My father has consistently been hitting lows of 50 mg/dl [2.8 mmol/L] and below at night. Most of the time he wakes up, but recently, he was down to 20 mg/dl [1.1 mmol/L], and thank God my mother realized it. The paramedics arrived in time, and my father survived. Of course, we all now live in a panic state. My father’s doctor is trying to work with him, but no solution has helped. Do you have any suggestions? Is there any device that my father can use that will wake him up when his levels go below 80 mg/dl [4.4 mmol/L]?

With problems as severe as this, your father needs special help with managing the blood sugars. This is certainly one of the things he needs to discuss with his physician. If they are having problems getting the physician interested, please get another opinion. Specific recommendations regarding diet, type of insulin, target blood sugars, treatment of reactions, and frequency of monitoring are all important.

There is no easy answer to getting this better. In the big picture, it is important to stop the low sugars from occurring. You really need someone to help your parents work through this. There is a product called a GlucoWatch which does allow a patient to wear the device and it will signal if glucose levels hit a set high or low value. However, it is not yet available.

JTL

[Editor’s comment: Be certain that your parents know appropriate treatment for hypoglycemia and keep a Glucagon Emergency Kit on hand to use in such situations.

If your father is not currently being followed by a multidisciplinary diabetes team, I strongly suggest he visit with one. His physician, or a local chapter of the American Diabetes Association can provide them with a list.

SS]