Dr. Swaraj Waddankeri
Endocrinology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My husband has type 1 diabetes. He has had no Insulin today but has had five hypos today, and his sugar levels are dropping again. He had his regular food all day, drank juice and cans of coke. He has not done anything different to any other day and also has not been stressed either. He treated all his hypos the way he normally would. What could be causing all these hypos if he has not had any fast acting Insulin since last night? Any advice would be greatly appreciated. Thank you.
Hi,
Welcome to icliniq.com.
1. How long has he had diabetes?
2. When you say hypo, what were his sugars?
3. What is the dose of insulin that he is taking?
Patient's Query
Hi doctor,
He has had type 1 diabetes for five years. His sugars were in the 2s, but he did not test for 2 out of 5 of the hypos. He could just tell by the symptoms and knew that he needed to treat it. He is taking 36 units of Lantus every night and a 1:10 ratio of fast acting NovoRapid every time he eats.
Hi,
Welcome back to icliniq.com.
Frequent hypoglycemia in people who have diabetes and who were earlier very well controlled indicate two things.
I would suggest checking his creatinine and urine microalbumin at the earliest and also his TSH (thyroid-stimulating hormone) and free T4 along with a 8 AM cortisol. If all the above turn out to be negative, then we need to work him for autonomic neuropathy. In the meanwhile, kindly ask him to keep checking his sugars three to five times per day and try to correct it if he finds his sugars less 70 mg/dL. What symptom does he have when he has a hypo? Or is it asymptomatic?
Patient's Query
Hi doctor,
His symptoms usually consist of shaking hands, the excessive onset of sweating, heart racing fast, sudden loss of energy and feeling sleepy or faint and he just does not feel right. If he has a hypo through the night while sleeping, he will wake and sit up all of a sudden and not be able to go back to sleep. It is usually a good indicator that he needs to check his blood sugar levels as soon as possible. He also has had a protein leak in urine in the past that is, a few years ago. I will get him to go to the doctor to get them investigated. Thank you for your reply.
Hi,
Welcome back to icliniq.com.
Hope he recovers fast. Kindly keep me posted on the developments.
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Endocrinology
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