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Background: My grandfather is 88 years old with diabetes and advanced Alzheimer's and otherwise happy and healthy and perfectly mobile. He can climb stairs no problem etc. He can still shovel the deck of moderate snow for a solid amount of time. He gets his blood sugar levels tested before lunch and dinner every day. Before dinner he takes 38 ml of Lantis by injection (slow release of insulin). Before lunch and dinner he takes between 0 and 8 ml of Humulin by injection (fast release of insulin), dependent on what his test is. If he tests below 130 blood sugar then he gets no Humulin. Otherwise the amount increases up to 8ml depending on how high his test is, but never to exceed 8ml. He typically tests between 100 and 280 depending on his diet and exercise. If he gets a test well over 300 then we call the doctor. I think he's Type 1 diabetes.

A couple nights ago he had a seizure at about 12:45am that seemed to be related to low blood sugar level because a tablespoon of maple syrup stopped the seizure almost immediately and shortly after eating a few tablespoons of maple syrup he tested
33 at 1am. More syrup administered and he tested
58 at 1:30am. More syrup and applesauce administered a reading of 53 at 1:45am. More of the same fed to him and he tested
81 at 1:58am. Cottage cheese and applesauce with a little syrup were now given to him for a test of
101 at 2:13am. Bread with cheese and jam were next administered: 119 at 2:30am. I don't believe anymore food was given him the rest of the night and he had the following tests:

2:30am 119
2:47am 127
3:07am 187
4:40am 209
8:04am 135

As you can see continually feeding him maple syrup, applesauce, cottage cheese, bread and cheese did not skyrocket his blood sugar levels as one might expect. It took awhile before his blood sugar levels stayed up on their own without anymore sugar/food. Normally a tablespoon of maple syrup might be expected to raise my grandfather's blood glucose level by 50 or more. Instead, during the wee hours of Feb 12 it took all that sugar and food to raise it to safe levels.

Last night (technically this morning) Feb. 15, my grandfather had another seizure at 12:20am. I noticed the seizure a little earlier this time and got him maple syrup before the seizure had gotten bad, but he went into a full blown seizure anyway. 5 minutes or so later the seizures stopped as I kept giving him many tablespoons of maple syrup. When I tested him at about 12:30am he had a reading of 48 blood glucose level. Here is a breakdown of the food given and the blood glucose tests:

Note, the food descriptions are what he ate before the test. So leading up to the 12:28am test he ate many tablespoons of maple syrup and apple sauce and some nuts.

12:28am, 48: many tablespoons of maple syrup and apple sauce and some nuts.
12:41am, 47,
12:53am, 63, nuts, syrup, applesauce
1:06am, 83, cottage cheese, honey, apple sauce, syrup
1:21am, 163, nuts, cottage cheese, honey, apple sauce, syrup
2:23am, 122, slice of ezekiel bread with mayo and slices of cheddar cheese and the last couple bites of the cottage cheese, honey, apple sauce with syrup.
3:22am, 138,
4:22am, 106, a cookie and a some nuts
6:07am 191, another good sized bowl of apple sauce, syrup, cottage cheese and another cookie and probably some nuts, too.

As you can see, his blood sugar was even more reluctant to stay up this night than the first night. Even though he had all that sugar and food his blood sugar was still dropping when I backed off between 2:23am and 3:22am. Between 3:22am and 4:22am I gave him a cookie and some nuts and yet his blood sugar still dropped from 138 to 106 during that hour. Whatever was nosediving his blood sugar levels only finally quit at around 5 or 6 am, when it finally jumped to 191 as it normally would with this sort of sugary intake.

Normally he would never, ever eat this much sugar. Normally he eats a normal diet or a low glycemic diet. On the low glycemic diet his blood sugar is well controlled and regularly can expect tests in between 120 and 180 and never these nosedives in glucose level. On the normal diets 200s are typical readings before meals. Normal diet means a very limited amount of sweets, but allowed high glycemic foods like pasta and white rice. Low glycemic diet means low glycemic foods only, such as hearty, slow release whole grains and proteins like cottage cheese and chicken.

The simple explanation for these seizures and reluctant to rebound glucose levels would be that my dad accidentally gave my grandfather 38 Humulin instead of 38 Lantis. This would explain the stubborn glucose levels as the humulin at that dose would surely nosedive the glucose levels for as long as it was working through his system, something like six hours, which is about the amount of elapsed time his glucose levels stopped nosediving.

Can exercise earlier in the day, or some other factor, such as stress, explain these excessive nosedives in blood sugar level late at night? My father, who administered his insulin at dinner, is adamant that he did not accidentally swap the Lantis with the Humulin, which would be the simplest and most fitting explanation for the obstinately nosediving blood sugar levels: 38 ml humulin would be a severe overdose as my grandfather is very sensitive to humulin and is never to have more than 8 ml.

I look forward to your replies!
 

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What I don't understand about this is why did you continue to give your grandfather more carbs and sugar when his levels hit between 80-100? 80-100 is a safe blood sugar. When you continued giving him foods that caused his blood sugar to rise, you actually were sending him into unhealthy numbers (at 163 you continued giving him sugar and carbs. Why? 163 is certainly not a dangerous blood sugar.)

It seems your grandfather is having these seizures due to an extreme hypo while he is sleeping? Or, is he awake when these are happening? Regardless, this is an indication that his insulin needs to be adjusted since it is causing him to go way too low while he is sleeping/awake during the early morning hours.

You should be telling his doctor about these attacks and have the doctor adjust his insulin. You are giving too much carbs and sugar beyond a safe level of blood sugars and causing highs.
 
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The simple explanation for these seizures and reluctant to rebound glucose levels would be that my dad accidentally gave my grandfather 38 Humulin instead of 38 Lantis.
That does sound like the problem to me. Even before I got to that I was wondering 'what did he inject?'

It's great that you were able to stay on top of the situation, keep feeding and keep the blood levels from crashing. His bgs did go higher than anyone would like, but with 38 units of rapid acting insulin, finesse might have to be sacrificed.

Of course I don't know, that's just how the situation looked to me from all this distance.
 

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Discussion Starter · #4 ·
What I don't understand about this is why did you continue to give your grandfather more carbs and sugar when his levels hit between 80-100? 80-100 is a safe blood sugar. When you continued giving him foods that caused his blood sugar to rise, you actually were sending him into unhealthy numbers (at 163 you continued giving him sugar and carbs. Why? 163 is certainly not a dangerous blood sugar.)
And in that particular situation how long would it take to go from 80 to 40? I was having a hard enough time staying awake myself. Not gonna risk it. Also, did you notice what is number was an hour after all that carb binging and the 163 reading? If we (the rest of his caregivers) tried to keep my grandfather's numbers between 80 and 100 he'd be having seizures every other day. Every diabetic's normal range is different. My grandfather lives most of his life between 130 and 200.
cheers
 

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As others have said, get this information to his doctor so insulin can be adjusted. Bouts between exogenous insulin and ingested carbs are bound to be tumultuous and erratic. The solution as I think you already know is less of both.

Meanwhile, lows are MUCH more dangerous than highs, certainly any of the highs you mentioned so I wouldn't even worry about any of that. Stay away from the lows! They can kill someone in a single day. The highs you mentioned "might" kill someone in 20 or 30 years or more. That's the two of them in perspective.
 
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Meanwhile, lows are MUCH more dangerous than highs, certainly any of the highs you mentioned so I wouldn't even worry about any of that. Stay away from the lows! They can kill someone in a single day. The highs you mentioned "might" kill someone in 20 or 30 years or more. That's the two of them in perspective.
This was precisely the understanding I was operating under. Thanks for the confirmation.
 

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Discussion Starter · #7 ·
It seems your grandfather is having these seizures due to an extreme hypo while he is sleeping? Or, is he awake when these are happening? Regardless, this is an indication that his insulin needs to be adjusted since it is causing him to go way too low while he is sleeping/awake during the early morning hours.

You should be telling his doctor about these attacks and have the doctor adjust his insulin. You are giving too much carbs and sugar beyond a safe level of blood sugars and causing highs.
We're in the process of trying to setup a meeting with the doc to find out what to do and to assess what other possible causes there could be for nosediving glucose levels. He's awake while having them, but not sure if he is woken up by them. My grandparents go to bed around 10:30 so if he's having a seizure at 12:30 seems plausible he'd be asleep before it happened.

It isn't just a matter of adjusting his insulin, tho. Other times he has lots of high readings and his blood sugar doesn't drop enough between meals. The question is, why on these two particular incidents did it nosedive so aggressively for so long. I agree it's very tempting to just say it was an administering error of insulin, but since my dad is adamant it wasn't, I want to explore all possible explanations. Maybe his blood sugar regulatory system is just out of whack from being so old? :-/ Maybe this is a consequence of leaving the low glycemic diet and adopting a normal one? Maybe he just didn't eat enough at supper and the stress of undergoing a seizure caused his blood sugar to nosedive? Apparently, some Type 1's blood sugar drops when under stress. Others' go up. source: diabetes_org
 

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Maybe this is a consequence of leaving the low glycemic diet and adopting a normal one?
And why exactly are you transitioning him from the low-glycemic diet to a normal one when you've already told us:
On the low glycemic diet his blood sugar is well controlled and regularly can expect tests in between 120 and 180 and never these nosedives in glucose level.
I have no use for the glycemic index because in the first place, it was developed for non-diabetics, not us. But if you were having some success with it, why are you leaving it now?
 

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I was told NOT to do the LC/HF diet as I was epileptic and it would cause more seizure etc, don't use a-substitutes as that would cause seizures, rollercoastering would cause seizures.
I'm tickled to pieces to say I am not classified epileptic anymore, haven't had even a minor seizure or seen a halo since I went on LC/HF, low glycemic diet.
If I rollercoaster due to panic at a prescribed low (not a true low) which is actually below 77 more like 54 for me, that will set off pre seizure warnings.

I do know that although I was sure I was doing everything right and being careful, you don't function immediately after a seizure, I used to be off for days.

Auto pilot kicks in and things can get confusing. The biggest thing is make no drastic changes, diet is so important talk to the Dr. Maybe its a food allergy?

The epileptic diet I was on was a ketogenic diet.

Could he be reacting to a new Med, a new insulin?
just my. 02 cents worth in what I've read so far.
 

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@shanny: I'm not in charge of my grandfather's diet. "I just work here." My grandmother used to manage my grandpa's diet and was very strict about how much he would eat at each meal and that he would never have any processed anything. She micromanaged Fa to a T and he took to this level of management very compliantly. When she became too old to keep it up, my dad, who is an Aries, became his parents' primary caregiver and decided at his age my grandfather deserves to eat whatever he likes (to a limit). I haven't talked to the doctor yet, but hopefully 'the bosses' have scheduled an appointment and it will work with my schedule so I can attend it, as I am very keen at getting to the bottom of this, since my dad's too busy trying to save the world.

@Kantim: thanks for the link, it was a good read.
 

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I was told NOT to do the LC/HF diet as I was epileptic and it would cause more seizure etc, don't use a-substitutes as that would cause seizures, rollercoastering would cause seizures.
I'm tickled to pieces to say I am not classified epileptic anymore, haven't had even a minor seizure or seen a halo since I went on LC/HF, low glycemic diet.
If I rollercoaster due to panic at a prescribed low (not a true low) which is actually below 77 more like 54 for me, that will set off pre seizure warnings.

I do know that although I was sure I was doing everything right and being careful, you don't function immediately after a seizure, I used to be off for days.

Auto pilot kicks in and things can get confusing. The biggest thing is make no drastic changes, diet is so important talk to the Dr. Maybe its a food allergy?

The epileptic diet I was on was a ketogenic diet.

Could he be reacting to a new Med, a new insulin?
just my. 02 cents worth in what I've read so far.
I'm confused. You're contrasting LC/HF and "ketogenic". Ketogenic diets are definitely LC/HF. Neither diet causes low blood sugar. In fact, for one prone to low blood sugar, they control it. If one is "rollercoasting", these diets will reduce the swings. They are the best possible diet for an epileptic. Although the medical establishment much prefers chemicals over diet when all their chemicals fail to address epilepsy, their last resort is a very LC/HF (i.e., ketogenic) diet.
 
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I'm confused. You're contrasting LC/HF and "ketogenic". Ketogenic diets are definitely LC/HF. Neither diet causes low blood sugar. In fact, for one prone to low blood sugar, they control it. If one is "rollercoasting", these diets will reduce the swings. They are the best possible diet for an epileptic. Although the medical establishment much prefers chemicals over diet when all their chemicals fail to address epilepsy, their last resort is a very LC/HF (i.e., ketogenic) diet.
No I wasn't contrasting the two, I was making a point, my seizures were non medicated (my choice) the medical community said no ketogenic diet, I controlled mine w ketogenic diet. Sorry if I was confusing.
Drs still tell me I have to have 120 grams of carbs to stop seizures, I have 30 or less a day slowly dropping and I'm fine.
I believe trying the ketogenic diet kept me off insulin or medication for years, I had seizures when I didn't have this group explaining more, didn't read labels assuming I was eating right.
 
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