Hypoglycemic Seizures ***Serious!

[Maddogg]

I've been type 1 diabetic for over 7 years and I've never had any serious problems with hypoglycemia. My last Hemoglobin H1C was 5.4, which is probably one the better scores i've recently had.
However, I've been rather unlucky so far in 2009, in the last 3 months I've had three, yes, 3 seizures directly related to hypoglycemia, and not necessarily a bad case of hypoglycemia. My most recent seizure, I was at 3.2 mmol/L, I've been fully consicous and feeling fine with blood sugars below 2.0 mmol/L on several occasions (no joke!). I was taken to the hospital for one the seizures because I stopped breathing for 3 minutes and I had extreme chest and back pain, they pumped me full of morphine and other painkillers and sent me home after 6 hours or so.

My diabetes has been in fairly good to excellent control for several months, but these seizures are really having a toll on me.

I'm gonna book an apointment with my family doctor about this... but has anybody (type 1 or type 2) ever experienced these types of seizures, or something similar, and with the frequency that I've experienced them?!? My gf is really worried about me, I don't want to freak her out anymore.

Thanks in advance...

[xMenace]

Can you describe these seizures in more detail? I don't really know what you are experiencing.

[poodlebone]

Did the seizures start when you were unconscious, or were you awake/aware when they started? I had seizures on MDI and they either happened in the morning, not too long before I'd normally wake up, or at work. In all cases I passed out (or had already been asleep) and woke up seizing. When I finally woke up I was mostly aware of what was happening but couldn't do anything to help myself. I was also freezing cold every time. I was told that those were signs that my liver had dumped and my BG was on the way back up. That makes sense to me because when I awoke I knew what was happening; not totally spaced out as I would be when my BG was extremely low right before passing out. Also, when I could finally test my BG would be in the 50s - 80s range and then just continue to climb.

They are very scary, not only for the person experiencing them but for others as well. For me, getting a pump was the only thing that stopped them. My body does not deal well with long acting insulin.

[zoelula]

I think for something like this I would want to be seen by an endo, not a family doctor to really get to the bottom of what is causing it.

[BlueSky]

I had temporal lobe epilepsy for many years before I was diagnosed T1, but the grand mal seizures had become infrequent (about one a year). After I became T1, I started having a lot more seizures, and they were usually triggered by low blood sugar. But with me, BG had to drop below 2.0 mmol/l before this happened.

You could have a predisposition to epileptic seizures, and lowish blood glucose is the trigger. Anti-convulsant medication may help. But you need to focus your energy on avoiding low BG. In particular, be very careful with alcohol, as it causes you to go low during the night.

Discuss it with your endo, and he might refer you to a neurologist. Just make sure that the two of them talk each other, because they will be treating different elements of the same problem.

[valc3]

I'll throw something else into this mix. Have you started or stopped taking any other medications? Also, are your lows being caused by the seizures?

[Lizzie G]

it sounds like the seizures could be a separate issue? i would want to get this checked out by a neurologist, a family doctor or endo doesnt have the expertise in this field to rule out serious neurological problems.

[xMenace]

I have had convulsions/seizures a few times. I suppose I was unconscious as dw couldn't wake me. It's hard to draw a clear line when you crash while sleeping. I've never drifted into seizures while I was awake.

[jimhuck]

I assume you're having all of these seizures while you're asleep. The more frequently you have these severe lows, the lower your BG is able to go without manifesting signs.

I used to have 6 seizures or so per year. My BG was dropping to 20-30.

I finally stabilized my BG, and avoided having any lows for 3 or 4 months. This "re-sensitized" me to low BG, and I don't have seizures any more.

You said your A1C is 5.4. That is good, but is your BG swinging high and low? It sounds like it is. It also sounds like you're taking a lot of insulin.

The only way I was able to stabilize my BG and avoid swings in BG was cutting carbs out of my diet and drastically reducing the amount of insulin I was taking. I cut my insulin dosage by about 60 percent.

Bernstein said it best: small insulin dosages result in small errors, large insulin dosages result in large errors.

See a doc about this ASAP....seizures are deadly, Most diabetics survive them, but some don't.

My advice is to cut carbs and cut insulin....I'm not a doc, so don't take my advice without checking with one.

[Maddogg]

Can you describe these seizures in more detail? I don't really know what you are experiencing.

2 of them happened in my sleep, the other was in the middle of the afternoon when I was fully awake and just before eating a large plate of pasta. My girlfriend described that my whole body stiffens up and I jerk my limbs around for at least a minute (the longest was almost 3 minutes), and then my lips and face go blue because of lack of oxygen... I've been told that its normal for most people to stop breathing when they have a seizure.

I assume you're having all of these seizures while you're asleep. The more frequently you have these severe lows, the lower your BG is able to go without manifesting signs.

I used to have 6 seizures or so per year. My BG was dropping to 20-30.

I finally stabilized my BG, and avoided having any lows for 3 or 4 months. This "re-sensitized" me to low BG, and I don't have seizures any more.

You said your A1C is 5.4. That is good, but is your BG swinging high and low? It sounds like it is. It also sounds like you're taking a lot of insulin.

The only way I was able to stabilize my BG and avoid swings in BG was cutting carbs out of my diet and drastically reducing the amount of insulin I was taking. I cut my insulin dosage by about 60 percent.

Bernstein said it best: small insulin dosages result in small errors, large insulin dosages result in large errors.

See a doc about this ASAP....seizures are deadly, Most diabetics survive them, but some don't.

My advice is to cut carbs and cut insulin....I'm not a doc, so don't take my advice without checking with one.


You're right about 1 important thing Jim, my body has gotten really used to lows for the past several months (almost a year), I've lost most of my sensitivity to low blood sugars, which isn't good. I don't get too many hypers, and my blood sugar rarely goes up and down by extreme differences. I don't want to cut food and carbs out of my diet (i'm trying to gain weight eh) but I can probably cut some insulin.
I'm not a very patient man though, I don't want to have to have nearly perfect control (hardly any hypos, if any) for half a year just to regain the ability to feel hypos better.... Any other solutions? Maybe changing insulin type, or other over the counter or prescription drugs/herbs I can take to get back to normal faster?

[BlueSky]

... I don't want to have to have nearly perfect control (hardly any hypos, if any) for half a year just to regain the ability to feel hypos better.... Any other solutions? Maybe changing insulin type, or other over the counter or prescription drugs/herbs I can take to get back to normal faster?
Jim is absolutely right. Your priority has to be on stabilising your blood glucose. It is only by minimising those post-prandial blood glucose excursions that the lows will stop happening. Just reducing insulin won't make that happen. The highs will get higher, and you will have to do bigger/ more frequent corrections to achieve satisfactory control.

On the other hand, cutting out the carb and reducing insulin because you don't need as much will give you the stability you need. Blood glucose won't go as high as it did, and it won't drop as fast or as far either.

By doing this, I stopped the seizures, and I was able to stop the anti-convulsant medication too.

[ligawab]

My thoughts and prayers are with you.


ligawab (life is good and we are blessed)

[xMenace]

2 of them happened in my sleep, the other was in the middle of the afternoon when I was fully awake and just before eating a large plate of pasta.

I'll assume by asleep you mean sometime in the middle of the night. Nearly everybody bottoms out in the afternoons, unless you run weird shifts and sleeping patterns. Many of us also drift low between midnight and 4am. With flat basal insulins, these two time periods usually need to be addressed carefully. I have a long history of hypos at both of these times.

One option is to lower your basal insulin to keep these time periods out of the danger zone. This requires you to now address your highs: dawn and evening. Evening is easy, just take a standard small dose of preferrably regular insulin, but rapid will help too. Fixing your dawn numbers is more difficult. You could get up at 5am and do the same to add a shot of rapid, but many can't do that. You could also give a shot at your normal waking time, but you'll have a daily spike gnawing at your A1C. DPs start early.

A second option is to use food. Always make sure you have a snack before bed to cover your expected dive. Always have a mid-afternoon snack for the same reason. Uncovered!
The negatives with this is you are feeding the disease and will gain weight, and as Jim states adding food adds to variability.

The easiest option is to use a pump and set your rates to cover these hills and valleys.

[ferzan.lermiogl]

2 of them happened in my sleep, the other was in the middle of the afternoon when I was fully awake and just before eating a large plate of pasta. My girlfriend described that my whole body stiffens up and I jerk my limbs around for at least a minute (the longest was almost 3 minutes), and then my lips and face go blue because of lack of oxygen... I've been told that its normal for most people to stop breathing when they have a seizure.




You're right about 1 important thing Jim, my body has gotten really used to lows for the past several months (almost a year), I've lost most of my sensitivity to low blood sugars, which isn't good. I don't get too many hypers, and my blood sugar rarely goes up and down by extreme differences. I don't want to cut food and carbs out of my diet (i'm trying to gain weight eh) but I can probably cut some insulin.
I'm not a very patient man though, I don't want to have to have nearly perfect control (hardly any hypos, if any) for half a year just to regain the ability to feel hypos better.... Any other solutions? Maybe changing insulin type, or other over the counter or prescription drugs/herbs I can take to get back to normal faster?
I am agree with others that you need to discuss all with your doctor. I just want to recommend you to inject GlucaGen (glucagon hormone;prescribed anti-insulin hormone) to increase blood glucose faster (in 5-15 minutes). I use it if my blood glucose is <40-60 mg/dl. It is easy to inject (subcutaneously). You just need to have enough glycogen in your liver.

[RWright]

I am agree with others that you need to discuss all with your doctor. I just want to recommend you to inject GlucaGen (glucagon hormone;prescribed anti-insulin hormone) to increase blood glucose faster (in 5-15 minutes). I use it if my blood glucose is <40-60 mg/dl. It is easy to inject (subcutaneously). You just need to have enough glycogen in your liver.

I was told that if you are able to inject the Glucagen yourself, that you should not use it. The doc said it was for someone else to use if you were unresponsive or unable to be treated. How high does your sugar go after this?

[Del]

My anecdote is from this morning.... a bit different I think from anything in this thread so far.

I had a seizure which was very weird and scary (in retrospect). I measured when I got up and it was 76. About 20 minutes after that while in the shower, I rubbed my eyes as I tend to do to try to wake up, and suddenly it was like a pane of thick yellow opaque plexiglass was over my eyes, I could barely see. So I got out and headed downstairs to get something to eat (just in case, I was not hungry) and that's where my memory gets very sketchy. My wife rushed down after I had fallen down and apparently I was having some sort of seizure. I do remember dropping a bottle of water I had in my hand. My hands were shaking like crazy.

Since then I've just been tired. I do also remember my wife giving me grape juice, and thinking how strange it all was, it was like I was watching a movie. I wasn't scared at the time, I was just trying to get to the couch to rest when I fell. Very first seizure ever.

I am sort of thinking that it would be highly unlikely for this to be a result of low blood sugar as I must have been in the 30s. I took no rapid insulin and haven't for about a year. To go from 76 to around 30 in 20 minutes with no rapid insulin and no exercise would be virtually impossible, wouldn't it?

I guess an MRI is in order.

Or just maybe this evil Protophane is at work again? It has done weird things before, never a seizure though.

Anything similar out there?

[Jonathan_R]

I have had seizures off and on since I was 12. Mine were grand mal. Since I have become type 1, I have become even more susceptible. My most recent one was this past Saturday (July 11th). I was at Barnes & Nobles after having passed up several offers from my wife for bites of her Cinnabon. I started feeling a bit light headed and went to sit down. I guess I didn't make it. I vaguely remember waking up at the book store wanting to hurl, and hugging a rather large trash can. The next thing I know, I'm at the hospital. I ended up with a 6 cm cut, and needing 4 staples and 1 stitch. They said my blood sugar was 86.

Previously, about 2 years ago, my blood sugar dropped to thirty something, and I had a seizure. Back then, I used to routinely dip into the thirties, and spike over the six hundreds. This was when I was seeing my primary care doctor and endo.

[Cluck]

I just want to recommend you to inject GlucaGen (glucagon hormone;prescribed anti-insulin hormone) to increase blood glucose faster (in 5-15 minutes). I use it if my blood glucose is <40-60 mg/dl. It is easy to inject (subcutaneously). You just need to have enough glycogen in your liver.

I'd suggest that you take glucose tablets or glucose liquid instead. They will work just as fast and do not put that extra load on your liver.

I've read somewhere (wish I had a link) that if the liver is constantly doing glucose dumps then eventually it becomes less able to do so and glucagon injections stop working.

Personally, I'd save those injections for when/if I'm unconscious and my dh (or someone else) can inject me. When I'm awake I'd rather eat or drink.

[ferzan.lermiogl]

I was told that if you are able to inject the Glucagen yourself, that you should not use it. The doc said it was for someone else to use if you were unresponsive or unable to be treated. How high does your sugar go after this?

This is true, glucagon is injected by someone if you are unconscious or can not take sugar orally. To my experience, If blood glucose level decreases sharply, it is easier to recognize and to correct by glucose tablets or fluids in a short time. If blood glucose level decreases slowly, it may cause worse condition (for me, around 40-50 mg/dl or lower): in this case, although I take glucose tablets (5-10 or more) or drink liquid form, it takes long time to increase blood sugar level, and also for feeling good. After then. it increases to very high levels (300 or more mg/dl). I also can not drink/eat much/many sweet fluids or glucose tablets in this situation (because of taste). You know, glucaGen is 1 ml (when mix the powder and solution): I prefer to inject 1/4 or 1/2 of this solution. It increases the level quickly. Then I measure it after 15-30 and 60 min. If I inject glucaGen immediately, my BG does not exceed 140-160. If it is necessary (usually when BG is 30 or less), I drink 100 ml fruit juice after 15 min. of injection. It does not happen frequently (very low BG levels). I mean I do not need to use GlucaGen every day or chronically; so do not think it is harmful for my liver. (It also decreases glucogen load in my liver, maybe!). However, I have to point out that I apply thls as a consequence of my own experience.