Hypoglycemic Brain Injury?

[JimInSF]

Hi all, I'm a type 1 diabetic and I had a severe hypoglycemic episode 2 days ago while I was sleeping, requiring my wife to give me glucagon.  It was three days after a previous episode (also sleeping), and I am still feeling a bit "foggy."  I feel woozy and vaguely off-balance, and the closest analogy I can give to the feeling is that of a vicious, vicious hangover.  I also have headaches, not in a consistent location and generally not for very long, that come and go since the episode.

There were no externally obvious symptoms of seizure (convulsions, etc.) on this last one, and we have no idea how long I was in a severely glucose deprived state - it might have been only a few minutes, or could have been up to a couple of hours.

I've had a few similar episodes before (other than the last few weeks, the last was 13 years ago - recent events have been caused by some difficulties with a change in my insulin therapy), and a few of them actually involved observable seizure symptoms (convulsions, etc.), always during my sleep.  (When I get hypoglycemia awake, I get noticeable symptoms and just eat something - it only happens in my sleep.)  

However, I've never felt woozy or otherwise had symptoms other than muscle soreness for more than a couple of hours afterward - and I'm therefore very concerned about the nature and extent of any possible neurological injury that might have resulted here.  Is this "fog" a common after effect of severe hypoglycemia, esp. nocturnal hypo?  Of seizures?  A side effect of glucagon (on repeat administrations)?  If this is a known symptom or side effect of any of these things, it is out of the norm for it to last this long after an incident?  (It seems to be improving a bit after 2 days but I still definitely feel something and this is scary!)

Is there anything I can do to mitigate the effects of such an incident after the fact, either now for this event, or sooner after the event if, god forbid, it ever happens again?  Post-seizure or other post-injury neuroprotective therapies, foods or medications?  

Any and all thoughts and recommendations you may have would be very much appreciated.

[caregiver222]

It is extremely unlikely you have had any permanent injury from a couple of episodes of hypoglycemia. Yes, long term consequences of repeated episodes may cause some problems. Low blood sugar can often cause muscular palsy, which a lay person may call a siezure, but it not a true siezure.  The solution is:

(1) You have to keep your blood sugar under control.
(2) Re-read suggestion #1

I DONWANNAHEAR this is "impossible".

Horsefeathers!

You have to resolve yourself to frequent (ouch) blood sticks, precise control of diet, and administering insulin to match your blood sugar levels and maintain a low hbcA1c.

I am sure you have a caring health care provider whom you have been ignoring.

Get off the stick. Get with the program.

Make a resolution to take control of your life, your insulin and your diet.

[JimInSF]

Wow.  I guess I shouldn't be surprised but I am.

For your information, my most recent A1c was 5.9 (6 weeks ago), and I already not only test my blood sugar many times per day, but use a continuous glucose monitoring system on a full time basis in concert with an insulin pump.  Not that I expect that you to really understand what this means given your response, but suffice it to say that my endocrinologist, the former head of a well known diabetes clinic, says I am one of the best controlled diabetics he treats.  My recent episodes have been triggered by a change in insulin type, while making necessary adjustments for differing absorption patterns.

But of course, leave it to some random idiot on the internet who doesn't know a thing about me, my control, or diabetes in general to give the typical "blame the diabetic" response based on the worst possible assumptions without knowing anything about my control or regimen, and in response to a neurology question.

I feel sorry for anyone under your care "caregiver".

[caregiver222]

My apologies if I have insulted you. That was not my intent.

[JimInSF]

Apology accepted - this is something I have experienced from a number of people though and you should not be so cavalier about how easy it is to control diabetes.  If you don't have it, esp. type 1, it's easy to make assumptions about how easy it is to control your glucose that are completely untrue for many people.  

Tiny changes in our bodies can have substantial effects on how we process insulin, how our livers release glucose, etc., and something as small as taking a walk in the park or catching a common cold or having a stressful conversation at the office can have dramatic effects on blood sugar, plus there are other things that are extremely hard to control for like your liver dumping sugar and/or becoming insulin resistant in your sleep early in the morning (AKA the "dawn phenomenon").  This is not just as simple as sticking your finger and controlling what you eat - not by a long shot.  It is very frustrating and hurtful when diabetics, on top of having to deal with their disease, have to hear people blame them for being unable to control things perfectly, and very easy for people who have never had to try it themselves to toss such statements around - please keep that in mind.