http://type2diabetestreatment.net/diabetes-mellitus/ask-dmine-light-years-away-with-low-blood-sugar/
Happy Saturday! Welcome to Ask D"Mine, our weekly advice column hosted by veteran type 1, diabetes author and community educator Wil Dubois. This week, Wil offers some thoughts on what seems like out-of-body moments we sometimes experience when those hypos occur.
Ever happened to you? Read on to find out what the "hippocampus" might have to do with it...
Got your own questions? Email us at AskDMine@diabetesmine.com
Ben, type 1 from Arkansas, writes:T1D for 18 years now and your articles are great. Luckily, I’ve been pretty good and haven’t had too many issues, but... Over the past couple years, I’ve been having delusions when my blood sugar gets low at night. I wake up thinking I am billions of light years from wher
e I reside, which is terrifying. I know my address, name, kids name, wife’s name, how much I love them (which makes it even worse), SSN, blood type, 1+1=2, etc., etc., etc. But, I am convinced during these fantasy spells that nothing I’m experiencing is real, and I’m destined to be punished if I don’t get back to the place I’m at billions of light years away from ASAP.
And getting back is impossible. But, I’ll try anything. A couple of weeks ago, I woke up in this state, and ran about a mile naked while drinking honey. It’s kind of funny, I mean, if I had been drinking alcohol or something. But, this is real life. These delusions scare me like nothing I’ve ever experienced.
I’ve done what I can to prevent them and from doing anything stupid. I got a CGM. I gave away my guns. As soon as I recognize what is happening, I tell my wife to lock me out of the house. But, I’m a big boy and my logical side has almost zero control of my body during these times. I’ve read the hippocampus can be affected by low blood sugar, but this seems extreme. My docs are great, and I love them, but they don’t know and think it’s just a low blood sugar thing. Have you ever heard of people experiencing breaks from reality as extreme as what I am? And, if so, do you have any advice?
Wil@Ask D’Mine answers: Thank you for your kind words about my articles, and thanks for being a reader! And good for you for being proactive about this, arming yourself with a CGM, and disarming yourself in regards to the firearms. I can see why you have your wife lock you out of the house, but I wonder if you might be safer locked in. Still, I think it’s clear we can trust your non-hypoglycemic judgment on battle plans.
As to what I’ve heard about the range of behavior when sugar is low, trust me when I tell you that the way we D-folks react to low blood sugar is as varied as my wife’s burgeoning shoe collection. And you are right that people—medical and otherwise—who have not experienced low blood sugar have no perspective on what it’s like to suddenly not be yourself or to not be able to fully control your actions. But I think we can give every adult (and most teenagers) on the planet a hint of what we are dealing with by drawing a parallel between the effect of low blood sugar on the brain and the effect of alcohol on the brain.
Consider how alcohol affects different people in different ways. My editor at the first daily newspaper I worked for was a small, quiet, soft-spoken, mild-mannered man. When he was sober. When he was drunk he was the biggest son-of-a-bitch I’ve ever known. He was nasty, sharp-tongued, belligerent, and sometimes violent.
In short, he was a mean drunk.
Oh yes, booze can make the shy bold and the bold cry. It can turn the wallflower into a tramp, which is why we men are eager to buy you ladies drinks. It makes some people (myself included) more creative, while it makes others completely worthless—from a productivity prospective. In short, alcohol can alter our state of consciousness.
It does so chemically, by changing the normal levels of neurotransmitters in our brains. Likewise, although the method of action is quite a bit more complex, hypoglycemia can trigger a wide range of behavior shifts in people who have diabetes. Some people get silly. Some get paranoid. Some get profoundly violent.
Others, apparently, believe they are billions of light years from home.
Still others suffer no change in behavior at all, but I think this is because of one very important difference between an alcohol-befuddled brain and a hypoglycemia-befuddled brain: Speed. The altered state of consciousness from booze is slow to develop and long to last. Low blood sugar, on the other hand, hits fast, and in most folks doesn’t last long. I’m guessing that most of us would have some pretty bizarre thoughts and behaviors if our lows lasted longer, because a hypo triggers a brain-wide series of failures with some areas of the brain over functioning and others under functioning.
This glucose-triggered schizophrenia of brain activity might explain why you know your social security number but also “know” for a fact that you are a space alien. Of course, keeping an open mind, we should consider the possibility that maybe you really are a space alien, but are only aware of it when your sugar is low.
But avoiding that conversation for today, I want to point out that the hippocampus you mentioned is one of the parts of the brain shown to have reduced activity during hypoglycemia. So as you asked, we need to talk about the hippocampus. Actually, more correctly we should say hippocampi, as humans have two, one on each side of the brain. The hippocampi are seahorse-shaped brain parts located more or less in the lower midbrain, and their role in brain function is not 100% understood. The best guesses of people who spend their waking time thinking about the brain (and doing both human and animal research on it) is that the hippocampi play a role in both short- and long-term memory processing.
In humans the hippocampi can be damaged by surgery, hypoxia (lack of oxygen) and encephalitis (brain swelling) all of which are shown to lead to anterograde amnesia—the inability to form and retain new memories, while old memories remain intact.
And you thought diabetes sucked.
Hey, what about alternate states of consciousness? What role do the hippocampi play in that? Well, that gets a bit more into fringy science, but if you read enough about altered states, the H-word will eventually come up. But I’m not sure that really matters, for two reasons.
First, the hippocampi are just one small part of the brain. All of the brain’s many parts and hemispheres are malfunctioning when brain sugar is low. And secondly (and more importantly), whether your altered state of consciousness is created by an altered pair of hippocampi or a fully mis-firing brain really isn’t relevant, because you can’t change either.
So what can you do?
Well, realistically, all you can do is to avoid the damn hypos in the first place. I noticed you said that these events tend to happen at night. That being the case, if you do not have one yet, I think you should arm yourself with an insulin pump in addition to the CGM. This will allow you to set the delivery of basal insulin on the light side overnight, running your blood sugar just a hair high as a safety margin against nocturnal lows (something impossible to do with a traditional basal insulin).
You might also set a higher low alarm threshold on your CGM at night, to give you more time to intercept a low before it hits. And get liquid glucose and keep it ready to go on your bedside so you don’t have to run around naked like a drunken man looking for honey. Pajamas might be in order, too.
I’d also eat Atkins for dinner if I were you. You want a low-carb, high-fat dinner and no nighttime snacking to reduce the risk of lows overnight. Most lows, at least the wicked fast ones, are associated with meal or correction bolus insulin doses, so you want to do everything in your power to avoid a lot of insulin after the sun sets.
I think that will keep you home with your family here. But, of course, the folks a billion light years away are sure gonna miss you.
This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.Disclaimer: Content created by the Diabetes Mine team. For more details click here.
Disclaimer
This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn"t adhere to Healthline"s editorial guidelines. For more information about Healthline"s partnership with Diabetes Mine, please click here.
Type 2 Diabetes TreatmentType 2 Diabetes Diet
Diabetes Destroyer Reviews
Original Article
#DiabetesMellitus
No comments:
Post a Comment