Diabetic Hypoglycemia?

[CassandraJade]

Forgive me for using a new screen name, but I'm a regular here and wanted to get some anonymous advice.

My other half has Type 2 diabetes, along with several other health conditions. He's been diagnosed for about 6 years now, and generally handles it very well. He takes Metformin exclusively--was on glipizide for awhile, but it made his sugar consistently run too low.

The problem is, even with the Metformin, he sometimes experiences diabetic hypoglycemia (low blood sugar). Normally he can feel it coming on, and he takes glucose pills and then eats, and everything's fine.

For some reason, his body occasionally skips that step. He goes from fine to super-low with little or no warning. It seems to be worse when he gets a lot of exercise in the heat.

When that happens, he goes into what I call a black rage. He's never been physically abusive AT ALL, so I'm not scared for myself, but I'm worried about him. He becomes verbally abusive, combative, mean and, worst of all, flatly refuses to take glucose or eat.

We're in Texas at the moment, and the temperature is around 102. We were on the top floor of a lightly air-conditioned three-story museum (no elevator) when it hit. I suggested he take glucose pills (he always carries them) and he refused--said he'd be okay until we got out and got some food.

Well, in this small west Texas town, Mexican food is about the only option. And he hates Mexican food. We drove around for literally an hour and a half, discovering all the now-closed fast food places that showed up on our GPS. I finally suggested that we go back to the room, where we had a dozen zero-preparation options that I was glad to fix for him (PB&J, instant soup, waffles, Hot Pockets, stuff like that).

He flipped out. Accusing me of "shrieking" at him and telling him what he was *going* to do, he drove back all right (he won't let me drive when he's like that either). And flatly refused to eat. And spent the next hour and a half screaming at top volume and berating me for not *letting* him go out to eat.

As always happens in these situations, I finally ended up crying and begging him to eat something, while he continued to pour on the blame about how it was MY fault that he no longer felt like eating. Eventually I guess I had cried and begged enough, because he checked his blood sugar. It was dangerously low. He then consumed exactly enough carbs to get him out of the danger zone, but not enough to raise his sugar high enough to get him out of the black rage. And here we sit in our hotel room, four hours after leaving the museum, going around and around in circles.

Please don't tell me that I need to leave him, or how emotionally abusive he is, or anything like that. This sort of behavior ONLY occurs when he has a sudden, massive blood sugar drop, and has not happened at all in well over a year. I'm not going to leave him over something medically induced and rare.

What I would like to know is, does anyone else have any experience with diabetic hypoglycemia, particularly the rage aspect of it? What can I do to better help him help himself? I know his blood sugar's not my responsibility, but I'm pretty eager to avoid these situations, or at least lessen the duration and severity.

Thanks for anything you have!

 

[RitaE]

Tell him he is mentally altered, not acting rationally, and if he won't do an immediate blood sugar check and then fix the problem you are going to pick up your cell phone and call for an ambulance because you can't handle him on your own.

And then do it.

And next time absolutely refuse to get into a car with him and drive around when he is acting like that.

I know you don't want people to give you harshness right now but sitting around in a hotel room going around and around and sobbing at him isn't going to do a darn thing to fix the problem.

I believe you when you say he is a good guy and not abusive. But if his illness is causing him to act in an abusive manner then the end result isn't all that different than an alcoholic who is drinking or somebody on an anti-psychotic med that they've stopped taking. He isn't managing the illness and you're getting blasted with the result.

 

[dngnb8]

Tell him he is mentally altered, not acting rationally, and if he won't do an immediate blood sugar check and then fix the problem you are going to pick up your cell phone and call for an ambulance because you can't handle him on your own.

And then do it.

This is the case. Low sugar means he will be short tempered, frustrated etc.

Be persistent.

 

[diznygirl]

Forgive me for using a new screen name, but I'm a regular here and wanted to get some anonymous advice.

My other half has Type 2 diabetes, along with several other health conditions. He's been diagnosed for about 6 years now, and generally handles it very well. He takes Metformin exclusively--was on glipizide for awhile, but it made his sugar consistently run too low.

The problem is, even with the Metformin, he sometimes experiences diabetic hypoglycemia (low blood sugar). Normally he can feel it coming on, and he takes glucose pills and then eats, and everything's fine.

For some reason, his body occasionally skips that step. He goes from fine to super-low with little or no warning. It seems to be worse when he gets a lot of exercise in the heat.

When that happens, he goes into what I call a black rage. He's never been physically abusive AT ALL, so I'm not scared for myself, but I'm worried about him. He becomes verbally abusive, combative, mean and, worst of all, flatly refuses to take glucose or eat.

We're in Texas at the moment, and the temperature is around 102. We were on the top floor of a lightly air-conditioned three-story museum (no elevator) when it hit. I suggested he take glucose pills (he always carries them) and he refused--said he'd be okay until we got out and got some food.

Well, in this small west Texas town, Mexican food is about the only option. And he hates Mexican food. We drove around for literally an hour and a half, discovering all the now-closed fast food places that showed up on our GPS. I finally suggested that we go back to the room, where we had a dozen zero-preparation options that I was glad to fix for him (PB&J, instant soup, waffles, Hot Pockets, stuff like that).

He flipped out. Accusing me of "shrieking" at him and telling him what he was *going* to do, he drove back all right (he won't let me drive when he's like that either). And flatly refused to eat. And spent the next hour and a half screaming at top volume and berating me for not *letting* him go out to eat.

As always happens in these situations, I finally ended up crying and begging him to eat something, while he continued to pour on the blame about how it was MY fault that he no longer felt like eating. Eventually I guess I had cried and begged enough, because he checked his blood sugar. It was dangerously low. He then consumed exactly enough carbs to get him out of the danger zone, but not enough to raise his sugar high enough to get him out of the black rage. And here we sit in our hotel room, four hours after leaving the museum, going around and around in circles.

Please don't tell me that I need to leave him, or how emotionally abusive he is, or anything like that. This sort of behavior ONLY occurs when he has a sudden, massive blood sugar drop, and has not happened at all in well over a year. I'm not going to leave him over something medically induced and rare.

What I would like to know is, does anyone else have any experience with diabetic hypoglycemia, particularly the rage aspect of it? What can I do to better help him help himself? I know his blood sugar's not my responsibility, but I'm pretty eager to avoid these situations, or at least lessen the duration and severity.

Thanks for anything you have!

I totally agree with Rita.

You need to stand up to him and show him you mean business. If that means leaving him, then you need to do that. As much as you say you aren't, you ARE in harm's way when he is like this. You are both currently gambling - him with his health, and you with your safety.

 

[CassandraJade]

Tell him he is mentally altered, not acting rationally, and if he won't do an immediate blood sugar check and then fix the problem you are going to pick up your cell phone and call for an ambulance because you can't handle him on your own.

And then do it.

I actually did that once. And for some reason they sent a cop instead of an ambulance. And he put on a major song and dance and let the cop watch as he made a nice PB&J sandwich. And then the cop gave ME a stern lecture about abusing 911 So I'm kind of reluctant to do that again.

And next time absolutely refuse to get into a car with him and drive around when he is acting like that.

I agree. And I certainly would have refused if I'd realized just how bad it was when we left the museum. Once we were on the road, I didn't just want to jump out at a stop sign or something. It's been so long since this happened that it didn't occur to me it was happening again.

I believe you when you say he is a good guy and not abusive. But if his illness is causing him to act in an abusive manner then the end result isn't all that different than an alcoholic who is drinking or somebody on an anti-psychotic med that they've stopped taking. He isn't managing the illness and you're getting blasted with the result.

I agree in a lot of ways. But where I see the difference, or maybe I'm just rationalizing, is that he really does try to do everything right. He didn't intentionally stop taking a med or pick up a drink or something. This just happens to some diabetics sometimes. Now as for his handling of it, clearly that's something we're going to have a nice, long talk about once this episode is over. But the reaction itself isn't anything he could have prevented.

Sigh. I really appreciate your thoughts. I just don't know exactly how to put them into action here.

 

[RitaE]

Simply explain to the cops that you sincerely felt the situation was spiraling out of control and you were trying to prevent a serious episode. And if the policeman has a problem with that then he needs to be reported.

As for you boyfriend - I get it, I really do. My Dad was a diabetic and I think that they kind of get frustrated with every blip in their moods being attributed blood sugar levels and people pestering them all the time. It's probably kind of like every time a woman gets pissy and some man comes along and asks if she has PMS.

But still, yes he could have prevented the worst of this if he would have agreed to check his blood sugar the first time you told him you thought it'd be a good idea. He didn't do it and then it got much, much worse.

And when it gets like that you really don't have a bunch of options other than protecting yourself -- and since he can really get to the point where he can't take care of himself, then calling for help. It's not like you can knock him to the ground and force medicate him - right?

 

[DisMN]

Hi *newbie* LOL

I experience very sudden lows too and become irrationally snarky and generally just don't feel good. I have learned to read myself to tell that a low is nearing and immediately pop a piece of candy, a carb or just about anything to get my blood sugar back up. Please have your husband keep a wrapped mint or something similar in his pocket.......then when he feels a little funky he can pop that and then quickly find something more substantial to tide him over.

Walking and exercise do make mine come on more often as well....and I think that's quite common.

Good luck to you both!!

 

[CassandraJade]

Simply explain to the cops that you sincerely felt the situation was spiraling out of control and you were trying to prevent a serious episode. And if the policeman has a problem with that then he needs to be reported.

As for you boyfriend - I get it, I really do. My Dad was a diabetic and I think that they kind of get frustrated with every blip in their moods being attributed blood sugar levels and people pestering them all the time. It's probably kind of like every time a woman gets pissy and some man comes along and asks if she has PMS.

But still, yes he could have prevented the worst of this if he would have agreed to check his blood sugar the first time you told him you thought it'd be a good idea. He didn't do it and then it got much, much worse.

And when it gets like that you really don't have a bunch of options other than protecting yourself -- and since he can really get to the point where he can't take care of himself, then calling for help. It's not like you can knock him to the ground and force medicate him - right?

I know what you mean about feeling pestered. When we first got together, I was a bit "mother hen" about his various conditions. He finally said, "Stop trying to make me an invalid." Boy was that a wakeup call for me! I think he also gets mad at the disease itself, and having to watch his diet so closely. From what he's told me about his younger years, apparently he used to be one of those don't need to eat don't need to sleep types. It's got to be frustrating to get a little older and suddenly have to control everything so closely.

But still...it's no excuse for this behavior. Like I said, he's normally just so chill and relaxed and laid-back. We rarely ever fight, and when we do we're able to talk it out pretty quickly and move on. This one thing is all that's really standing in our way...but it's a big thing! We have got to talk about it again, once this one's over, and come up with new preventative measures. I tried to joke him out of it, and threatened to knock him down and force medication on him (if you knew our relative sizes, you'd know how ridiculous that image is). Didn't help much though.

Thanks so much for *listening." I know there's not much you can do, but venting sure does help sometimes!

 

[RF536]

My mom can be the same way, she has been diabetic for almost 50 yrs and still has the rare occasion when her blood sugar drops without warning. She can be very stubborn and somewhat combative, when this happens. I remember in high school one time this happened, and she was insisting that she was fine and to just let her go to bed. My dad was working out of town at the time, luckily my BF (now DH) informed her that she was going to either let us take her to ER, or he would call and ambulance. Turns out her blood sugar was in the 20's and the doctor said that if we had let her go to bed like she wanted chances are she would have died in her sleep.

When he gets to that point he truely is unable to make rational decisions, you need to be firm and if he will not take action on his own, you need to call for help. You should never be made to feel like you are abusing 911 for calling when he gets this way. This is what they are there for, to help those in need.

 

[Bella the Ball 360]

Forgive me for using a new screen name, but I'm a regular here and wanted to get some anonymous advice.

My other half has Type 2 diabetes, along with several other health conditions. He's been diagnosed for about 6 years now, and generally handles it very well. He takes Metformin exclusively--was on glipizide for awhile, but it made his sugar consistently run too low.

The problem is, even with the Metformin, he sometimes experiences diabetic hypoglycemia (low blood sugar). Normally he can feel it coming on, and he takes glucose pills and then eats, and everything's fine.

For some reason, his body occasionally skips that step. He goes from fine to super-low with little or no warning. It seems to be worse when he gets a lot of exercise in the heat.

When that happens, he goes into what I call a black rage. He's never been physically abusive AT ALL, so I'm not scared for myself, but I'm worried about him. He becomes verbally abusive, combative, mean and, worst of all, flatly refuses to take glucose or eat.

We're in Texas at the moment, and the temperature is around 102. We were on the top floor of a lightly air-conditioned three-story museum (no elevator) when it hit. I suggested he take glucose pills (he always carries them) and he refused--said he'd be okay until we got out and got some food.

Well, in this small west Texas town, Mexican food is about the only option. And he hates Mexican food. We drove around for literally an hour and a half, discovering all the now-closed fast food places that showed up on our GPS. I finally suggested that we go back to the room, where we had a dozen zero-preparation options that I was glad to fix for him (PB&J, instant soup, waffles, Hot Pockets, stuff like that).

He flipped out. Accusing me of "shrieking" at him and telling him what he was *going* to do, he drove back all right (he won't let me drive when he's like that either). And flatly refused to eat. And spent the next hour and a half screaming at top volume and berating me for not *letting* him go out to eat.

As always happens in these situations, I finally ended up crying and begging him to eat something, while he continued to pour on the blame about how it was MY fault that he no longer felt like eating. Eventually I guess I had cried and begged enough, because he checked his blood sugar. It was dangerously low. He then consumed exactly enough carbs to get him out of the danger zone, but not enough to raise his sugar high enough to get him out of the black rage. And here we sit in our hotel room, four hours after leaving the museum, going around and around in circles.

Please don't tell me that I need to leave him, or how emotionally abusive he is, or anything like that. This sort of behavior ONLY occurs when he has a sudden, massive blood sugar drop, and has not happened at all in well over a year. I'm not going to leave him over something medically induced and rare.

What I would like to know is, does anyone else have any experience with diabetic hypoglycemia, particularly the rage aspect of it? What can I do to better help him help himself? I know his blood sugar's not my responsibility, but I'm pretty eager to avoid these situations, or at least lessen the duration and severity.

Thanks for anything you have!

I share your life. Trust me when he gets irrational it is beyond what I can handle. Once he flipped out because I put my Splender in his coffee by mistake. I mean flipped. Feel free to PM me whenever you feel the need for support. Mine has type 2 and gets all the Diabetes magazines, takes classes and then refuses to do anything they tell him. He has already had a stent put in and I know exactly the feeling you have when you become the target of abuse for absolutely NO reason. I try to be understanding but it gets harder and harder. Even if I ignore the ranting and walk away he continues and I can count the beats between his raving. He will turn on a dime if someone comes like his mother or a friend so I guess I need to ask why he can control it for them but not me.

 

[CassandraJade]

My mom can be the same way, she has been diabetic for almost 50 yrs and still has the rare occasion when her blood sugar drops without warning. She can be very stubborn and somewhat combative, when this happens. I remember in high school one time this happened, and she was insisting that she was fine and to just let her go to bed. My dad was working out of town at the time, luckily my BF (now DH) informed her that she was going to either let us take her to ER, or he would call and ambulance. Turns out her blood sugar was in the 20's and the doctor said that if we had let her go to bed like she wanted chances are she would have died in her sleep.

When he gets to that point he truely is unable to make rational decisions, you need to be firm and if he will not take action on his own, you need to call for help. You should never be made to feel like you are abusing 911 for calling when he gets this way. This is what they are there for, to help those in need.

Oh wow, that is so scary. BF's wasn't quite that bad just now, thank God, but he was close. He has some anger management stuff that he's spent a lifetime working on, and it's all gone now except during these times, but man oh man. I can't even imagine how he would react if I gave him an ultimatum like that, even one so desperately necessary to his health.

I share your life. Trust me when he gets irrational it is beyond what I can handle. Once he flipped out because I put my Splender in his coffee by mistake. I mean flipped. Feel free to PM me whenever you feel the need for support. Mine has type 2 and gets all the Diabetes magazines, takes classes and then refuses to do anything they tell him. He has already had a stent put in and I know exactly the feeling you have when you become the target of abuse for absolutely NO reason. I try to be understanding but it gets harder and harder. Even if I ignore the ranting and walk away he continues and I can count the beats between his raving. He will turn on a dime if someone comes like his mother or a friend so I guess I need to ask why he can control it for them but not me.

OMG, we are totally sharing the same life. Mine's also had a stent put in. He really does try, though, except when it gets like this. Then it's just flatly game over. He wants me out of his life, he blames me for everything bad that's ever happened to him, and he uses the blood sugar as a means of control. He knows it'll kill him if he doesn't eat, so he uses it to punish me. He wants me to be scared for his life. It gives him a feeling of power. He'll push it just exactly to the brink and then eat something, all the while telling me that I caused it. But I'm scared that one of these days he's going to push it too far, and he won't be able to bring himself back without medical intervention.

Isn't it funny how they'll turn on a dime when other people come around though. A psychologist told me that it's because we're the ones they feel safest with, so we're the ones they act out with. Shouldn't you treat the person you're closest to with *more* love, compassion and respect than everyone else, not *less*?

Ugh, it's just so maddening. It's like Jekyll and Hyde. He's this wonderful, sweet, solicitous person who goes out of his way every day to make me happy. But when this kicks in, it feels like a nightmare. Feel free to PM me for support as well. I know how lonely it can feel.

 

[Sadie22]

OP, is your husband's medical team aware of his hypoglycemia unawareness? It's actually not all that uncommon. You and your husband need to discuss it with the medical team and they need to educate him regarding this. Does he wear Medic Alert jewelry stating that he is subject to this medical condition? People have been arrested while suffering from this phase of the illness.

 

[Maryr1]

I am a type 1 diabetic so I can share some insight on this. I have frequent hypo episodes, usually heat/exercise related. First and foremost, please know that when your spouse is being like this it is out of his control. Many times people become immune to the warning signals of low blood sugar over time. You need to talk to his doctor and readjust the amount of medication he is taking especially when he is going to be more active and in the heat. Second, he needs to eat BEFORE he exerts himself-something small, and complex. (Granola bar, cheese and crackers). I also suck on hard candy to give me a little boost. Keep regular soda around because a glass of that will boost his sugar very quickly. Do not let him drive if he seems symptomatic to you-get a glucometer and use it regularly. I test EVERY time I get behind the wheel-no matter how I feel or how far I am driving. The dose of medication your husband is on does not have to be the same every day depending upon his level of activity-if you are on an active vacation, maybe he needs less than on a day that you are just laying low at home, KWIM? Talk to your doctor.

 

[Sadie22]

If you post on the disabilities board you may get more responses from other people in the same situation. I have Type 2 and I take Metformin as well. I would strongly advise discussing this with the medical team. Of course your DH would have to cooperate but a medicine change or some new equipment may help.

 

[ElizK]

My mother DIED in December after going into a hypoglycemic coma. It was so awful. After 5 days in a coma, there was little hope of any recovery, so we had to make the decision to pull all care. She passed two days later. Does he realize that could happen to him?

 

[rkandmjsmommy]

My advice would be talk to his doctor, when his sugar is NOT low It seems metformin is not working for him at this point, metformin alone does not usually cause hypoglycemia, so the heat, his diet etc. are playing a role. Maybe you can set him up with a dietician to help his diet so this doesnt happen. Has he recently lost weight? Since he is type 2 maybe he can be diet controlled....I HIGHLY suggest checking with his endocrinoligist
Good luck

 

[bumbershoot]

Does he wear Medic Alert jewelry stating that he is subject to this medical condition?

Really good question. Having a bracelet could help you if you need to call emergency services again...add credence to your description of the problem.

Has he recently lost weight? Since he is type 2 maybe he can be diet controlled....I HIGHLY suggest checking with his endocrinoligist
Good luck

OH yes yes.

You say "even with the Metformin, he sometimes experiences diabetic hypoglycemia".

metformin *lowers* the blood sugar. It's not something to prevent low blood sugar. So if he has lost weight (which can cause blood sugar to lower) or has been exercising more or is eating well otherwise, he just might be so low *naturally* that his need for metformin doesn't exist, or doesn't exist to the extent that his prescription takes him.

He NEEDS to see his endocrinologist. If he doesn't have one (and the "family doc" REFUSED to give DH a referral to one since it's "just" type 2, but we self-referred with the help of the diagnosing Urgent Care guy!) he needs to get one. A good one. And then determine if the prescribed amount is correct, or if the drug is correct anymore.


And ALWAYS carry good snacks with you, always...don't leave the house without something nice. DH likes Clif brand MoJo bars as they have 9 grams of protein as well as some carbs, and they are tasty.


Best of luck to you two!!!

 

[NMAmy]

I'm hypoglycemic so I can understand your BF's lack of rationality during a blood sugar drop. However, there is no excuse for the way he's treating you--particularly when you say he turns on a dime when other people are around. That shows he CAN control his behavior during these times but he chooses not to with you and you're allowing that behavior to continue and even cater to it.

My advice? Quit playing to his tantrums. When his blood sugar is normal, have a serious conversation which will lay out exactly how you will behave the next time this happens and stick to it. If it were me in this situation, I'd tell him that if he behaves this way again when he has a blood sugar drop, I'd be calling 911 for an ambulance and since his anger is all directed at you, I'd be leaving when they were on their way. He has shown he can behave nicely with them and not with you. No begging for him to do the right thing. He can either take care of himself or not but I believe that as long as you keep enabling him in this behavior, it will continue.

And, seriously, stop allowing him to drive when he's in this mode. How would you feel if he killed himself or someone else? Allowing him to drive and going along with him is tantamount to getting into a car with a drunk driver. He is not having normal reactions at that time and he's a danger to himself and others.

When you call for the ambulance, don't go into details about his erratic behavior. Simply tell them that you think his blood sugar has dropped and he isn't acting rationally. Perhaps they sent a cop last time because they felt it was a domestic dispute.

Hypoglycemia is serious and your boyfriend needs to take it seriously. He needs to speak with his doctor about his behavior and the drops. My mother used to think that hypoglycemia was no big deal until she almost died from it. The ER doctor told her, "High blood sugar can kill you eventually. Low blood sugar will kill you today." He needs to stop being a jerk about this and take responsibility for his own health care.

 

[kbeverina]

Get a prescription for a glucagon shot. Carry it with you all the time and know how to use it (if he loses consciousness, you will still call 911 and they'll walk you through it).

 

[bear_mom]

He needs to work with his doctors and get these episodes under control. Hypoglycemic events can be just as damaging to the body as hyperglycemic events - this is new, I learned it at a recent diabetic conferece I went to.

There are many different medications he can take to control his diabetes besides metformin.

Emily