Foggy Headed

[BillyMc]

Iwas diagnosed with Diabetes in May.  I am 38. 158lbs.(170 at diagnosis)  Tried all the orals : Metformin,glyburide,actos.  Sugars were controlled,but felt terrible.  My tests indicate to Drs. I am or am becoming type 1 and concerned with weight loss so placed on insulin.  Lantus -5 units.  Sugars are controlled and A1c  in the 6'es.  The big problem is that I am basically foggyheaded all the time upon awakening.  Unclear, drunk feeling although not like I am going to fall down.  they have checked adrenal glands, thyroid,etc.  there seems to be no pattern with sugar levels.  Could it be the suger levels, or insulin itself??  Or something else.  Blood flow to the brain issue.  I have always been healthy and active.  Now I am out of work and struggling with day to day activities.  Any ideas appreciated.

[JDRF-Team-sgg]

Are you taking your Lantus in the evening or in the morning? There IS a peak activity of Lantus that happens about 4-6 hours after injection. You may be getting hypo during your sleep, but your body is "fixing" it by the time you wake up. This would be because your pancreas is ceasing its work after receiving the message that you are low, and your liver may be releasing emergency sugars. Both of these would make you feel that "I have been run over by a train" feeling. You might want to try setting your alarm clock for about 2-3 a.m. and doing a finger ***** for about a week. Write down the result of the glucose test and also how you feel when you wake up in the morning and what your morning glucose test is. A pattern may develop of low during the night, with rising sugars in the morning.

If this happens, your doctor may allow you to take your dose of Lantus in the morning so that its peak happens just before lunch, when you are due to eat anyway and when you are awake. Many of us who take Lantus and who are prone to night lows opt to do this morning dose instead of the evening dose.

Obviously you would need to discuss this with your doctor. And of course you cannot just change one night, for you either would be doubling the dose by taking the Lantus the next morning or you would be going without Lantus for a half a day if you wait until the 2nd morning to take it. Most doctors have you adjust 1 unit at a time until you have changed the time for the entire dose -- it can take a week or so to do the adjustment when the adjustment is made. I am NOT a doctor, so please do NOT make any adjustments based on my writings without working directly with your own doctor.

I am a type 1 diabetic, and I know that you can FEEL bad when the glucose test comes back very normal if your glucose is in the midst of a drop or when insulin is peaking. You truly can feel the drop even when glucose is not low when you do the finger *****. So if this happens during the day when you are awake, you might start testing not only when you feel bad, but also about a half hour later. You can then see if you were in the start of a drop when you felt bad. In my case, the feeling is 100 percent correct, and it ALWAYS means that a drop is happening. So during the day, check your glucose not only when you feel crummy, but also after about a half hour, if the original finger ***** showed your levels as normal.

One last thought... some people get used to feeling the high glucose levels and find that for a period of time after going on insulin and having normal sugars again, they FEEL like they are hypoglycemic even though the numbers are normal.  This is because the body has gotten used to the high sugar levels as being the norm. It may take months for the feelings of hypoglycemia to go away and for your body to adjust to being in the normal sugar range. People who have had this happen do say that eventually you adjust to the new normal level and feel good again if this is what is happening to you. So if your night tests do not show that you are dropping while you sleep, it may just be that your body is still adjusting to being in the normal glucose range.

[BillyMc]

First -- thanks for the great reply and thought on the subject!

I am already taking the Lantus first thing in the morning so that may cancel out the low at night thought.  My readings in the morning (fasting)  are 100-120.  Pretty normal.  After the shot, I will start to get the FH (fuzzy head)  in about 20 minutes whether I eat or not.  I am told it would be 2-3 hours for new dose to kick in so it is perplexing.  The last 2 days the FH has lasted all day.  Maybe I am having constant erratic spikes and they may put me on a 24 hour monitor to check.  

As to insulin length, have been on about 6 weeks.

My nutritionist has also mentioned the "body has to adjust"  theory on normal levels since I was running 300 on diagnosis.  That was in May  and I am actually heartened to hear that it could take months to adjust.  Otherwise, it that was not an option I would be less positive.  So maybe it is a combination of quick up/down sugars and adjustment period?

Is there documented cases of people being intolerent to the synthetic insulin?

Thanks again.

[JDRF-Team-sgg]

Since your normal sugars were as high as in the 300's when you were put on insulin, I suspect that the adjustment period is part of your problem. I think you are feeling your insulin starting to work, and that this is making you feel crummy. I know that I can feel really bad when the insulin is working and lowering glucose levels. I think you can sort of check out the "adjustment period" theory by seeing how you feel when glucose levels go up and down out of the normal range. If your sugar occasionally rises up, say, to about 200, do you feel bad? You should start to feel a real thirst and a fatique at that point. I find that if I have a high sugar even up around 170 or so, I often feel sleepy now. This is because I am now used to staying in the 70-126 range most of the time, even after meals. If high sugars don't faze you, then it could mean that your body still sees higher levels than are healthy the "norm". You should feel good between about 80-130, but if you drop into the 70's you should start feeling kind of tired.

As for intolerance to synthetic insulin, there are a few cases I have heard of whereby people had allergies. In those cases, chaging brands seemed to help. Unfortunately, the only 24-hour insulin available right now is made by Lantus. So there isn't another option to easily switch to in order to check to see if the problem is an allergy of some sort. Your symptoms do not sound like the allergy symptoms listed in anything I have read, though.

A thought on the fuzzy-headed feeling. I wonder if having just a tiny bit of juice when this happens may help you? Not enough to make your sugar levels rise back to the 200 and 300 levels that your body may be looking for as normal, but about 4 ounces only. I find that juice or gatorade is quickly absorbed and if you are feeling a drop, a 4-6 ounce juice or gatorade drink may level off the drop so you don't feel bad. You could even go a tiny bit lighter on the carbs at breakfast time and then drink the juice about an hour later. Grazing lightly like this may keep you feeling good. You may even need to keep slight amounts of carbs going in every few hours. You could try it and see if it helps you. You may just be very sensitive to the insulin. I am sensitive to insulin, and a little goes a long way for me. I keep 6-oz cans of juice in my desk drawer at work, and I sip them off and on all day when I feel drops in glucose. It keeps me even-keeled and feeling energetic. It is worth a try. Of course you would want to check your glucose levels when doing this so you don't run higher than the normal 70-126 range. I wish you the best!