Imagine for a moment you’re scared, your heart rate starts racing. Maybe you’re in the woods alone and you hear a stick crack somewhere behind you, footsteps crunching through the dead leaves. Or you’re walking home in the dark after a night in the pub, the streets deserted but suddenly footsteps appear from an alleyway to your right. Pick up that feeling of your heart racing and carry it with you for a moment.
Now imagine, alongside it, you’re disorientated and can’t catch a thought no matter how much you try. You want to think, you know there is something wrong but for a moment that seems like eternity you can’t put your finger on it.
Package up that racing heart with the disorientation and add to this image, sweats, cold sweats, a panicky feeling, like night sweats you get with a horrible virus.
Got it? Well welcome to the world of a hypo, and in particular a night-time hypoglycaemic episode. Most of the symptoms between those in day and the night are similar, the heart racing, the disorientation, sweating, you could also add in, blurred vision, short temper, shakes, hunger, a variety of different symptoms that are different for all Type One Diabetics.
But the heart racing panic is exclusive my night-time hypos, the waking up and not knowing, like that moment in the morning when you wake and lie in a pillow of sleep and waking at the same time. Except if that’s heaven, this is hell. You realise as you wake that you’re sweating and then the klaxon that diabetics talk about kicks in: “Shit, I’m dying. Get up, get up, get up!”
It’s not an overdramatic thought this dying thing. It’s called ‘Dead in Bed’ and, although rare, accounts for a certain number of deaths a year. Not getting an instant sugar surge through any hypoglycaemic incident can lead to a coma. It’s a serious matter, these pesky hypos.
Hypoglycaemia, or a ‘hypo’, means that glucose levels have dropped to a dangerously low level (less than 4mmol, or a severe hypo, less than 2.8mmol) and the person requires immediate treatment. In very severe cases, a person experiencing hypoglycaemia can lose consciousness, and require help from external parties is needed. Visit the NHS website here or for a more personal view, visit Ditzy Diabetic
My night-time hypos started in four months after my diagnosis (Jan 2014) and a few weeks in the New Plan of carb counting). The serious day-time hypos started a month later. For around seven months it was a daily battle, night-time hypos, day-time hypos, night-time hypos, day-time hypos; a never ending nightmare of flashing red arrows on my monitor indicating low blood sugars and the ensuring ‘treatment’ of Jelly Babies. Sometimes I’d have two a night.
The first time it happened I woke in the middle of the night at 2.2mmol with all of the above symptoms. Panic set in. I’m not sure it’s ever really left me, waking in the night for me now (16 months post diagnosis) sets an alarm bell off every time. After few of these episodes, I was scared. After months of fluctuations in blood sugars and countless nights of broken sleep, I was angry. Eventually though I just felt broken and beaten. I also felt incredible frustration that despite all my best efforts, record keeping, and learning, ‘it’ would not settle. The consultant, nurses and dietician would offer some solace, telling me that I’d had it hard since diagnosis, that things hadn’t really settled, that I’d been thrown in at the deep end. It made me feel better for that exact moment in time but at 2.30am, shaking, heart racing, stuffing sugar in my mouth, I just wanted my life back.
Unfortunately these lows were exacerbated by incredible highs (hyperglycemia). Mostly for me, these came in the morning, cutting me down before breakfast sometimes, but predominantly after breakfast, with a sick, nauseous feeling that often meant I had to lie down and sleep. My blood glucose on waking would be high in the morning (sometimes due to an overnight hypo), only to be exacerbated by what I know now to be the dawn phenomenon (a natural rise of blood sugars in the morning we all have), plus my own-first-thing-in-the-morning insulin resistance. So where the optimum blood sugars are 4mmol-7mmol, I’d be sitting at over 20mmols by 9.30/10am. Trying to live my life, look after a child, get to business meetings, while feeling so sick became impossible. Something had to give.
Being diagnosed was like giving birth to another child: all consuming, relentless and ever challenging.
Looking over my Diabetes Diary for 2014, there’s not a recording page that isn’t littered with either highs or lows. The pages are pocketed with highlighted orange marking them.
This ever-changing picture came on the back of changes to insulin times, amounts, patterns, ratios (the amount of insulin required for every 10g of carbohydrates, for more on carb counting, see here) and correction doses (amounts to bring high bloods back into line), as the medical staff tried to work out what levels of insulin I needed and when.
On top of this, my notes are awash with mistakes I made, learnings, starting to try to understand the impact of activity (shopping, housework) and exercise and how to make insulin adjustments for them, as well as the likes of insulin for snacks/coffees. Slowly learning about things like the dawn phenomenon, the impact of monthly cycles on blood sugars, and noticing patterns, like periods you may be particularly insulin sensitive, or resistant, were all starting too. Man, it was enough to make my head spin.
‘They’ say the first year of being a Type One diabetic is the hardest. They weren’t wrong.
I was only ten months in.