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seizures

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

bev

Well-Known Member
Relationship to Diabetes
Parent of person with diabetes
I just read a post on an american site which scared me so much i thought i would share it with you.
A young boy (teenage i think) ate a load of food and cake without testing or doing the right amount of insulin. Next morning his mum suspected he was really low but the meter didnt show as low- anyway a few minutes later he had a siezure! Luckily he was ok - but can anyone tell me what the triggers are for a siezure - is it low or high levels? And what action would i take? Bev
 
My understanding is that both hypo and hyperglycaemia can cause seizures and/or convulsions, although I think it is more common in hypoglycaemia, as the brain is severely deprived of energy. I think you have to drop really low for this to happen, and it would probably be due to too much insulin so that the depletion of blood glucose continues unchecked beyond safe levels. The body's normal response would be to release glucagon, forcing the liver to release stores of glucose. The treatment would be an injection of glucagon and a call to 999.

With high blood sugars, I think you'd have to go into extreme acidosis (DKA), probably almost comatose.

Whilst it's a worry, I think it would be rare not to spot that you were heading in either direction, although clearly it does happen.

But, I'm not a doctor!
 
Don't panic - it might never happen to you, but if it does...

We're missing a bit of the American website story, I think? What DID his blood glucose meter read? Then, convert mg % or mg / 100ml or mg / dl units used in USA to mmol/l units used in UK.

However, first aid for anyone having a seizure is the same, regardless of cause - ensure they can't hurt themselves further eg protect from falling out of bed / falling downstairs / leaning against hot radiator / cracking head or limbs on furniture edges etc. Don't put anything in their mouth, as that might damage their own mouth - or your fingers! Meanwhile, if fit lasts more than a couple of minutes, phone 999 or 112 for ambulance. When the paramedics arrive, make them aware of diabetes history. If you can get a drop of capilliary blood to test, then do so.

Remember that the USA is a very different place to the UK - no NHS and different blood glucose units being some of differences most relevent to people with diabetes and their families.
 
Who posted this story on the US website? Was it the mother herself? If not I would be suspicious of second or third hand stories. If it was the mother, as copepod says, what was the meter reading? Why would his mum suspect a hypo if he had eaten a lot of cake?

If you are worried about this happening the best thing is to make sure you are prepared. Keep handy a jar of ketone strips and some glucagon. Try and keep your son's blood sugars as well controlled as possible, which it seems you do already. Maybe go on a first aid course.

As Northerner says, i think seizures are more common with low sugars. I think that it happens if you have started to lose hypo warning signs so that your body does not realise you are low, then suddenly collapses when it finds it does not have enough sugar. This is an important thing to try and avoid, make sure your son has good warning signs of hypos. From reading your posts here it seems you are doing your best to be in control of your son's diabetes and I would have thought that the better someone's diabetes is controlled, the less likely they are to have this sort of extreme situation.

The best thing though is to discuss this with your son's doctor/nurse who will be able to give you a professional opinion of how likely it is to happen based on your son's blood sugars as well as telling you what to do if it happened.
 
His meter showed his level was 101( i dont know how to convert ) which wasnt showing 'low'enough to worry! The mum later thought that there must have been a fault with the meter as he was obviously low and it should have shown a much lower reading. I do realise that seizures are quite rare - but i just wanted to know the proceedure just in case! We have a box in the fridge containing what i think is glucose - but- its a 'proper' needle that has to be drawn up etc - but we have never been shown how to use it - i think i would just ring 999 as i would be panicking too much! Bev
 
Here is the story i have copied off the site!

This boy is giving his mother gray hairs.

Yesterday, Sean was sneaking brownies and let his BG go HI. He ate a meal and took insulin with sliding scale at 10 p.m. last night. He took his Lantus at the same time.

When I got up this morning, I decided to check his BG before letting him sleep any longer (today is a school holiday). He woke up when I came in the room, but he was grouchy and argumentative (even more so than normal). Something in me knew that something was wrong. I asked him if he felt low. He yelled, "I don't know. Leave me alone."

I told him I needed a BG reading. He gave me his hand, but didn't like my less-than-expert handling of the lancet, so he grabbed it to do it himself. Somehow he lost the lancet in his covers, and when I asked him for it, he started yelling at me again, "I don't know where it is." He fought me when I tried to pull back his covers to look for it. So I asked him again, "Do you feel low?" Again, he said he didn't know.

I was concerned by now. I found the lancet and drew some blood. It was very watery, like it gets when he is low. I was sure he was having a crash, but the glucometer read 101. He said, "See? I'm fine. Go away." I should have trusted my instincts, but 101 seemed like a safe number, so I went downstairs to get him something to eat.

To my surprise, he got up and followed me down the stairs. I'm glad he did, becausee when he got to the bottom of the stairs, he collapsed and started seizing.

I was already in the other room, but my youngest saw it happen and went for his dad, who then called for me. I was there in seconds. (My husband told me later that he had smelled a sweet, fruity smell on Sean's breath, which confuses me, because I thought that was linked to high blood glucose.)

The convulsions only lasted a few seconds, then Sean seemed to wake up. I knew that the glucagon I had given him the last time had made him horribly ill, so -- since he seemed to be conscious -- I used the tube of glucose gel first.

He started coming out of it very slowly. Since I had already used the gel, I wasn't sure if or when I should give him the glucagon shot now.

Over the next 15 minutes, he faded in and out, sometimes able to answer questions and sometimes not. As soon as I could, I took another BG reading. It had been 15 minutes and the meter read 140.

But he still wasn't coming out of it. I wished then that I had used the glucagon, but didn't know if I should now that he was up to 140.

As soon as he could follow our directions, we gave him apple juice. He didn't want it, but we managed to get a couple of boxes down him. When I tested again, he was at 121.

At this point, I called the diabetes hotline and spoke to the nurse. She told me that it sounded like he was coming out of it, but that I should ALWAYS use the glucogon if he has had a seizure, even if he seems able to take the gel.

She said it is normal for him to take 20-30 minutes for him to "come back" after a seizure, so the time it was taking wasn't unusual. She stayed on the phone with me until he was lucid. She then told me to monitor him and call back in an hour.

An hour later, his BG was 168. Despite the fact that we didn't give him glucagon, he got very sick, anyway. (So next time he gets the shot right away.) And he has a horrible headache. He's just gone to sleep, and if this is anything like last time, we won't see much of him today.

I called the nurse back as she had asked, and again, she stressed to me that I must ALWAYS use glucagon with a seizure, and that it was time to have a Come-to-Jesus meeting with this boy about his keeping a chart, monitoring his numbers more closely (he's been lax), and ACCEPTING HELP FROM PARENTS. I told her she was preaching to the choir, but that we'd try again.

He already has an appointment with his doctor on Thursday, thank goodness.

I am just shaking mad at myself. I SUSPECTED -- with good reason -- that he might be low after last night. I KNEW he was acting strangely. I SAW that his blood was so thin it was watery. And I STILL ASSUMED he was okay just because the glucometer read 101.

I'm just thanking God that I went and woke him up when I did. Even though I didn't catch all the signs, my going in there did prompt him to get out of bed. If he had still been asleep, no one would have known.

Has anyone done a study on the stress level of parents of children with diabetes? I'd bet good money that we have shortened life spans.
__________________
Katherine <><

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S, 14, T1D dxd 3/31/07
R, 13, Hashimoto's
S2, 7 - asthma; T1D antibodies
 
His meter showed his level was 101( i dont know how to convert ) which wasnt showing 'low'enough to worry! The mum later thought that there must have been a fault with the meter as he was obviously low and it should have shown a much lower reading. I do realise that seizures are quite rare - but i just wanted to know the proceedure just in case! We have a box in the fridge containing what i think is glucose - but- its a 'proper' needle that has to be drawn up etc - but we have never been shown how to use it - i think i would just ring 999 as i would be panicking too much! Bev

101 mg/dl = 5.6 mmol/l (you divide by 18), so no, that wouldn't be low at all. If I'd thought someone (or myself) was low and got a reading like that I'd try taking another one straight away for confirmation. Maybe the seizure wasn't actually due to low blood sugar, but some other condition?

The box in your fridge is probably glucagon. It's a hormone like insulin, produced by the alpha cells of the pancreas, that acts like an 'anti' insulin and prompts the liver to release glucose. I've read that it doesn't work if the person is drunk - not that that would apply to Alex!
 
Thanks for the full story Bev. It seems very odd - none of those readings seem to be abnormal. The sweet breath symptom suggests ketones - i.e. high blood sugar and acidosis, so the solution would not be to give him more sugar/glucagon etc. as that would not bring him out of his collapsed state - he'd need insulin, and probably intravenously.

Very strange story! Perhaps the meter or the testing strips were faulty and he really was low, but his breath is counter to that.
 
THIS HAPPENED TO ME 6 YEARS AGO!!! tested myself and it was 7.8, injected Humulin I, the same amount as i always did and next thing i know there's two paramedics in my room

when i came to, dad said he'd heard banging in my room, turned on the light and saw me fitting. this had never happened before and he freaked out (obviously) and called 999, Paramedics came, who took my sugars, it was 2.1 or something ridiculous so they gave me the glucagon shot and i came to and felt fine within 15 minutes

Have now been told by my DSN that HUMULIN I is infamous for this, and it scared me so much that i changed to twice a day, and have now been convinced to go back to four times a day but use Lantus instead

just thought i'd share with you all xxx
 
Please Bev, don't panic about stories on American websites with different blood glucose units and no NHS - ambulances, NHS Direct to phone etc. Bets to check with your diabetes team about any specific worries and how you would cope. In particular, ask them to show you how to use "the box in the fridge" - it's almost certainly glucagon, as Northerner said, and given into muscle. Glucose is given by ambulance technicians / paramedics or hospital staff into a vein.

I'd recommend that EVERYONE does a first aid course, appropriate to their age - even a 2 hours session will teach the basics of cardio-pulmonary resuscitation to use if someone's heart and / or breathing stops, up to a 4 day course or even remote area / expedition first aid. My mum was a nurse, who took my sister & I (then in primary school age) with her when she trained monitors in first aid for youth holidays, mainly so that the monitors could practice improvising slings with jumpers etc on children, I think - I just remember it was fun, with a visit to Tintern Abbey each time. On one holiday, there was a monitor with epilepsy, so she briefed us so we'd know what to do, including using a telephone for free 999 calls (1970s, long before mobile phones caused reduction in number of phone boxes). When we were at secondary school, she taught us & others first aid at Guides. Later, she took some delight in telling other parents of high achieving, privately educated teenagers (we were both at local comprehensive school) that she was just as proud of us both getting life-saving and first aid qualifications as she was of our O & A level results.

I have used the skills learned on several occasions, including intervening to stop a fellow train passenger from attempting to pour orange juice into the mouth of another passenger who was fitting in the corridor, and several incidents of attempting to resuscitate people pulled from the sea. My sister has helped with several severe bleeding incidents, including a neighbour who went through a glass window.
 
THIS HAPPENED TO ME 6 YEARS AGO!!! tested myself and it was 7.8, injected Humulin I, the same amount as i always did and next thing i know there's two paramedics in my room

when i came to, dad said he'd heard banging in my room, turned on the light and saw me fitting. this had never happened before and he freaked out (obviously) and called 999, Paramedics came, who took my sugars, it was 2.1 or something ridiculous so they gave me the glucagon shot and i came to and felt fine within 15 minutes

Have now been told by my DSN that HUMULIN I is infamous for this, and it scared me so much that i changed to twice a day, and have now been convinced to go back to four times a day but use Lantus instead

just thought i'd share with you all xxx

that sounds awful. but now you have scared me as i take humulin I at night time, i have never heard of it being linked to seizures. It sounds as though you were using humulin i as fast acting though? Am i right? Are there different types of humulin i, fast and short acting? confused:(
 
Don't be scared, be prepared

Hi

I will describe what happened last year, it will be vivid so if you don't want to know stop reading now. This is just to clarify that although it doesn't happen every day, it does happen.

I had to use Glucagon (orange emergency injection kit) on my daughter last February 2nd 2008 at 11 pm. She was 7 at the time. She is now 8. I found her mid fit in bed. It was not a thrashing around fit, it was a still, limbs in odd positions and foaming at the mouth. She was making the noise of a wounded animal, certainly not human. I tested and she was 1.7, she had been 8.0 an hour and half before so wasn't due to test for another half hour.

I had to leave her and run into my bedroom, next door, and grabbed a can of coke and straw. My daughter has always been able to drink mid fit but this was not a 'normal' fit for her but it was all I had to hand. I tried it once and it wasn't going to work so had to run downstairs to get the glucagon kit.

Adrenaline had taken over and I was not mum anymore with emotions at that point. I administered the glucagon which I had not used before (it was easy), I have studied the pictures and read the leaflet loads of times. Don't worry about getting it in muscle, it can just go sub cut and will work just fine. Within seconds (well quite a few) she was coming around, still howling but more human. She cried and cried and cried.

That night she slept in with me and she hit about 24.0, I gave tiny bits of insulin to bring her down a bit. I didn't ring 999 but you should so don't do what I did. I made the choice because she was due to be a bridesmaid the next day. She floated down the aisle with levels of 27.0! You have to run the levels high (not that high of course) for about 24 to 48 hours as the liver has to replenish and you cannot use the glucagon injection again for a while.

It is frightening and I hate nighttimes now. I have the added bonus of my daughter having had 98 % of her pancreas being removed at birth and the tiny bit left still works when you treat a hypo. It was rotten when she was born, continuously producing insulin and the remaining teeny bit has not yet burnt out so when you give coke or such like when hypo it wakes up so it is very hard to deal with a hypo.

My one piece of advice, have more than one glucagon kit. Keep one in the fridge, one upstairs and one with you when you go out plus one at school. Also keep coke and straws or whatever you use upstairs as well.

Hope I haven't frightened anyone too much. If it happens to your child or whoever you live with, you can deal with it, all fits are different. Lots of fits are just very still staring eyes, they are not all thrashing around.

Adrienne
 
His meter showed his level was 101( i dont know how to convert ) which wasnt showing 'low'enough to worry! The mum later thought that there must have been a fault with the meter as he was obviously low and it should have shown a much lower reading. I do realise that seizures are quite rare - but i just wanted to know the proceedure just in case! We have a box in the fridge containing what i think is glucose - but- its a 'proper' needle that has to be drawn up etc - but we have never been shown how to use it - i think i would just ring 999 as i would be panicking too much! Bev

Hi Bev,

This is what his blood sugar would convert to from mg/dl which the Americans use into mmol/L: 5.6 mmol/L

I used this link to convert it:

http://www.diabetes.co.uk/blood-sugar-converter.html

To me this is a perfect blood sugar.

From memory of my biology lessons (alarmingly recent!) on diabetes blood sugars are normally within 80 - 120 mg/dl or 4.4 - 6.6 mmol/L

Generally when I'm out through my school's CCF I generally give a brief to all the cadets and officers on what to do should I go down. Basically scream for an officer (who I have shown how to use my blood machine and they know where my glucagon jab is along with which scenario to use it in) and get an ambulance to me. This is regardless of whether I am hypo or not. I would much rather be safe than sorry.

Tom H
 
Hi and thanks for all your replies!
Adrienne,
How awful for you and your daughter - you must have been at your wits end! I think in those circumstances i would have done the same - so why are we given these needles without any instructions on how to use them? Also might it take more than one injection to bring someone round from a fit? If so, why do we only have 1? I think i will be asking to go on a first aid course. Thankyou for sharing your experience with us - it cant have been easy dreadging up those memories. Bev x
 
Glucagon instructions & First Aid courses

Glucagon kits contain instructions - at least the one I had until it expired some 5 years ago, when I sent it to a mountain rescue team for training purposes (not to inject into anyone) and didn't replace it. However, the time to read instructions is in a moment of peace, NOT when someone is hypoglycaemic. A first aid course will proabably mention diabetes, but is unlikely to cover use of glucagon, so ask a pharmacist or diabetes specialist nurse.
Bev (and anyone else considering it) - I hope you find a suitable first aid course. There are course specifically aimed at those who look after children, including parents, school workers, youth leaders etc. I've always used Red Cross, just because they've always been the most convenient, but St John Ambulance are also very good, and I'm sure there are others, some which operate only in local areas. St Andrew's First Aid serves Scotland (not exactly a small local area, I realise). I first came into contact with Red Cross, when my mum used me to demonstrate baby bathing, when I was only a few months old - I had a lot of extra baths, then my younger sister took over!
 
Hi and thanks Copepod!

Your mum sounds fun! Do you know if the red cross courses are free? Bev
 
Bev, can I suggest you look at the Red Cross, St Johns etc websites yourself? There are so many different course, and you can interpret your needs, locations etc better than anyone else.
 
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Hi and thanks for all your replies!

so why are we given these needles without any instructions on how to use them? Also might it take more than one injection to bring someone round from a fit? If so, why do we only have 1? I think i will be asking to go on a first aid course. Thankyou for sharing your experience with us - it cant have been easy dreadging up those memories. Bev x

The instructions that come with a novo glucagen kit are here:
http://www.butterflies4u.co.uk/novo_documents/GlucaGen.pdf
 
To be quite honest with that story - the fit may not be attributed to diabetes at all - people can be so quick to blame everything on diabetes - who knows - the kid may have developed epilepsy - and the story has got lots of weird events in it that do not fit with diabetes. For instance the fits I have had don't suddenly 'happen' out of the blue. (But everyone's experience is different). Also with epilepsy - the best way to help them out of a fit is to interact with them - which the mother did when she was talking and gave teh boy glucogel. By giving hilm that may have been enough to trip the on switch in his brain again!

Bev - fits happen and they can vbe scary for the carer and unpleasant for the person - but we come out of thm and are OK! I have many fits over the years due to very low blood sugar - even below 1!!! They do not always take the same form and I always come out of them with glucogel/glucose or a paramedic! I actually rang the DUK Careline once as I had a whole year of going really low - and parts of my body would be paralysed - which is horrendous when you live on your own (as I did at the time) and my limbs contorted - so when you are with it enough to give treat yourself - it is so hard to do. Apparently your body starts shutting down bits that it won't need to conserve the working of your vital organs. The worst was when my body did this and I had no bloomin' glucose by my bed and I had to drag/crawl through my flat (I had forgotten to top it up by my bed - Doh!) to get some as I couldn't stand and my arms were beginning to give up too! It took such a long time as I was also off my face (ie you find thinking rationally very hard to do). I have been unconcious, fitted, paralysed, yelled, and the worst was when my dad and brother found me naked in the kitchen when I was 26 LOL!! BTW - I haven't had such bad ones for a long time now. I went through a very strange stage! I have only ever had glucogel at home and it has always done the job.
Don't panic!
 
Glucagon kits contain instructions - at least the one I had until it expired some 5 years ago, when I sent it to a mountain rescue team for training purposes (not to inject into anyone) and didn't replace it./QUOTE]

Hi Copepod,

They still do have instructions in. Nice pictures. I point this out to cadets when I'm with them in the field, the officers get exactly the same idiots guide to diabetes.

Tom H
 
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