1. Lifeline

    Lifeline North of South. Contributor

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    Diabetes

    Discussion in 'Research' started by Lifeline, Sep 15, 2017.

    A question for the medical professionals:

    How does one recognise symptoms of low blood sugar in someone else? Is there a progression of symptoms towards more severe that a bystander is able to recognise? How long does it usually take until the real life-threatening stuff sets in? Is there a distinctive symptom?

    I've researched, but all the websites I've found go into detail for recognising the symptoms in one's self. I am asking for a bystander...

    Thanks a bunch in advance!
     
  2. Tenderiser

    Tenderiser Not a man or BayView

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    I have diabetes but I'm sure I can answer from the perspective of someone else. ;)

    How does one recognise symptoms of low blood sugar in someone else?
    The symptoms vary from patient to patient, as I'm sure you found out. That's good because you can choose ones for your character that would be visible to other people. These include:
    • Slurred speech
    • Staggering or a wonky gait
    • Shaking hands
    • General confusion
    • Irritability (I remember when I woke my husband up to go and get me sugar, because I couldn't walk safely down the stairs, I SEETHED at how slow and unreasonable he was, even though it took probably 20 seconds)
    ...as you can tell, someone having a hypo can look drunk to onlookers.

    So somebody who knows the diabetic well might be able to say, "Dude, you're snapping at me for no reason. Check your sugar," if you want something subtle. Otherwise, any of the physical symptoms above.

    Is there a progression of symptoms towards more severe that a bystander is able to recognise?

    Absolutely. Without sugar, the symptoms will progress quickly to, well, death. For me, it starts out a feeling - sort of like when you're drinking and you can feel you're getting drunk, but aren't quite drunk yet. If I don't treat at that stage, it will progress to the shaking/staggering/confusion/irritable stage. If I still didn't treat it, my brain would shut down (as you probably know, the ONLY fuel the brain can use is glucose - not fat or protein), I would go into a coma, and die.

    Night-time hypos are usually the most severe, because most of us don't wake until our glucose levels are dangerously low. When you're awake, you're more likely to feel one coming and treat it quickly.

    How long does it usually take until the real life-threatening stuff sets in?

    For me, symptoms progress to "Hmm, I think my sugar is getting low..." to "Can't walk or speak properly" in about 30 minutes.

    IIRC some diabetics have died in their sleep from hypos - they got them while asleep and just never woke up to be able to treat them. From that, it seems it would take less than eight hours for sure. I would guess more 1-4 hours: our brains demand a LOT of glucose to keep going, and the clock is ticking the moment our blood can't feed it enough.

    Hope that helps! Happy to clarify or answer anything else if you need it. :)
     
  3. OurJud

    OurJud Contributor Contributor

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    Diabetes comes in two types. Type one and type two. Type two is controlled by diet and oral medication where type one sufferers need regular insulin replacement via injection. For this reason you need to decide which your character has.

    Symptoms in T2 sufferers are practically impossible to spot from an outward perspective, and it's only when the sufferer announces any symptoms that another person would know. Light-headedness from low blood sugar levels, cravings for something sweet (to bring the levels back up), mild shaking, lack of energy. Prolonged symptoms include tiredness, need to urinate often, thirst. This assumes a person with mild diabetes (if such a thing exists).

    I'm not altogether sure how T1 sufferers go on.
     
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  4. Lifeline

    Lifeline North of South. Contributor

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    Hey, thanks :) That's very helpful!

    I have a guy who can't get treated (for reasons I'm not gonna into right now). The bystander is a person who knows him well, but he's equally unable to do anything about it. So from what @Tenderiser says, the bystander would be able to recognise that something's not right from his friends mannerism, and then there'd be the 'half an hour', and then.. how long?

    'Something's not right' from shaking/sweating/staggering/confusion... have I got that right?
     
  5. OurJud

    OurJud Contributor Contributor

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    @Lifeline - you don't say as much, but do I assume this bystander doesn't know this person has diabetes?

    Also, assuming the guy hasn't fallen into a coma, why doesn't he just tell the bystander what the problem is?
     
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  6. Lifeline

    Lifeline North of South. Contributor

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    The bystander knows.
     
  7. OurJud

    OurJud Contributor Contributor

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    So why doesn't he call an ambulance? Or go buy him a Snicker from a shop?
     
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  8. Tenderiser

    Tenderiser Not a man or BayView

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    Yep I would have the bystander recognise that the diabetic is getting irritable/confused (or both). For me it would probably be 10 minutes before the physical symptoms would start, and they would get steadily worse. By 30 minutes literally all I would be able to think would be, "Need sugar. Need sugar." Nothing else would make sense.

    After that... I'm just guessing. I don't think there's data on this, because diabetics dying of hypos at home wouldn't be monitored, and ones dying in hospital would have treatment that would skew the results. If I were writing this, I'd probably have the character slip into a coma after about 1.5-2 hours, and dead in another 2ish hours.
     
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  9. Lifeline

    Lifeline North of South. Contributor

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    This is part of the 'reason' why both of them can't do anything about it. I'd rather write it first than talk about it. Suffice it to say that I write sometimes ugly stuff.
    From what Tenderiser said, the ill guy and the bystander both would recognise what's happening but... well.
     
    Last edited: Sep 15, 2017
  10. Lifeline

    Lifeline North of South. Contributor

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    Thanks, that gives me a timeframe I can use. Sorry for being so short-worded, but this scene is distressing to imagine and it'll get worse when I write :rolleyes:
     
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  11. OurJud

    OurJud Contributor Contributor

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    They're both limbless, aren't they?
     
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  12. Lifeline

    Lifeline North of South. Contributor

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    Now you've lost me. Why wouldn't they have limbs? There are other reasons for not being able to get treatment o_O
     
  13. OurJud

    OurJud Contributor Contributor

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    There are, yes, but it was the 'distressing' element that made me wonder.
     
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  14. Lifeline

    Lifeline North of South. Contributor

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    I'm writing war, and writing in close 3rd. There may be people who don't feel what they write, but I'm not one of them. If a scene is ugly, I want to hide under my blankets.
     
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  15. Homer Potvin

    Homer Potvin Get off my Balzac... Contributor

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    Sorry... couldn't help it.


    upload_2017-9-15_16-6-30.jpeg
     
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  16. Lifeline

    Lifeline North of South. Contributor

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    :) I'd like to laugh but I don't get the joke.. pleeeeease explain? ;)
     
  17. big soft moose

    big soft moose The Moderating Moose Staff Supporter Contributor Community Volunteer

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    lots of info here http://www.diabetes.co.uk/
     
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  18. OurJud

    OurJud Contributor Contributor

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    Wilfred Brimley - one of the old guys in the film Cocoon - featured in a commercial for the disease and has since been the subject of many internet memes, presumably becuase of the way he pronounced diabetes (diabeetus).
     
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  19. GingerCoffee

    GingerCoffee Web Surfer Girl Contributor

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    When you say, "can't get treated", you won't likely have a hypoglycemic situation unless your character had access to insulin.

    Insulin moves glucose from the bloodstream into the cells. If you don't have enough insulin you become hyperglycemic, not hypo. Hypoglycemia almost always (there are some exceptions) comes from an external insulin source, in other words, the person gets an insulin injection and doesn't take in enough glucose to match.

    Diabetes doesn't make you hypoglycemic, the treatment for diabetes does.

    Sometimes the pancreas secretes insulin irregularly so that people get a spike in insulin with a meal and there is too much insulin after the meal causing hypoglycemia. You see postprandial (meaning after a meal) hypoglycemia in gestational diabetes in pregnancy. It's a little different than simple diabetes where the pancreas doesn't produce enough insulin all the time, or in some cases people cannot use the insulin their body produces (insulin resistance).

    I'm not aware of postprandial hypoglycemia being severe enough to cause a coma, but I could be wrong.
     
    Last edited: Sep 15, 2017
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  20. 20oz

    20oz Active Member

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    Well, my mom has diabetes.

    When she has low blood sugar, she starts breathing heavily, her hands start to shake and she's struggling to sit up. She usually avoids it by eating candy, cookies, anything sweet, but Del Monte Peaches really helps in controlling her blood sugar if it get serious enough. There are times when she screams my name and I'd find her on the floor, disoriented, unconscious. That shit's scary when that happens. I just hope she never succumbs to a diabetic coma.
     
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  21. Tenderiser

    Tenderiser Not a man or BayView

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    Her doctors should have told her, but I know diabetics often get terrible care so I'll say it anyway... the best treatment for a hypo is a sugary drink, not food. Liquids get sugar into the bloodstream almost immediately, whereas food needs to be broken down first. You could mention to your mom that something like Lucozade (is that a thing in the states?) or even non-diet coke or fruit juice will make her feel better MUCH faster than candy or cookies.

    I keep 200ml cartons of fruit juice on me for hypos. They're a handy size. :)
     
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  22. 20oz

    20oz Active Member

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    I could be a little clearer, it's always been my problem with forum-talk.

    She eats sweets during the course of the day. It helps regularize her blood sugar. When she is desperate, however, she drinks the syrup from Del Monte Peaches. For some reason, she doesn't like to drink juices, but I do buy them just in case. (She's a weird woman, I'm not exactly sure what she wants most of the time.)
     
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  23. OurJud

    OurJud Contributor Contributor

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    Not that I want to mislead you or suggest your mother manages her condition differently, but this is just about the worst thing a diabetic could do. Sweets give an instant sugar-rush, quickly relieving the symptoms as blood sugar levels rise, but those levels very quickly plummet causing the symptoms you talk of. These sudden highs and lows in sugar levels will only make her condition worse over time.

    Is she not being treated and advised by a doctor?

    Maybe diabetes comes in many forms, but I have been told to cut out as much sugary food as I can, and opt for foods with slow release carbs instead.
     
    Last edited: Sep 16, 2017
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