Tag: hypoglycemia treatment


frankly friday: to glucagon or not (it shouldn’t be a question)


Hello all you happy people.  I’ve got another diabetes issue clanking around my brain lately.  First, let me explain about that funny word in the title…

GLUCAGON- n. (gloo-KA-gon)  Glucagon is a naturally occurring hormone.  It raises blood glucose whenever it falls too low.  …in a REGULAR person, that is.  For us diabetics, we may or may not still secrete some glucagon naturally.  The thing is, if we’ve over-dosed our insulin or had more exercise or stress or missed a meal… we could end up with LOTS more insulin in our bodies than would ever happen normally in a non-diabetic.  So, if that happens, and we still secrete a little glucagon ourselves, it will still not be enough to prevent hypoglycemia.  We will still go severely low and may lose consciousness or even die.  (here is an even better explanation!)

Low blood sugar is SERIOUS!  That’s why you always see a type 1 with tons of snacks or other means of raising blood sugar if necessary.

Yep, this is why most T1Ds carry huge purses (or the guys even carry a bag in the first place!) We have A LOT of stuff to keep with us!

RABBIT TRAIL:  While I’m on this topic, let me just say that it is tough having to treat a medical condition, a potentially deadly medical condition, with food.  Countless type 1’s have been heckled, bullied, scorned, gossiped about…you name it, over this self-preservation method we MUST use.

This is what a lot of people picture when they think of a type 1 needing to “have a snack”… *siiiigh*

Let me explain…let’s say for instance, you are in a roomful of high school students, taking a test perhaps, and you begin to feel your sugar dropping.  The rule of this class, from this teacher, is no candy in class.  The fastest way to counter the impending hypo is to quickly chew up a couple peppermints or glucose tabs or Lifesavers (my fave).  The teacher is aware of your condition (because you informed them, like a good diabetic) but the kids sitting around you may not.  Even if they do, because they don’t know anything about diabetes, they think you are faking, milking it or worse, doing it for spite.  Then there are those times (BTDT too many times!) when you have a substitute OR even a regular teacher who doesn’t understand diabetes and is completely uncooperative or gives you a hard time about treating hypos in or during class.  (remind me to tell you about the middle school teacher I had who had flunked out of med school & insisted on making a major production every time I went low in his class!!   GAH!!)

Then there are those wonderful times when, as an adult…maybe a parent, even, when you have to treat in front of children.  That’s always lovely.  Here… these photos will give you the gist of what I mean:

    

(thanks, Jimmy Kimmel, for these perfect examples of how kids respond when they think you’re hogging all the candy)

Then you have co-workers and such who will respond this way:

    

Yeah, no matter how many times you explain, no matter how much info you give them, they STILL don’t get why you have to stop and EAT FOOD and you call it “treatment” or say it’s because you are sick.

That’s the big problem…people don’t see food as “medicine”, they don’t relate food intake with how the body functions.  They don’t get that as type 1 diabetics, we must MANUALLY balance food intake with energy expenditures and insulin dosages.  EVERY DAY.  ALL DAY.  And even while we sleep.  They don’t get that if we have too much insulin (or perhaps overexert or expend too much energy for the nutrients in our bodies) or if we don’t inject insulin according to our food intake, or if we experience an illness (like a cold, people.  A COLD can derail our diabetes!) or excess stress, it can cause all sorts of problems for us simply because we do NOT have a functioning pancreas to do all that thinking for us like everyone else.

deep breath  Sorry…thought I needed to throw that stuff in there.  Heh.

Okay, so back to the glucagon question.  You see, like EVERYTHING ELSE with diabetes, (and most any other illness or disease these days!) medication and supplies are NOT cheap.  With diabetes, there’s a never-ending list of supplies that we need and most of those need to be kept with us, on our person, all the time.  Especially when travelling or any sort of activity where we are away from home.

                                                       just a drop in the bucket

The point to all this is…when trying to decide what to spend our family’s limited funds on, medically speaking, I sometimes have to choose what is absolutely vital over what is not-so-absolutely vital.  Yeah…stinky choices, I know.  So when I have to pick, I must choose my insulin (because without that, I will die) and all the instruments I need to administer the insulin (reservoirs, tubing sets, batteries, alcohol swabs, syringes in case the pump fails) and also testing supplies so I know how to dose the insulin (test strips, lancets, sensors, transmitters and batteries).  Other than those, I also need adequate food supply and foods that can be carried easily, so certain types of snacks and candy and/or glucose tabs or gels.  When figuring all this up, most often, spending another $50 on a glucagon kit, which always has a short shelf-life and will likely expire before I need it (which means it must be thrown away)  becomes an easy “no” and usually a very distant after-thought.

                                                                    The glucagon kit.

Fifty bucks might not be a lot to you, but to us, it’s a small fortune.  I have a REALLY hard time laying out $50 that most often has to be thrown away in a few short months.

However, when you are sitting on a highway in another state with no exits in sight and no way to get off the road (because you’re with the Hubby in his work truck pulling a trailer) and you are popping Lifesavers in your mouth, chewing as fast as you can, drinking a can of Coke and trying to fend off a very aggressive low that feels like it’s threatening to put you under…you begin to feel really stupid about not spending that $50 bucks.  That is, you feel stupid in between your life flashing before your eyes, wondering if you told your kids you loved them enough or hugged your mom the last time you saw her or if your best friends know how much you love them.

I’m not exaggerating.  That’s how it feels when you are close to passing out while your blood sugar is plummeting.  It’s horrible and you do NOT want to experience it.

So what’s a poor diabetic supposed to do?

I honestly don’t know right now.  I mean, if it was just a matter of scrounging up the extra money so I’d have the thing, it wouldn’t be a big deal.  But when it expires so quickly and it’s not every day/week/month or even year that you even need a kit??  It’s hard to know what to do.

However, it’s those times that you never suspect, the times you could never “plan” for, those times when you ~thought~ you planned everything very, very well–when you ate properly, counted all the carbs, dosed exactly as prescribed but STILL everything goes wrong….those are the times you keep a kit for.

How do YOU deal with this?  I have been reading and chatting with folks in the DOC about this and some have great insurance so keeping a good kit isn’t an issue, others speak of never being without several for their children (which would TOTALLY different!  it’s much easier to risk my own life…I’d never be without a kit for one of my children!)   So how do YOU handle this issue?  What do you think should or could be done??  I know making the kits more affordable would be an awesome first step for me.  Even half that price would be helpful.  I don’t understand why insurance doesn’t cover them more than they do since having one of these kits can help me avoid a trip to the ER or worse.

Before we discuss, let me drop this info on you…I know many people, even in my own family, who would shudder at the thought of having to mix a medication and give me an injection in an emergency.  I understand.  Opening a glucagon kit when someone you love is passed out can be intensely scary!  People panic, especially since it has to be mixed, not just drawn out like insulin.  Maybe I’m just way out of the loop on this, but Eli Lilly has an app to show people how to use glucagon!  I’m not sure how this would work, especially if you use a password on your phone (and I think most people do these days!) but there IS an app!!  Look: 

Cool!

Okay, so let’s dish…what is your stance on the glucagon issue?  Is it hard for you to afford and/or justify purchasing it for yourself?  How do you handle it?

Inquiring minds want to know…

 


frankly friday: how about an inhaled glucagon?


spine

Say what?  Yes, I just read about this new stuff that could be coming out soon.  Instead of depending on someone who is with you knowing how to mix and inject a traditional glucagon pack for you, they could just spray it up your nose!

Locemia Solutions

That’s a pretty awesome idea!  This company who’s been doing research, Locemia Solutions, has basically been working in secret on this stuff but is now sharing that they are ready to apply for all the FDA crapola to be put on the market!

For those of you who don’t know, THIS is the current and ONLY method for delivering glucagon:

As you can see, it’s NOT a simple task even for someone who’s used to drawing syringes and giving injections!  And realize that glucagon is an EMERGENCY measure.  It’s meant to be administered by whoever is near you when you are unconscious or unable to eat and drink on your own because your blood sugar has gone extremely low, so if that person or persons don’t happen to know you’re a diabetic, or even if they do, chances are they won’t know what to do with this stuff.  There ARE detailed instructions inside the case, but seriously, do YOU wanna depend on someone in a freak-out moment doing it all right and possibly saving your life?

Me neither!

About the worst they could do giving a shot of spray in your nose is give you a nosebleed, right?  And how much less freaked-out might they be having to do that instead of mixing, drawing and giving an injection?!  Let us know, any non-T1Ds out there…which would YOU rather do for your friend or loved one?

This was especially close to home for me this morning because last night, I did it again.  insert furious face here  I have had my pump for about 12 years now.  I have NEVER taken a break from it, never opted to go back to MDIs (multiple daily injections) for awhile.  Getting that thing really saved my life, and as much as I hate it sometimes…like when the tubing gets hung on a doorknob as I’m working in the house or when I’m struggling to find a comfortable place to wear the thing with some more fashionable clothing, I wouldn’t part with it!

Maybe that’s why it’s such a habit for me to just press that button and dose without stopping to think sometimes.  That’s pretty much what I did last night.  Yes, again!!  I was SO angry with myself that I probably shot it a bit lower just from that emotional surge, ya know?  (Tell me I’m not the only one who does that…intense emotion can drop my sugar!  Do any of you experience that??)  I was up watching TV by myself since Tommy had gone on to bed.  He’s staying super-tired from all his projects out in the garage so after trying to settle in with him, I found I just wasn’t sleepy yet and thought I’d catch up on something from my watchlist on Hulu.  I had the munchies for some reason and wanted to eat a few chips.  I rarely buy those, but heh there was a special at Kroger, so I had some of my fave bbq chips.  I faintly recall bending over to get them out of the pantry while simultaneously pressing my trusty button…and I have no clue what I gave.  After I realized what I’d done and was in the middle of trying to treat myself for the hypo (about 20 minutes later) I looked on my pump to see how big a dose I’d given.  SEVEN UNITS!!  What?!  WHY on earth did I do that?!?!  I don’t even know other than it is such a habit for me now!!  Especially after that last episode doing this kind of thing?!?!  WHY!?!?  I could have just strangled myself, really.  SO angry!!  And scared.  Not a good combination when you’re trying to raise a low blood sugar.

If any of you Ds out there have had this sort of issue, how did you STOP yourself from going auto-pilot with your pump dosing?  I am thinking of putting some tape or some sort of fuzzy sticker on the button so I’ll stop and think about what I’m doing.  Maybe I should just put the whole pump in a ziplock or some sort of case so that I have to take it out to use it?  Have you tried any tactics like that to retrain yourself to test first or at least THINK before you dose??  PLEASE don’t tell me I’m the only one who does this?!?!

woman

Tommy commanded (yes, he did!) me to go pick up a glucagon.  I haven’t yet, but we will probably do that tomorrow.  I’m getting ready to call the endo’s office right now for a prescription AND to find out if they can help with another insurance-related problem that is making me furious.  Maybe I’ll share about that once I ever get any hint that there’s a solution.  SIGH

Happy (& SAFE) weekend to you all!   Happy Mother’s Day to all you moms.

Blessings!

G~