Excessive sleepiness before hypos?

[C6H12O6]

I just wanted say hello. I am fairly newly diagnosed and am so grateful to you on this forum for all the information hyou have shared. Hearing how to manage in 'real life' opposed to the medical version of living with diabetes has made my transition much smoother.

I do have one question I'm hoping you might be able to help me with - does anyone get overwhelming sleepiness as they approach a hypo? I'm finding that if I get below about 4.4 I start to get so tired I have actually fallen asleep in my chair at work. Once I've had some 'sugar' I'm quickly fine but I wondered is this is common or should I be looking for some other cause?

 

[rebrascora]

Hi and welcome

The first few hypos I experienced after starting on insulin, I felt incredibly sleepy after I had treated the hypo and presumably my levels were coming back up but my body was still in shock and responding to the low. There were just a few occasions when it happened and it was almost like I was about to pass out and just wanted to close my eyes and drift off and it was a real fight not to.... usually accompanied by a cold sweat. I don't get that anymore, so it may just be the body not being used to those lower levels having been running high for a long time and shutting down as a self preservation thing to conserve glucose.
It also may be more to do with the speed at which your levels are dropping rather than the actual BG reading being not quite hypo. Do you have Freestyle Libre or are you finger pricking? Have you actually fallen asleep before being able to treat a hypo? Is there any pattern to when it happens. I am wondering if it is mistiming of your bolus insulin causing your levels to rocket right up an hour or so after eating and then plummeting when the insulin kicks in. If you have the Libre you will be able to see if this is happening. Is there a time of day when it is more likely to happen?

 

[Inka]

Yes, feeling really sleepy is a hypo sign for me. I always test my blood sugar if I feel sleepy. As I’ve had Type 1 many years, I now aim to try to stay above 5 as a minimum, so if I was 4.4 I’d have a tiny amount of carbs to bring me up a little even though 4.4 isn’t technically a hypo.

Beware confusing actual tiredness and feeling sleepy due to low sugar. Always check.

Welcome to the forum 🙂

 

[C6H12O6]

Thank you both for your replies and kind welcome 🙂

There were just a few occasions when it happened and it was almost like I was about to pass out and just wanted to close my eyes and drift off and it was a real fight not to.

Rebrascora you have described it perfectly- it's not like being tired, it's totally overwhelming I'm sorry you have the same symptom Inka but it's less lonely for me so thank you for sharing. I have been having a glucose tablet to keep me going long enough to test. I have fallen asleep when in the high 4s and then woken up low. I think I will have to adopt your technique of eating a little bit to keep me awake, Inka.

It also may be more to do with the speed at which your levels are dropping rather than the actual BG reading being not quite hypo. Do you have Freestyle Libre or are you finger pricking? Have you actually fallen asleep before being able to treat a hypo? Is there any pattern to when it happens. I am wondering if it is mistiming of your bolus insulin causing your levels to rocket right up an hour or so after eating and then plummeting when the insulin kicks in. If you have the Libre you will be able to see if this is happening. Is there a time of day when it is more likely to happen?

It could well be to do with mistiming insulin. I'm on NovoRapid (with Tresiba basal) and rapid it is not! Sadly it also isn't predictable so I do get it wrong on way or the other sometimes but not always. I'm struggling to get my lunchtime ratio right - I often go sleepy before lunch which makes sense but also mid afternoon which might mean I'm overbolusing I suppose - it's such a tricky balance.

I do have a Libre and sometimes it does show a plummet but not always. I finger prick as well when compos mentos enough and it seems to be a small window between awake and nearly asleep so the Libre doesn't always pick the subtleties up. I've set my low alarm to 4.9 to try to give me the heads up in good time.

Thank you again for your help and for being somewhere I can sound out my experiences and be really understood

 

[rebrascora]

If it's of any help to you, Novo(notso)Rapid was taking in excess of an hour to kick in for me at breakfast time. I usually had to prebolus an hour and 15 mins before breakfast which often meant that I got distracted doing something and forgot to eat and then hypoed. If I only waited 30-40 mins I would spike up to 15 and then come hurtling down to 4-5 later on when it did kick in and that used to make me feel rubbish. I gradually increased the time I waited by 5 mins every couple of days until I found 75 mins was about right for me but many people would hypo well before then, so it is a very individual thing and you need to experiment very cautiously to find the sweet spot timing that works for you at different times of day.
Thankfully for lunch and evening meal it would only take 20-30 mins to work. I am now on Fiasp which is supposed to be much faster acting, but I still need to prebolus 45 mins on a morning with that. I inject as soon as I wake up and before I get out of bed and then I potter on with my morning routine shower/coffee etc and then breakfast when I can see the insulin starting to drop my levels and that now works better for me, but Fiasp is not without its "quirks" shall we say, so I am not particularly recommending it. I would encourage you to try prebolusing a bit earlier though. I will say that my consultant was horrified that I injected so far in advance of breakfast but he couldn't argue with my records. They normally recommend no more than 20 mins but I am not the only one who finds they need much longer, so worth playing about with it in that respect to see if you can get it to work better for you.

Good that you have Libre 2 and can set alarms and I think setting it at 4.9 is a good plan. Let us know how you get on. Hopefully your body will get used to those lower readings and you will "grow out" of this urge to sleep/creeping unconsciousness like I did, as it is something that would make you unsafe to drive or operate machinery if it persists. I only ever experienced it after I hypoed and I had taken treatment, so it was more like a delayed hypo response and at least by then the glucose was in my body being absorbed, so not as risky as falling asleep before taking anything.