Can't wake up 19 year old type 1 diabetic

[MitchsMom]

My 19 year old son was diagnosed at age 13 with type 1 diabetes.  He has overall good blood sugar control.  He's an athlete -- trains for marathons and bikes at least 30 miles a day and has for the past couple of years.  The problem is, (when you least expect it), we can't wake him up in the morning because of extemely low blood sugar.

Now please don't tell me the reasons this may happen -- we know them all.  He constantly tweaks his insulin, food, exercise ratios, but every once in a while it doesn't work. In these cases, I try to wake him up in the morning and can't.

We haven't had to use the glucagon shot yet.  We've always been able to revive him by sneakily wiping honey onto his lips, (while avoiding his clenched fist blows).  It's a miserable way to start the day.  Does anyone out there have a better method than ours?

[JDRF Volunteer SG]

Actually, I would recommend that you use the glucagon. I have had a series of very low episodes at times when under stress from job or from moving with my military spouse, and I frankly PREFER to have him use glucagon rather than trying to get me to drink juice or honey. It is less stressful to all, and I feel much better after glucagon than I do while waiting for the food or drink to digest. It is the most comfortable way to recover for both the patient and the caregiver. It works in about 15 minutes, and the recovery is much more pleasant for me this way. I simply wake up feeling fairly normal as opposed to slowly regaining my senses while dealing with muscle cramps or some of the other side effects of very low glucose. I would encourage you to not think of it as only for utmost emergency... keep several kits handy and use them in cases like these. After he comes to and is OK, then bring him some solid food to stabilize.

[MitchsMom]

Thanks.  I always considered the glucagon shot as a last resort.

How will he ever be able to safely live by himself?

[JDRF Volunteer SG]

Some of us who have had problems with morning lows who take Lantus insulin find that we are safer if we take our dose in the morning and only a couple of units if any at bedtime. This is because the insulin doesn't peak while we sleep if this is our schedule, and also it is wearing off as we sleep so severe lows actually will sort of fix themselves as hours go by. I prefer to do this because I was prone to night lows. Like your son, I am very careful, but sometimes we just misjudge our digestion time or our activity no matter what we do.

My husband is an active duty military officer, and so when he travels I am alone. I have worked out a system so that my sister has my phone number and an emergency number of someone who has a key to our place. I send a brief "I am OK" e-mail every morning when I am alone. She is instructed to call me if she doesn't see this e-mail by a certain time. If she gets no answer, she is to call the emergency person. It involves very little from either of us, but is a safety net that is comforting to both of us.

One more thing... I keep not one, but TWO 6-oz pop-top cans of apple juice on my nightstand by my bed. If I stir during the night, I can simply roll over and open one and drink it for 22 carbs. This is more likely for me to be able to accomplish than if I had to get up and go to the kitchen, for we feel extremely fatigued when low and are likely to simply go back to sleep if the "fix" is not right there by us.

But seriously, if he uses Lantus, you may want to talk to his doctor about splitting the dose or taking it all in the morning. Many folks who take Lantus at night find that its peak action in about 4 hours makes them prone to night lows.