September 27, 2004
Question from New York, USA:
Is it possible for a type 1 to be aware of having hypoglycemia severe enough to cause convulsions? I’m asking because I have experienced at least two reactions where I felt myself jerking and shaking at night, not just trembles, but all out, full-body jerking. Once, I was not able to test my glucose level, but made it to the glucagon and was able to inject myself (I live alone). Last night, when I was finally able to rouse myself from bed, I had a reading of 29 mg/dl [1.6 mmol/L] on my meter.
I have been diabetic for nearly 34 years and well controlled. I always thought that seizures or convulsions were beyond the ability of a diabetic to really be aware of, but after my experiences, I wonder. How low would glucose readings be to cause convulsions or, does that vary according to the individual? Also, if I did experience convulsions, why was I able to eventually wake myself up? I assume it is due to the body releasing stored sugar, but why does the body allow itself to go to such an extreme before this release?
Seizures with hypoglycemia are a result of the nerve cells in your brain unable to acquire glucose. Glucose is their main fuel. When they don’t have it, they don’t work. Seizures, when they result in generalized activity, are not associated with a conscious state. You would not be able to note yourself having tonic clonic movements. Rather, they would have to be noticed by someone else. When you get to this point, it is important to avoid low sugars as this is a warning of more problems to come. It means you have lost your early warning symptoms for hypoglycemia. You need to work with your diabetes care team to avoid lows and avoid the risks of seizures. This is a medical necessity.