that our child will go DKA in a matter of hours without insulin?

[KCP]

I totally agree with erich: Those movies really annoy me!!!
I can last ages without insulin. I dont have a pancreas so i have no physical way of making insulin myself.
Granted i usually start to feel pretty gross after awhile...

[Dad-of-Elias]

This all on two injections per day and two BG tests.

More questions... cause I'd love to know your approach... What insulin are you using? One shot for long acting and one shot for short acting? Before which meal do you bolus? What two times of day do you test (or do you test in combination with a CBGM system)? Are you eating low carbs? Exercising excessively or not at all. Thanks!

[BlueSky]

..... I can last ages without insulin .....
Do you also use a pump? Or do you inject long-acting basal insulin? .... :wink:

[duck]

So you're telling me that our son's doctors (I'll say it again, doctors with an "s" at the end) are lying to us when the tell us that our child will go DKA in a matter of hours without insulin?

We're all different--I would NOT tell you otherwise, but when I was younger, a few times (more than I care to really think about nowadays) I went half a day or so without a bolus...Knock on wood, nothing "bad" happened.

[DeusXM]

Survival times for DKA vary according the individual. Some people seem to soldier on for a couple of weeks before they go into a coma, others seem to manage it in just a few hours. Most people are probably somewhere in between those two extremes.

Similarly, hypoglycaemia is unlikely to be fatal but if the right conditions are met (large presence of insulin, no food currently being digested, impaired liver function either through low glycogen supplies or alcohol), then a hypo can kill you in less than an hour too. Let's not trivialise these things; they are serious and real risk.

It's just that they're also reasonably unlikely ones in people with diabetes who are proactive in their control.

[Stuboy]

Im still honeymooning, and i've managed to miss (by accident) my bolus for a meal once and I wasn't really affected. I've also missed my basal once too (before i split) and also was not affected. But this is down to the honeymoon period.

I've noticed a few diabetic references in movies and programs on TV. Like CSI, the other night there was an episode where a diabetic guy killed these girls at swinger parties... they caught him because one girl said he had "sickly sweet" breath. When they got in his car they turned on the air vent fans and "the smell" came out of the vent (oh PUH LEASE!!?), and that they couldn't smell it on his breath "just now" because he'd already taken his insulin that day... suggesting that if you miss your insulin within a couple of hours you have ketones on your breath... I thought that was a bit far fetched tbh...

[Stuboy]

Also... found it convenient that most of the people in that investigation could smell the ketones... not everyone can smell them, it's a genetic thing. I can't smell them, my sisters can't, Laura can't, mum can't, dad can't, but the nurse who i first saw on diagnosis could... she knew my sugars were high before taking my blood test "5, 4... I can tell you know that will read "HI", she said... 2, 1.... "HI". Before i'd even sat down she said has anyone told you recently you have Sweet Breath? (i thought she was coming on to me, lmao)

[DeusXM]

It's pretty much a standard thing though that diabetes will always look poorly portrayed in the media. When you think about it, for all of us, our goal is to minimise the effect diabetes has on our lives. The moment you make diabetes part of a storyline, it has to have an effect.

If you have a character with diabetes in a storyline, then that character has to have diabetes for a narrative reason, which invariably means that they'll have to be different to the majority of us for whom diabetes is something we just get on with.

The other side is of course that it would seem the entire universe received a class on diabetes at some point in 1964 and hasn't bothered to see if things have changed. But I'd imagine that's the same for so many things, be it portrayal of cancer or another illness, or even just if they've got the architecture wrong in a movie (yes, that's you, Apocalypto!).

[erich]

I am a landscape design/builder, onset at 16 while a military dependent. Never could afford insurance so over the years I would volunteer for medical studies involving complications, I would get a full workup and be promptly rejected because I showed no signs.

I am sure that my first 30 years of control was very loose, I only started BG testing about 8 years ago.
For those first 30 yrs I took once a day an average of 50 unit of NPH , now I do a mix of R & NPH twice a day, total of 60 units. I test morning and evening.

WalMart has the cheapest insulin and $20/50 test strips, back in 1987 when they first opened here , for the first 2 years they sold insulin for $7.50. It has always upset me that the Bio-tech revolution in insulin production never has lead to a reduction in price.


To me good control is a balance of the three main variables Insulin, food and activity. My hypo-awareness has always been 15-20 minutes before I began to sweat, which in the days of urine testing probably helped me keep tighter control.

The hypo experience seems to be so highly variable because it is our brain cells screaming at us and the thoughts and behavior that manifest are dependent on our individual personalities. Paranoia, anxiety, or withdrawal what ever predisposition we possess is amplified. This variability is probably why screen writers get it so wrong so often.

Erich


Excuse my ignorance but I thought a bolus was the lump of chewed food that one swallows?

[It Ain't Over]

I've noticed a few diabetic references in movies and programs on TV. Like CSI, the other night there was an episode where a diabetic guy killed these girls at swinger parties... they caught him because one girl said he had "sickly sweet" breath. When they got in his car they turned on the air vent fans and "the smell" came out of the vent (oh PUH LEASE!!?), and that they couldn't smell it on his breath "just now" because he'd already taken his insulin that day... suggesting that if you miss your insulin within a couple of hours you have ketones on your breath... I thought that was a bit far fetched tbh...

That describes a person experiencing ketoacidosis. If it was that bad he may not live long enough to complete the show.
Hollywood brain dead idiots.

[duck]

Excuse my ignorance but I thought a bolus was the lump of chewed food that one swallows?

It is...I guess they couldn't invent a new word for "bolus" as it applies to diabetes.

[Dad-of-Elias]

I'm really impressed with the way you've been able to manage the condition so effectively/efficiently for 35 years. It's great that you're so in tune with your body. I hope you find a solution to avoid the traumatic shock events. Best wishes, Rich

[JasonJayhawk]

An instance of several people surviving days without insulin -- during Katrina. Remember the video to one of the news websites where a nurse "saved" a type 1 diabetic female who hadn't had insulin in days, and she was saved with just "5 units of Lantus"?

DKA and going without insulin are two different things. You can take the same type 1 person, remove insulin from them, and do different things to them (exercise, food, water intake) and cause severe DKA in different cases.

Erich, thanks for your post! What type of insulin do you currently use? Have you ever had your pro-insulin levels checked? A minority of Type 1's may actually have a genetic form of diabetes that can be resolved with Type 2 medications (sulfonureas, I think).

[erich]

Thanks for the replies all

Dad:
It's a rare occurrence when both type of shock happen together.

My first was 1980,right before lunch ,working at a Psych Emergency room, a patient ripped out his IV, and it got very messy restraining him, and setting new IV. I tend to faint only at the blood I know and unfortunately I had done intake on this guy. In my near hypo state I fainted , woke 3 hours later , restrained myself in the seclusion room , with my cohort of mental health professionals , laughing at some of the delusional content I had been spouting.

The second 1992, was also right before lunch, Rushing to finish pruning a perfect Japanese Maple, I pruned off 1/4 inch of my finger, went into the clients house told them what was going to happen, downed as much OJ as I could , passed out woke 2 hours later , but as before took all day to feel normal again.

I Just thought I should share this risk so that others can act quick if such circumstance befalls them.

Jason:
Since WalMart arrived, I have used Novolin70/30 or a mix of R & NPH, morning & evening , average 60 units

No, had not heard of Pro-insulin , will ask my doc about it
Proinsulin - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Pro-insulin)


Over the years I have been asked to counsel folks who are very brittle and can't seem to strike a balance, even with multiple shots & testing, Seeing these folks struggle ,with what seems so simple to me, leads me to believe that D is a most variable disfunction dependent on individual body metabolism.

For those of you dealing with swings like this don't let a lucky fool like me, or any other A1c braggart get you down.



Cheers,
Erich

[SueM]

I'm another lucky so and so that managed for many years on 2 shots a day with no problems.
I have 3 shots now because I need neutral/regular at lunch time now due to taking steroids every day.
I have had lows that can only be re righted with steroids if I go into shock/injured/sugery/illness. But then my BP/BS/sodium levels etc have all gone west by then anyway. (addison's crisis)
If I am vomiting then it's a shot of steroids other wise it's steroids by mouth.
Normal lows I just eat a couple of biscuits or 4 glucose tablets and am fine.