Diabetic lows/friend passes out

[shaggy Moderator Find all posts View Profile Close shaggy]

My good friend Barbara didn't show up for our workout today and didn't call either which is just not like her. Went to her house (she keeps the door unlocked) and I entered to find her half naked on the floor. Since this is the 2nd time I've had to deal with this I didn't call 911 as I knew she would refuse to go to the hospital. I rushed to get her some juice and it took me about 1/2 hr to get her to wake up. She looked / acted drunk. Very scarey.
I had a hard time getting up & down on the floor with my leg but I managed. She was laying on her jeans and I never did find her top. Once she wakes up she is fine and we had to call the school to tell them we would be late picking up her neice. I worry she'll pass out driving ( last time she did , I revived her then to)

She is a very intelligent 5th grade teacher but absolutely can not tell when this is going to happen. Her husband used to call her every 2 hrs (even when he was in the hospital dying of cancer)

What can I do? shaggy

I think she needs a med alert necklace and a medical identity bracelet.

[MargeS Senior Member Find all posts View Profile Close MargeS]

She definitely needs to wear a medical alert. If not a fan of the over the counter type, a nice one can be ordered from a jeweler. Great idea for a gift... might make her more apt to wear it. Also carrying a card in her wallet (right with her ID, D/L or such) with her Doctor's name and phone number, and all meds that she takes.

She needs to use her glucose montior more frequently. Has she taken a diabetes course at her local hospital or ADA? Even if one has had diabetes for a long time, a refresher never hurts, recommendations change. Friends and/or family are usually welcome to come along and learn.

Wearing a watch with timer and setting it to remind her of meal and snack times is helpful, especially if she gets little advance notice from her body.

She needs to talk honestly with her Doctor. Adjustments in her meds might be necessary.

You sound like a great friend!

[calgal Senior Member Find all posts View Profile Close calgal]

She should also ask her MD for a prescription for glucagon, and you should be instructed in how to use it. If she is unconscious (unable to drink juice) an injection of glucagon can raise the blood sugar and revive her. Her MD needs to review all her meds and dosages. Some meds decrease the symptoms of an insulin reaction, making it harder for the patient to recognize what is going on. Also, long term diabetics can have few or no symptoms of low blood sugar. I hope she is under the care of an endocrinologist, as this pattern is obviously dangerous, and something (diet, glucose targets, and/or dosages) needs to be adjusted.

[idahodude Senior Member Find all posts View Profile Close idahodude]

There are also newer continuous glucose monitors on the market, which test blood sugars about every five minutes and alarm if they are getting low. They don't work perfectly yet (can be inaccurate) and are very expensive, but if she has decent insurance, many plans are starting to cover these for patients who have episodes like the one you've described. She should look into it.

[CarolF Senior Member Find all posts View Profile Close CarolF]

find her half naked on the floor. Since this is the 2nd time I've had to deal with this I didn't call 911 as I knew she would refuse to go to the hospital.

I worry she'll pass out driving ( last time she did , I revived her then to)

Her husband used to call her every 2 hrs (even when he was in the hospital dying of cancer)

What can I do? shaggy

She is soooo lucky to have a good friend like you Shaggy.

I do hope she will start acting responsibly soon. She is an adult with a responsible job (the care of children/role model) and a driving licence (the responsibility not to place other motorists in danger). You have revived her twice and I wonder how many others have also come to her rescue and on how many occasions. A dying man felt the need to look out for her by phoning every 2 hours. She refuses to go to hospital.


It sounds like she has had problems for a while and for some reason is not taking responsibility for herself. Perhaps it is depression or is there a fear of losing her driving licence if she is deemed not medically fit to drive. She is going to feel a lot worse if she kills someone whilst driving.

How is your body feeling after this latest episode?

May I suggest you look closely at your own needs and the boundaries you might put in place around this friendship to keep you safe and able to enjoy the friendship.

[Beaglemom3 Senior Member Find all posts View Profile Close Beaglemom3]

Shaggy,
You must always call 911. Doesn't matter what your friend says, they (EMS)can give her the proper medication at the home and she can refuse transport.
Please, always call 911. Your friend could die and you are setting yourself up for legal problems.

Just advice here.
B.

[GrayFal Silver Contributor and supermoderator Find all posts View Profile Close GrayFal]

Shaggy,
You must always call 911. Doesn't matter what your friend says, they (EMS)can give her the proper medication at the home and she can refuse transport.
Please, always call 911. Your friend could die and you are setting yourself up for legal problems.

Just advice here.
B.

ALWAYS call 911 - PLEASE do not take your friends life in your hands.
THINK how you would feel if she died while u were trying to get her to drink juice and she aspirated (juice goes into her lungs rather then stomach because she is unable to swallow) or the delay in calling 911 caused her not to wake up from a diabetic coma?

Your love of your friend is clouding the fact that she is putting YOU and other friends in a bad position - she needs to take responsibility for her medical condition.

[Beaglemom3 Senior Member Find all posts View Profile Close Beaglemom3]

Please remember, too, that with hypoglycemic states(severe) people are always irritable, uncooperative and not thinking clearly. Do not let these folks dictate your actions.
Always, always err on the side of safety.
If she refuses to go with the emergency responders, there are 2 courses of action; they may have her sign a refusal (if appropriate) or they will take her anyway depending on her level of functioning.
They will decide if she is medically competent to refuse transport.
You are very well-meaning, but as Pat says, the danger of aspiration is huge among other issues.
Also, re: Glucagon, please do not take that on (no offense calgal- I know you mean well) .
HIPAA rules may prevent you or anyone else from speaking to her physician.
B

Late edit: Even I, a seasoned RN/ANP x30+ years, would call 911.

[shaggy Moderator Find all posts View Profile Close shaggy]

OK, I promise the next time I will call 911. This has been going on for years. She really scared the bejeezes out of me yesterday. She looked and acted like she was drunk. When I got her revived, , she knew who I was, she didn't know how she got on the floor or why she took her jeans and top of. I asked her why she doesn't get upset over these episodes. What happens if noone shows up? She says someone always shows up and not to worry but thank you for saving my life.

When the police called me to tell me she had passed out in her car (I was the # last called on her phone) when I got there emt was there and I rushed over , opened her purse, got the juice , and got it down her. So much for the emts. One of the guys told me they were called on Thurs night and this was just Monday. Now this one was a couple of weeks later.

As far as I can figure she must have passed out around 1:15 and I didn't get there until 2"30 . Is this a predesesor (sp) of going into a diabetic coma?

shaggy

[jackio Gold Contributor Find all posts View Profile Close jackio]

Shaggy, you are a good friend. Yes, the "drunken" behavior is a precursor to a diabetic coma, where you cannot revive your friend. The other nurses are 100% correct - always call 911. Even after you have raised her blood sugar to revive her, she can always have rebound low blood sugar.
She definitely needs a medalert bracelet or necklace. Two teenagers I know have the letters IDDM tatooed across their left chests. They are athletes, and are not allowed to wear jewelry while playing sports. They want to make sure there is no mistaking that they are diabetic if EMS ever has to respond to them. (IDDM = Insulin Dependent Diabetes Mellitus).
Insulin peaks and troughs. Perhaps your friend is not eating in the proper intervals to meet up with the insulin that is "on board" in her blood. She needs to speak to both her MD and a nutritionist, to find out what kind of foods will hold her longer, and at what times she needs to test.
Please encourage her to take better care of herself. Diabetes is a disease that requires continuous education to effectively manage.

[Beaglemom3 Senior Member Find all posts View Profile Close Beaglemom3]

OK, I promise the next time I will call 911. This has been going on for years. She really scared the bejeezes out of me yesterday. She looked and acted like she was drunk. When I got her revived, , she knew who I was, she didn't know how she got on the floor or why she took her jeans and top of. I asked her why she doesn't get upset over these episodes. What happens if noone shows up? She says someone always shows up and not to worry but thank you for saving my life.

When the police called me to tell me she had passed out in her car (I was the # last called on her phone) when I got there emt was there and I rushed over , opened her purse, got the juice , and got it down her. So much for the emts. One of the guys told me they were called on Thurs night and this was just Monday. Now this one was a couple of weeks later.

As far as I can figure she must have passed out around 1:15 and I didn't get there until 2"30 . Is this a predesesor (sp) of going into a diabetic coma?

shaggy

Did you give her juice while the EMTs were with her ? I'm not understanding this.Was she awake ?
Please remember that they are in charge of the scene and unless someone else is more medically senior to them, then giving them information is helpful, but nothing else.

[riverdees05 Platinum Contributor Find all posts View Profile Close riverdees05]

Where I worked our Plant Manger, who was retired and lived by himself went into a diabetic coma and it was some time before someone found him. He spent the remainder of his life in a Skilled Nursing Center - about 15 years. It was so sad, your friend needs to start taking care of herself or she could end up like him, which is a faith worse than death.

[Beaglemom3 Senior Member Find all posts View Profile Close Beaglemom3]

Where I worked our Plant Manger, who was retired and lived by himself went into a diabetic coma and it was some time before someone found him. He spent the remainder of his life in a Skilled Nursing Center - about 15 years. It was so sad, your friend needs to start taking care of herself or she could end up like him, which is a faith worse than death.

This is frequently the case, the sad case, when the brain is starved of glucose, cells die.

[shaggy Moderator Find all posts View Profile Close shaggy]

EMS had her halfway up in the car and she was eating on a chicken sandwich but still acting stupid . The policeman who had called me wanted to know if she had a medical condition. Told her she was diabetic and he said I thought so, I didn't smell alcohol. The emt's just sort of moved out of my way even when I tried to hand them the juice. I wanted to have them take her to the er but she refused and signed a release form. She does this every time. I'm thinking of calling her daughter who is 3 hrs away or talking to her sister. How long does it take before she goes into a diabetic coma after this happens? shaggy

[idahodude Senior Member Find all posts View Profile Close idahodude]

EMS had her halfway up in the car and she was eating on a chicken sandwich but still acting stupid . The policeman who had called me wanted to know if she had a medical condition. Told her she was diabetic and he said I thought so, I didn't smell alcohol. The emt's just sort of moved out of my way even when I tried to hand them the juice. I wanted to have them take her to the er but she refused and signed a release form. She does this every time. I'm thinking of calling her daughter who is 3 hrs away or talking to her sister. How long does it take before she goes into a diabetic coma after this happens? shaggy

That depends largely on how much insulin is active in her system and how well her body can counteract it. Basically the diabetic coma is starting when the blood sugar drops so low that she can't respond. If it stays too low too long, then brain cells start to die (this starts at about 5-10 minutes if the blood sugar levels are low enough). The body is remarkable in trying to prevent this, but can't always do so. The body will also secrete glucagon in at attempt to get the blood sugar up, but if the liver is depleted of glycogen (storage sugar) and/or not functioning well, then that doesn't help. Frequently, the patien will start seizing if the blood sugar gets low enough as well. Not a pretty picture, but I have seen people die from this. In fact, my first death as a medical student was from a patient who went into a hypoglycemic coma and wasn't brought out quickly enough.