Low sugar moods

[Cm1]

Hi after a bit of advice. Recently starting dating a type 1 diabetic. I have notice when his sugar is low his mood changes drastically he becomes extremely irritable and argumentative. I ask him to check his bloods or have aome
LucoZade and he refuses unless I physically put the lucoZade in his hand. Then he drinks it and settles back to normal. Afterwards he does not really want to discuss the situation. What I want to know is does he actually remember what he says when he is like this? Is it normal behaviour for someone with low sugar to become so stubborn and argumentative or could this just be his personality? I have never encountered a diabetic before . Many thanks

 

[Lucyr]

This absolutely isn’t just how diabetes is. It’s probably mostly his choice around how he manages, or doesn’t manage, his diabetes. If he wanted to reduce the number of times this happened he could use a CGM (sensor you attach to body), set the alarms on it to warn him before he goes low, fingerprick then have something sugary to avoid getting to that behaviour stage.

It’s normal to have some hypos and it’s normal to have the very rare occasion where you can’t sort it yourself but you shouldn’t be seeing this as a pattern when you’re newly dating him.

Also he sounds like he’s unable to treat hypos by himself and may have hypo unawareness if he’s getting this low and refusing treatment and you’re having to convince him. If he does have hypo unawareness and drives he’d needs to stop driving, let the DVLA know and would lose his licence.

 

[Cm1]

He finger prick tests frequently throughout the day and always before driving. This has only happened once where he didn’t listen to me when I said to have a drink other times as I can notice an onset he accepts what I say. He is under immense stress at the moment so I wonder if that is not helping ? I do believe he manages things well but it was more the mood changes I am interested in whether that is him
being low sugar or he is just not as nice as I thought he was. If it is normal with low blood to become irritable in diabetics more so ?

 

[Lucyr]

He finger prick tests frequently throughout the day and always before driving. This has only happened once where he didn’t listen to me when I said to have a drink other times as I can notice an onset he accepts what I say.

If he isn’t recognising the hypos himself and you have to point out the onset of a hypo to him then he has hypo unawareness. He absolutely shouldn’t be driving if he isn’t recognising the symptoms himself and you are having to point them out.

I’d suggest he stops driving immediately, speaks to his medical team about the hypo unawareness to check if it is that going on, then report it to the DVLA. Once he has the letter declining his driving licence he can then use that to apply for a disabled bus pass.

 

[dannybgoode]

Is it normal behaviour for someone with low sugar to become so stubborn and argumentative or could this just be his personality?

In a word yes, this is very normal behaviour for some diabetics when their blood sugar is low. It describes one of my wife's colleagues pretty much spot on for example. Usually a lovely person but gets very agitated and argumentative when their BG gets too low.

It's common also for this too manifest itself in refusing to check your BG and/or to get some nice quick carbs in.

I don't think that, without speaking to him, it's possible to say he's hypo unaware either. He may be but it could also be that, if he's been living on his own or with people that haven't been helping him, he's just enjoying being able to stop concentrating on 'having diabetes' all the time for a bit or there could be other factors at play.

Lucy is correct that, if he is hypo unaware, then he does need to speak to his medical team and the DVLA however as I say, he may be fully hypo aware and just enjoying the fact you're around to look after him.

If he's testing before driving though (and every two hours if on a long drive) then it sounds like he knows the rules.

 

[Inka]

He finger prick tests frequently throughout the day and always before driving. This has only happened once where he didn’t listen to me when I said to have a drink other times as I can notice an onset he accepts what I say. He is under immense stress at the moment so I wonder if that is not helping ? I do believe he manages things well but it was more the mood changes I am interested in whether that is him
being low sugar or he is just not as nice as I thought he was. If it is normal with low blood to become irritable in diabetics more so ?

Irritability, panic, weepiness and more can all be signs of a hypo @Cm1 Low blood sugar can affect the brain and moods. Him rejecting the hypo treatment you offered him can be normal too - like a defence mechanism borne from fear and confusion.

Why doesn’t he have a Libre or other CGM? That would alert him if he was going low.

People can be embarrassed by low blood sugars and feel sensitive and shaken, so he might not want to discuss that occasion with you. I suggest you approach it in a more general way.

 

[Cm1]

Many thank all I will discuss more with him

 

[Inka]

Many thank all I will discuss more with him

I just picked up on one further thing you said @Cm1 You said he was treating his hypo with Lucozade? This is no longer a good idea. The (stupid) sugar tax has meant that the amount of sugar in Lucozade has been drastically reduced. It’s no longer a good hypo treatment because of this, especially for bad hypos.

Proper branded Coke is ok as they’ve left the sugar alone. Appletiser is also ok, as are Lift Glucose Shots. All of those are available in small cans or little bottles. Of course, he can also use Dextro glucose tablets.

 

[dannybgoode]

You said he was treating his hypo with Lucozade? This is no longer a good idea.

Are you sure that applies to all Lucozade? My DSNs are still recommending it and it's been very effective for my two hypos.

It's got to be the clear original stuff but carbs are 8.9g/100ml. Coke 10.6g/100ml so not a lot in it.

You are correct that in the non-clear stuff sugar has been greatly reduced and my DSNs mentioned to avoid that.

 

[Inka]

Yes @dannybgoode Lucozade - marketed as a glucose drink - has reduced the amount of glucose/sugar in it. There was a big outcry at the sugar tax. My DSNs no longer recommend Lucozade because of the risk of getting too little sugar. It used to have more in it. There’s also the risk of mistakenly taking one of its many non-sugar versions. If you look at the Original, you’ll see it has sweetener in. The helpful glucose/sugar has been reduced and replaced by crappy sweeteners as in so many drinks that were once good hypo treatments.

 

[dannybgoode]

Yes @dannybgoode Lucozade - marketed as a glucose drink - has reduced the amount of glucose/sugar in it. There was a big outcry at the sugar tax. My DSNs no longer recommend Lucozade because of the risk of getting too little sugar. It used to have more in it. There’s also the risk of mistakenly taking one of its many non-sugar versions. If you look at the Original, you’ll see it has sweetener in. The helpful glucose/sugar has been reduced and replaced by crappy sweeteners as in so many drinks that were once good hypo treatments.

9g/100ml carbs seems plenty to me and it worked brilliantly for my two hypos so I'm happy to continue to have it as one of my 'weapons'. As I say my DSNs still have it on the list and it's still in the NHS pamphlet on treating hypos.

2/3 of a small bottle took me from 3.2 to 10 very quickly.

If you're diabetic and need hypo treatments I think the risk of having a low or no sugar variant by mistake is very low personally.

I do agree the sugar tax and the impact it's had on putting more crappier sweeteners in is not necessarily a good thing but that's another discussion 🙂

 

[everydayupsanddowns]

Are you sure that applies to all Lucozade? My DSNs are still recommending it and it's been very effective for my two hypos.

Unfortunately it does apply to all versions. I was one T1 who appealed to the manufacturers to leave us with just ONE full strength version. But no. There used to be 60g carbs in a 380ml bottle, now there are 30g carbs. You can still use it, but you have to drink half a bottle at a time, and all the sweeteners they have added to reformulate the flavour.

Full sugar coke is still strong enough that only 1/4 or 1/3 of a 380ml bottle is generally sufficient for me.

 

[dannybgoode]

You can still use it, but you have to drink half a bottle at a time,

This is exactly the information in the NHS treating hypos pamphlet 🙂

 

[everydayupsanddowns]

I do believe he manages things well but it was more the mood changes I am interested in whether that is him being low sugar or he is just not as nice as I thought he was. If it is normal with low blood to become irritable in diabetics more so ?

Good to hear that he is checking frequently, and knows the rules around driving. I do wonder whether his awareness may be slightly impaired. So not unable to drive, as he still does have awareness, but it’s getting a bit dented and patchy, and he’s only reliably spotting low BG when it gets a bit lower, and a few 3.8s are slipping under the radar?

I have also had times in my life where I've become very stubborn, irritable, and argumentative because of hypos. Most of them were fine and easily treated, but once in a while my BG would get lower and my brain function would be more affected. I don’t clearly remember these, but the fragments I do remember make me cringe.

It was only comparing notes with others on forums like this one that showed me that I was nothing like as good at managing my diabetes as I liked to believe (and had been told by my clinic). It took me a long time to repair my awareness, and I feel dreadful for the negative impact this had on my wife and kids. I just couldn’t see it at the time.

Personally I think he’s at a bit of a crossroads. He can get his awareness back if he reduces his time spent below 4.0 to an absolute minimum for 6-12 months. He may not like the idea of wearing a CGM that’ll ’nag him’, or ‘always be attached’, or ‘be a visible reminder of a condition he’d prefer to ignore most of the time’ (I felt all these things), but a CGM set to alert in the high 4s low 5s can be a massive help in re-sharpening awareness.

Unless he starts making some changes I fear he’ll only lose more awareness, begin to have hypos he cannot treat himself, lose his driving license, and possibly lose you as a partner.

Jane (my late wife) wrote these posts on our family diabetes blog which we started after a particularly nasty hypo really shook me up. You aren’t alone in having experienced this. And it can be fixed.

Still Learning

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

And about ‘the hammer’

Chapters

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

And here’s one of mine after a LOT of work. Resetting my personal low limit to 5.0 was a huge and positive change.

Gimme 5 - a new hypo strategy

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

I’ve not had a hypo I couldn’t treat myself in well over a decade now. They used to be several times a year in the bad days (and before the DVLA guidance was issued that would have banned me from driving)

 

[Inka]

This is exactly the information in the NHS treating hypos pamphlet 🙂

The concentration of hypo treatments makes a difference sometimes @dannybgoode Not just for comfort (it’s not always easy gulping down fizzy drinks). The Lift GlucoShots are in tiny bottles and very concentrated (15g carbs per tiny bottle). They work more quickly because of this. If you ever have a bad hypo (and I hope you don’t) you’ll feel the difference.

 

[dannybgoode]

Lift GlucoShots

I have those in my armoury too and the Lift chews, Glucogel and jelly babies. Got various bits scattered around different locations. Bit like a squirrel with acorns.

I have one of those hypo pouches with the Lift stuff and the Glucogel in it which is in my kit bag which goes with me everywhere though and in that as well are some destructions on what someone should do if they find me unresponsive.

All my colleagues at work have the same instructions so for emergencies it's Lift or Glucogel.

I actually really like original Lucozade and it's worked well twice now so for self-treating it's my go-to.

 

[Cm1]

Good to hear that he is checking frequently, and knows the rules around driving. I do wonder whether his awareness may be slightly impaired. So not unable to drive, as he still does have awareness, but it’s getting a bit dented and patchy, and he’s only reliably spotting low BG when it gets a bit lower, and a few 3.8s are slipping under the radar?

I have also had times in my life where I've become very stubborn, irritable, and argumentative because of hypos. Most of them were fine and easily treated, but once in a while my BG would get lower and my brain function would be more affected. I don’t clearly remember these, but the fragments I do remember make me cringe.

It was only comparing notes with others on forums like this one that showed me that I was nothing like as good at managing my diabetes as I liked to believe (and had been told by my clinic). It took me a long time to repair my awareness, and I feel dreadful for the negative impact this had on my wife and kids. I just couldn’t see it at the time.

Personally I think he’s at a bit of a crossroads. He can get his awareness back if he reduces his time spent below 4.0 to an absolute minimum for 6-12 months. He may not like the idea of wearing a CGM that’ll ’nag him’, or ‘always be attached’, or ‘be a visible reminder of a condition he’d prefer to ignore most of the time’ (I felt all these things), but a CGM set to alert in the high 4s low 5s can be a massive help in re-sharpening awareness.

Unless he starts making some changes I fear he’ll only lose more awareness, begin to have hypos he cannot treat himself, lose his driving license, and possibly lose you as a partner.

Jane (my late wife) wrote these posts on our family diabetes blog which we started after a particularly nasty hypo really shook me up. You aren’t alone in having experienced this. And it can be fixed.

Still Learning

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

And about ‘the hammer’

Chapters

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

And here’s one of mine after a LOT of work. Resetting my personal low limit to 5.0 was a huge and positive change.

Gimme 5 - a new hypo strategy

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

I’ve not had a hypo I couldn’t treat myself in well over a decade now. They used to be several times a year in the bad days (and before the DVLA guidance was issued that would have banned me from driving)

Wow your wife sounded like an amazing lady and her stories so well written. We have been dating 4 months now and he has had 3 full hypos in that time and a few incidents when I have managed to make him drink lucoZade and he has calmed down. Having no idea regarding the ‘norm’ for hypos I have no idea whether he is managing things correctly. He is under immense stress at the moment and not to speak out of line the hypos have been in the middle of the night after us having had sex earlier in the night - is this normal ?

 

[everydayupsanddowns]

the hypos have been in the middle of the night after us having had sex earlier in the night - is this normal ?

Not out of line at all.

Sex can act very much like other forms of exercise, and can reduce BG levels. It’ll vary from person to person, but it can be quite a significant effect.

Additionally it can be a time when BG levels naturally dip (cortisol levels often fall to their lowest around that time). So depending on how well adjusted his basal insulin is, and which one he uses, he may want to consider a carby snack before, and another before going to sleep?

 

[Cm1]

Not out of line at all.

Sex can act very much like other forms of exercise, and can reduce BG levels. It’ll vary from person to person, but it can be quite a significant effect.

Additionally it can be a time when BG levels naturally dip (cortisol levels often fall to their lowest around that time). So depending on how well adjusted his basal insulin is, and which one he uses, he may want to consider a carby snack before, and another before going to sleep?

Many thanks for your help I will try and discuss things with him but I think he feels quite embarrassed about his diabetes as if I would not want to be with him because if it but that is not the case I just want to try and fully understand it. Understand the dangerous levels the safe levels etc but he doesn’t want to make a big issue out of it

 

[rebrascora]

Does your partner have a sensor on his arm or stomach that gives him readings all the time on his phone. A small disc? This is the CGM (Constant Glucose Monitor) someone mentioned above. All Type 1 diabetics are now eligible for this technology on prescription and they have alarms built into them to warn you when your levels are dropping low.... or indeed going high. You can set the alarm level for what works for you, so many of us have it set just a bit above 4 to give us some advance warning before we even become hypo and others have it set at 3.9 which I think is the factory setting. It doesn't totally replace finger pricking as there are circumstances when it isn't as reliable as at other times, but this technology has revolutionized our diabetes management for many of us once you understand it's little quirks and limitations. It is so much more convenient than having to finger prick all the time. Most importantly it records your levels every few minutes, day and night so you have a much better "sight" of your diabetes. I can sometimes go a week without having to finger prick at all as it is acceptable to DVLA for testing although you still have to keep testing kit with you in the car for certain circumstances.
If your partner doesn't have this technology then his GP should be able to prescribe it.

And yes, any physical exertion including sex can drop your levels. I sometimes joke with my partner about how long it will be afterwards before my alarm goes off. 🙄 It is always a good idea to keep hypo treatments by the bed, so if he is staying at yours then maybe some jelly babies or glucose chews on the bedside table might be useful.

As others have said, hypos can make you confused and irritable or emotional (I burst into tears one day which is most unlike me) or even aggressive when that is not your normal behaviour. Having technology which helps prevent them would be even more important if you have a tendency to aggressiveness when hypo and I think it is important to make him aware of this concern you have, at a time when his levels are normal, as he may not be aware that he is being difficult. Your brain and body shut down to conserve your remaining blood glucose for the essential functions only but it can also trigger a fight or flight response as adrenaline is released and because you can't run, you can be just left with "fight" and it can sometimes be difficult to recognise that someone is trying to help you. Prevention this situation arising as much as possible, is important for your nearest and dearest as well as for your own long term health, so I would ask that he tries a sensor system for your benefit as much as his, if he doesn't already have one. The vast majority of people with Type 1 in the UK are now using these systems and finding them a huge benefit.