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June 6, 2000

Hypoglycemia

Question from Pennsylvania, USA:

Can you please comment on the capacity of a virtually out-of-control 55 year old (35 years with Type 1) diabetic -- high/low blood sugars, too much insulin for levels of physical activity, frequent, severe, unrecognized hypoglycemias -- to cause terror for loved ones. I behaved terribly, violently to people who love me as they tried to bring my sugars up, so much so that continues to affect my relationships, even after I am well stabilized on the pump (HbA1c=7.2, virtually no and mild and recognized insulin shocks). Is it possible, in shock, to hurt or try to hurt people you love? I thought the subconscious would block that. Where can I read more about this, show it to my wife and help her understand what happened then and the reduced risk of this very serious consequence to happen again?

Answer:

Low blood sugars affect brain function, and yes people can behave very inappropriately, even violently towards others (including ones they love). If you are still having these problems, I suggest you talk to your doctor about trying even harder to avoid mild low blood sugars. I would also suggest some family counselling to help you and your family deal with these issues.

If these episodes continue to occur even when your blood sugar is not low, you should speak to your doctor about having a neurological evaluation. It is possible that these episodes represent seizures and could be prevented with medication. If you have had many severe low blood sugars in the past, it is possible that you have developed a seizure disorder where you can have seizures even if your blood sugar is normal. If your physicians have ruled out a neurological problem, and these episodes occur when your blood sugar is normal, you should have a thorough psychiatric evaluation to make sure you haven’t developed a psychiatric disorder that might respond to medication.

TGL