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Re: [IPk] Some random thoughts

In message <003701c20113$5be2ecc0$email @ redacted>, Caroline Batistoni
<email @ redacted> writes
>This mail is going to be a whole lot of random rubbish that probably doesn't
>relate to anything, but I want to say it all anyway!
>First up, after my previous diasterous experience, I went back on the pump on
>Monday. I wiash I could say so far so good, but I'm not too sure. I've had
>randomly erratic blood sugars all day (varying between 2.9 and 19.5) I can't
>help but think "this isn't how its meant to be" I spoke to my DSN earlier and
>asked her if pumping ever just doesn't work our for some people. She said shes
>never known it (and shes worked with a lot of pumpers) Maybe I'm just a first.
>I guess I do like to be different!

The first few days can be like that, because you still have a lot of
long-acting insulin sloshing around.  One piece of advice which my nurse
gave me and I found useful, was not to use my usual targets (which I
never met anyway!) and go for stability instead.  Since hypoglycaemia
causes imbalance - see below - it is to be avoided at all costs short of
ketoacidosis.  I did this by treating 6, rather than 4 as the floor
(i.e. eating glucose tablets at a reading of 5.4!

Anything under 14 was not corrected.  When it topped 15, I checked for
ketones,  and bolused to bring down to 10 (not into the non-diabetic
target range).  

Now, I correct over 7, treat under 4, and target for 5.

The other thing I was advised to do (and took time off work to ensure I
could do it) was to keep every day completely the same.  Same food at
same times.  Same exercise (and a leisurely 1 mile walk is significant

>I was wondering if anyone here uses Quick sets. I had a problem this morning
Don't like the things - they wouldn't go in.  Gave up.  Am very allergic
to silhouettes, and really like most things about the sofset, apart from
being rather allergic to them, and feeling that the glue isn't as good
as it could be.
>All the recent talk about hypos and seizures has got me thinking about an old
>problem. I have epilepsy, which in the last eighteen months has been a
>nightmare to control (hence the break from my training to be a dentist. An
>epileptic seizure plus a high speed drill? I don't think so!) Touch wood, its
>pretty much under control right now. I've always wondered how someone wold
>tell the difference between a hypoglycaemic seizure and an epileptic one. I'm
>sure I've had glucagon (and the ensuing unpleasant side effects) several times
>in the last year completely unecessarily. As an example, and without wishing
>to speak ill off anyone at my diabetes clinic, I once had a seizure in the
>clinic which they treated with glucagon despite being aware of my epilepsy. A
>doctor later told me that my blood sugar had been 3.9 when they tested it.
>Surely 3.9 would not cause a seizure. I have blood sugars of 3.9 without
>having seizures.

I haven't observed a diabetic seizure, so couldn't say.  

3.9 is below the threshold, so needs treating.  If you were having a
seizure, glucagon was the only way (although, given the history of
epilepsy, I'd have waited 5 mins and checked what the bg was doing -
3.9's low, but not that low.
>And then theres the oposite way of looking at things, that epilepsy makes me
>more prone to having seizures with low blood sugars anyway (because my
>"seizure threshold" is lower) So perhaps 3.9 in this instance was enough to
>give me a seizure, in which case perhaps I do need glucagon all these times.
>Which then makes me worry about what might happen if I don't get it.
What would happen is that, providing you hadn't been drinking a lot, and
providing that you had had something to eat since the last time this
happened, your liver would notice something was up, and dump glucose
into your bloodstream.

It's happened once to me, and took me about two hours to wake up (with a
hell of a hangover) - I was trying to use a drug that had to be on an
empty stomach, and was putting off treating an impending hypo to give
the drug its necessary two hours.

>Sorry, I'm just confused. If anyone can make any sense of what I've written,
>I'd appreciate any thoughts you might have.

Makes pretty good sense - even the confusion as to whether it's dm
driving epilepsy, vice versa, both or neither.  As someone once said,
diabetes is an art, not a science - you don't get the do X and Y will
happen correlation the textbooks suggest.

Best wishes - it does get better!


dm 30+, 508 1+,
Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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