Wake up call

By morris.js Latest Reply 2009-12-14 08:23:32 -0600
Started 2008-06-04 01:28:58 -0500

This morning, I had a serious wake up call. I noticed a commotion in the parking lot next to my house, and went to investigate. When I got there, I was told about a Diabetic woman who was unconscious. Her friend told me that the woman had taken her insulin this morning, ate a breakfast sandwich with a cup of coffee. I asked if she had an emergency glucagon kit with her and the woman replied she did not. By the time the ambulance arrived, the woman had no pulse.
I am a type 2, who no longer needs insulin. However I do experience some serious lows in my sugar levels. It is common for me to drop into the 50's, occassionaly the 40's, and at one point a 35. I have always been fortunate enough to have my body give me warnings of these lows so that I can take some glucose or drink some orange juice. I will even wake up out of a sound sleep with cold sweats and shakes to warn me.
This incident this morning awoke me to the fact that there may come a time when I won't be able to take action. It is MANDATORY for all who take insulin, or anyone who experiences lows to have a Glucagon Emergency Kit with them. And even though those kits come with simple instructions for bystanders or family to use, make sure that those close to you or who are traveling with you, know the signs of Hypoglycemia, how to use the kit.
I was told later that the woman did not survive. I cannot help but wonder what the outcome may have been had I been dilligent enough to have a Glucagon Emergency Kit in my home.
In the last month, I experienced another incident where a woman in our Tae Kwon Do class almost went unconscious from low blood sugar levels…fortunately she was able to sip some orange juice and recover.
For those of you who do not know what Glucagon is, it is an injection that facilitates the release of stored glucose back into the bloodstream to assist those who are too out of it to assist themselves.
Please take precautions and be prepared. John

22 replies

Deborah Green
Deborah Green 2009-12-13 21:38:13 -0600 Report


Elrond 2009-12-13 21:53:05 -0600 Report

Deborah, glucagon is available by prescription only. If you want one, you will need to ask a physician. And the best rule of thumb is to never use one on a concious person. If the patient is able to swallow oral carbohydrates, that is the preferred treatment. In my case, I've kept glucagon handy for years because I'm subject to diabetic seizures, especially when my sugar drops unexpectedly while I'm sleeping. Twice in the last 10 years, I've needed glucagon to halt a seizure and restore me to conciousness enough to take oral carbs. I hate to think what may happen if it occurred while I was sleeping alone.

Elrond 2009-12-13 21:58:44 -0600 Report

By the way, glucagon must be mixed before injection. It would be very difficult for a person with very low sugar to self-inject. Chewing and swallowing tablets makes much more sense.

Deb-G 2009-12-14 08:23:32 -0600 Report

Deb…Ask your Dr to prescribe a Glucagon Hypo-Kit…There are 3 simple steps to mix and inject…It is not for self injection…its for others to use if you are unconscious or seizing…As I have found it is extremely fustrating for family to watch you have a GrandMal with nothing they can do but call 911…so we have the kit and all my family is aware of how to mix and inject…most of the time someone is around me that is aware of the injection…of course there is always a posibility something happens when I am out and nobody is with me (has happened) and then the injection really isn't much good…The seizure is your body's way of preventing coma…an emergency response also happens to raise your glucose level at that time…the glucagon wont stop a seizure that has started but it will prevent another one from following and may interrupt the severity…This is something to use in an emergency…not a typical low blood sugar episode…in those cases take your glucose liquid or tabs and then eat something…Glucagon is not dangerous to you but overuse of anything not truly needed isn't a good idea…Treat yourself orally whenever possible!…I dont have seizures in my sleep as I snack and test prior to bed…my seizures have all happened around late afternoon…so i'm happy to have this little orange box of security :) When I am at a sporting event…i have a Road I.D. sport band that alerts people to my complication and also the hypo kit… RoadID.com …good to have too!

Soozeeq 2008-06-04 19:06:06 -0500 Report

Boy that is a scary story. It really makes you think.

morris.js 2008-06-05 13:03:43 -0500 Report

Hi Everyone, Just an update for you. I saw my Doc today and told him the story of the woman, and he said with my history of lows, even though I am not on any insulin, I should have a Glucagon kit. Especially with the amount of activity that I do with high intensity, (the Tae Kwon Do). I do take Glimeperide, Brand name Amaryl, which is unlikely, but has the potential to cause Hypoglycemia, (low blood sugar).
Just thought I would pass on the fact that according to him, it is not only those on insulin that risk severe lows. Those that take other meds besides insulin should be aware if any of the side effects are possible Hypoglycemia, or those that have periods of intense workouts.

kdroberts 2008-06-05 13:50:40 -0500 Report

You're right, any drug that stimulates insulin production can, and will if you are not careful, cause lows. That goes especially for sulfonylureas (like glimeperide) that stimulate insulin production for 24 hours. It will cause lows, no ifs not buts, if your numbers are good and you cut back on carbs or skip a meal or work out harder than normal. That was the reason I stopped taking glyburide, too many episodes of blood sugar in the 50s. Other drugs that stimulate insulin are starlix, prandin, betta and januvia. However, they work very differently to sulfonylureas and are much less likely to cause hypoglycemia, although I do get it taking starlix from time to time. Byetta and januvia shouldn't cause lows but if you take them in combo with other diabetic meds the chance increases, but it's still low.

Diabetes and the treatments are too complicated sometimes!

Deb-G 2009-12-12 12:11:51 -0600 Report

I've had 2 Grand-Mal Hypoglycemic seizures…I now carry a Glucagon Hypokit with me at all times…Any altered consciousness warrants injection…it can save a life…and its better to be safe then sorry…No, you dont need it for typical lows of shakes and sweat…take glucose tabs, etc…but altered consciousness is dangerous on the brain even without seizure…If they have a kit, use it! :)

Deb-G 2009-12-12 12:16:04 -0600 Report

BTW…I dont like to wear medical alert stuff and the metals make me break out…BUT…there's a simple velcrow bracelet that you can slap on when biking, hiking, etc that can alert people to what you need in an emergency etc… RoadID.com and they are inexpensive…Great for people on the go and athletes…Thought i'd throw the tip out there for people on the go like me :)

Dancehawk 2008-06-04 17:09:06 -0500 Report

I am sorry about the woman. and you have touched on a area i had no clue about, I carry the glucols tablets but will look for the kit too.

Not sure if this will help or not but I eat a extend bar before bed, it keeps you stable for 9 hours while you sleep, exercise or daily junk, it really helps.
I use to wake up about 3 am needing to eat and feeling really weird i would check my sugar and i would be low,
Now i ho;d all night long and do not have the dawn effect either.
it is worth trying and carrying with you for a snack to help with your sugar.


jupton1 2008-06-04 14:44:35 -0500 Report

I ran as a medic in my home town for several years.I have seen this happen before,its kind of weird now,I have to treat myself..John

John Crowley
John Crowley 2008-06-04 10:44:09 -0500 Report

Wow! What a frightening experience.

I came across a homeless man having a seizure last summer. One of his friends was trying to roll him onto his side (I have no idea why). I tried to step into to help, but the friend just kept pushing on his shoulder. It was really a sad scene.

I can only imagine watching someone fall unconscious from a low blood sugar. Good reminder about emergency glucagon kits. And good reminder from kdroberts too about only using them in extreme emergencies.

taz202020 2008-06-04 11:11:33 -0500 Report

That man was probably trying to turn his friend on his side in case he vomitted. The man could have aspirated it into his lungs. I'm just guessing though.
I am a type 2 diabetic and found out about 9 months ago. I've never had to take insulin, I'm one metformin. I still have an occasional low around 65 and feel pretty bad. I wss told to carry a juice box with me so I keep one in my purse. I also carry a granola bar. Should I also get the pills to carry in my pocket? I was also worried what would happen if my glucose dropped too low when I was sleeping. I've been using the treadmill at night and lowering my bg but they are still at normal levels.If the bg goes down while you're sleeping does it usually wake you up? This kind of scares me. Should I ask my doctor for a perscription for the kit? Do you really think I need one? I was also wondering if any of you wear a medical alert bracelet or necklace.

kdroberts 2008-06-04 11:28:48 -0500 Report

Your body is pretty good about fixing problems, however when you "overdose" on insulin via insulin injection or drug (not metformin) it can override the fix. Normally when you are low your body will release glucagon on it's own and in an amount that isn't too much and your liver will release glucose and take care of the low. If you have too much insulin in your body then this reaction may not be enough. At night you should be fine if you just take metformin.

My personal opinion is that you definitely do not need a glucagon kitand you probably don't need any other blood sugar raising agents, although the glucose tabs are easy to carry and cheap to buy at Target so that wont hurt. For me personally, 65 isn't low enough to treat specifically, I'll just maybe take 1 glucose pill (4g of carb) or just eat my next meal. I'll treat when I get into the 50's. If you have questions it's always worth talking to your doctor.

I do not wear an ID bracelet, I've thought about it though. I do carry a medical card though that has my contact info, medical info and medications I take. It's easy to make and you just need to put on the vital info like contact details, emergency contact, medical conditions and medications. I have my doctors listed too and some people I know have things like usual blood pressure and heartbeat.

tmana 2008-06-04 17:18:42 -0500 Report

For NIDDM T2, anything under 70 is considered low and in need of treatment. My doc stated to me that if my bg should drop below 50, I *would* pass out, and that 40 would be low enough to kill me.

Regarding ID, I don't wear a medic-alert bracelet, and I'm too tied to my Polar Heart Rate Monitor's watch to spend for a Cadex watch (http://www.epill.com). I do, however, have my cellphone wallpaper set to a star of life with "Type 2 Diabetes", and ICE entries for both my Other Half and my doctor.

kdroberts 2008-06-04 18:07:35 -0500 Report

That's fine. I'm just saying for me what I do. I've been in the low 50's before (one time I didn't even realize it, just taking a pre meal level) and every time I was that just ate my next meal as normal. For me personally I don't like to treat lows with the 15/15 rule unless they are very low, like sub 40's or under which thankfully I haven't had, because a) glucose meters aren't accurate enough to give you a real reading (a reading of 70 could be 85 and still within the standard accuracy for a glucose meter, it could also be 55) and b) if I treat I rebound too high and it messes me up. I may have 4-8g of sugar carb if I test low and have symptoms of low blood sugar and it's not close to a meal but I never do the 15/15 rule anymore. On Sunday I started feeling shaky, tested at 63, ate 4g of glucose and then went back to what I was doing. I ate about an hour later at which time I was in the high 80's. Insulin users have different problems with lows, but for me it works. regardless of what type you are or what medication you take, there is no one size fits all so you have to work out a plan based on trial and error and with your doctor. I know for me personally that really treating blood sugar in the 60's is a bad idea because it will raise my blood sugar higher than I want.

I've not heard of blood sugar in the 40's killing you and I have read about people who test in the 20's and teens that have come out of it fine. of course they did need treatment and I know one person who.s father goes very low frequently, in the 30s, and has had to use glucagon, but they are still alive. Everyone is different though.

tstoikes 2009-12-12 18:11:38 -0600 Report

I think the minimum you should have a wallet card. I have often been in the mid 30's taking my insulin at night. When I switched to a single dose in the morning my levels have been nowhere near those lows. I also like to carry the glucose tabs. I may not need it but you never can tell when you will come across some one who's sugar is crashing.
As to braclet or necklace - a local paramedic told me they always check for one if a person is unconsious or unable to commincate.

kdroberts 2008-06-04 08:58:07 -0500 Report

Just to add to this. Glucagon is not something to be treated lightly and is prescription only. In this case it may have saved a life, however it is a last resort as it is very powerful. It's not something you need to use if you occasionally have sugars in the 50's and 60s and generally anyone who doesn't take insulin probably won't need it although if you take insulin producing drugs then there may be a case for having the kit on hand. I'm not trying to bash the kit because it does it's job very well, I just want to point out that it isn't something to be used as a first resort. I think if you ask people who have the kit or have ever used the kit if they want to or liked using it, the answer would be a resounding no.

I carry around glucose tablets that are very cheap and work very well for treating lows when I get them and I encourage anyone who takes an insulin producing drug to carry them on their person as well as put some in places they are most often.

morris.js 2008-06-04 09:22:22 -0500 Report

kdroberts, I never implied it was to be a first choice option. It is soley for those who are in real distress and cannot injest something to get their levels back up. Yes, it is a last resort thing, and it is by prescription only. I too carry glucose tablets all the time, but in the case this morning, the woman obviously was in serious trouble and could not eat anything on her own. I apologize to those who miss took what I meant by posting this discussion. This is exactly why there are "discussions" to make people aware.

tmana 2008-06-04 03:37:00 -0500 Report

The knowledge of how and when to administer glucagon (and its counterpart in the community of those with severe allergies, how and when to administer an epi-pen) should be made part of common basic First Aid training…

FWIW, the ADA does have a (rather choppy) training video on glucagon administration at http://web.diabetes.org/video/glucagon.wmv.

Ginetteb 2008-06-04 03:24:24 -0500 Report

Morris, this is one scary story. I don't often have lows, and when I am about to get one, I feel it coming. My insides start to shake and I sweat profusely. When that happens, if I'm too far from where I can get something to eat,(because the more I walk, the more exercise I do and the lower the sugar gets) I ask someone to get me whatever they can get their hands on that is sweet. That used to happen more often while I was working and they usually got me a regular coke which would help me immediately, and then I made it a point to get some protein in my body as quickly as possible.

But I agree with you about the importance to have some kind of kit with me at all times. It may mean for me to get a bigger purse.

Where can I get a Glucose Factors kit, or how can I make one?


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