I’m lying here at 4 o’clock in the morning, thinking about diabetes. Why? I’m not a diabetic but my husband is, and last night he had a bad hypo. Most of our days are spent together, but last night I wasn’t with him, as he was entertaining friends. It was only as the evening was winding up, and I came down to say goodbye, that I noticed his sugar level was dangerously low. He’s very good normally at spotting if he’s crashing but on the odd occasion, this sneaky disease will catch him out. I wondered why our friends hadn’t noticed, but I realised, that after 17 years as a partner of a diabetic, I can spot in an instant, the signs of him having a hypo.
Many years ago, we had a friend called Mr BBC, because he spoke with a beautiful clipped British accent. This was before my husband had been diagnosed. We knew he was diabetic, but as we were unfamiliar with the disease at that point, it meant little to us. We found him one day, talking nonsensically, sitting in his car at a reenactment event. Luckily, my husband had an inkling of what was wrong, and made him eat a chocolate bar. Mr BBC himself was convinced he was fine and was going to go and fight in a battle. The chocolate saved him that day, but sadly, at a later date, he slipped into a diabetic comma and died. So to go back to my original question, I felt the compunction to share my knowledge with you, so that maybe one day, you can spot the signs and possibly save someone’s life.
My husband is an insulin dependent diabetic. We don’t even know if he’s type one or two, as he’s never been tested, but he doesn’t fit the type two profile. He's never been over weight. He's always been fit. There's no family history of the disease. The doctor that gave him the diagnosis gave no advice, but simply said, “You’re a clever man, you’ll work it out.” Over the years, we have. The symptoms I’m going to list therefore, are most pertinent to him, every diabetic is different and this list may not be exhaustive.
Pale complexion - When a diabetic's sugar level is abnormally low, their skin can lose some of its colour and they end up looking like they’ve seen a ghost. I’ve no idea how this works for someone with a darker skin tone, but I imagine this could still be the case.
Uncharacteristic anger - This can be harder to spot if you don’t know the person but I’ll give you some examples. Whilst packing down at the end of a days eventing, my husband became obsessed with the two inch thick pole of our awning. He moved it backwards and forwards and still wasn’t satisfied with it. In the end he started kicking it so hard, it snapped in half! It was at this point I realised something was wrong, and I took him off to grab an ice cream.
Another time he was helping his mum to move, and as an experienced removal man, he was packing it in to the van with ease, but gradually he was finding it harder to think where to fit things. Her well meaning neighbour started telling him how to pack the van. I could see him becoming increasingly angrier with him and was being very short with him. He was still managing to control it but it got to the point where I was worried he might actually thump him. This was very uncharacteristic of my husband and I worked out something was wrong.
Vagueness - This leads me neatly into my next symptom, vagueness. He was unable to pack the van, because the hypo was affecting his ability to think logically. When I found my husband last night, he was standing in the middle of the room staring blankly into mid air. I asked him if he was having a hypo and he was only able to utter a string of garbled words. Often the vagueness isn’t this bad, and the person can just appear as if in a day dream, quiet and withdrawn. This would be harder to spot in a shy person but my husband luckily is quite outspoken. They’re often unable to answer questions put to them. Even a simple one, such as whether they are diabetic or not.
Mental Fog - This goes hand in hand with vagueness but I can give you a good example. We have a friend who is a type one diabetic and an outstanding board game player and I think has a very high IQ. One time when he was playing with us, he started making mistake after mistake, until he eventually lost, and he never loses. Even as someone experienced with diabetes, I didn’t realise at first what was wrong. We were relishing the opportunity to beat him for once. Simple tasks become like mountains to someone having a hypo. I realised once that my husband was having a hypo and took him into a supermarket to choose something to eat to raise his sugar level. Big mistake! He kept fussing backwards and forwards about what he should eat, and wasn’t hit with the urgency of the situation. In the end I grabbed some bananas and a chocolate bar and made the decision for him.
Wreckless behaviour - People having a hypo might not realise they are and will do uncharacteristically dangerous things. I once read about a diabetic who got bored waiting at a temporary red light and drove through it, around a blind bend. They saw no danger in the situation. Fortunately, this type of incident has been rare with my husband.
Over dramatism - This is an odd one but on occasion my husband has become very overly dramatic. He was performing once to an audience and I noticed his words and gestures were becoming extremely dramatic, like a ham actor giving the performance of his life. Every movement was grandly overstated, and every sentence pronounced with a flourish. It can be similar to a drunken person losing their inhibitions. This was not my husband’s normal way.
Sudden Blindness - Ok, so the diabetic is going to know themselves that something is not right here, but they might not assign it to being a hypo if they’ve never experienced it before. Their vision literally goes. They might see stars in front of their eyes. The first time this happened we were running a workshop when his eyesight suddenly went. He realised however it was a diabetic symptom, got me to take over his part, and went to eat a banana. His vision quickly returned. This is a good example of why diabetics should always check their blood sugar levels before setting off on a journey or undertaking any activity where they won't have a break for a couple of hours. Fortunately, the blindnesss hasn’t happened for years now and was a rare symptom.
Profuse sweating - Hard to spot in summer, or if they’ve been exercising, but this is a very common symptom. If my husband has a nighttime hypo, the bed sheets will be drenched. This often goes hand in hand with paleness and the person looks clammy.
Shaking & shivering - Again, a very common symptom. Particularly noticeable in the hands. If they’re holding something such as a cup of tea, the shake will be more pronounced. They often shiver too, and can feel cold, even on a hot day. Perhaps because they're sweating. My husband will bundle himself up in jumpers and duvets and still not feel warm.
Meanness - Sometimes they can be very mean, saying spiteful things, that they wouldn’t normally say. Don’t worry, it’s not them speaking, it’s the illness, and you should never take offence at what a diabetic having a hypo is saying. My husband once cut a slug in half with some snips after I mentioned reading that was what I’d heard someone did. ‘What a good idea!’ He said. SNIP! The poor unfortunate creature was in two. It’s not that my husband was anti slug killing, but not normally in such a brutal way, and in front of his vegetarian, animal loving wife.
Tiredness - This again can be hard to distinguish in the young or old but being excessively tired and going for a lie down at an uncharacteristic time of day can be a symptom.
A diabetic having a hypo may experience several, or just one of these symptoms. My list isn’t exhaustive, and other diabetics may have different symptoms, dependent on their age or other variables, but I hope at least, you’re now more aware of of some of the signs, and will keep this in mind for any friends, family, or indeed strangers you meet.
So in summary, look for uncharacteristic behaviour and unusual bodily functions such as shaking.
How can I help them? Firstly, if you don’t know them, ask them if they’re diabetic. Many diabetics will have some sort of medical wrist band, or necklace, to make people aware in case of medical emergencies. My husband however, does not. If they are diabetic, get them to sit down and use their blood testing kit. A good diabetic should carry this with them everywhere. They’re fairly simple to use and involve inserting a test strip into a machine. The diabetic then uses a finger pricker to draw a small drop of blood and applies the blood to the end of the strip. After a few seconds, the machine will give you a reading. If it’s below 4.5, they’re probably having a hypo. The lowest my husband has been is about 1.9. They’re feeling pretty crappy by that stage and may become unconscious. A healthy non diabetic person’s blood sugar should be about 5. If they are low, get them something to eat. If it’s still relatively high (say above 4), and they’re talking coherently, a bowl of shredded wheats or peanut butter on toast (If you know they're not allergic of course!), might be good, and more sustaining, but if they’re dangerously low, you need to get sugar into them quickly, to raise their blood sugar levels. Many diabetics carry sweets with them for this purpose. Ask them if they have any, or if they’re not coherent, find some food for them, asap. Anything quick acting, sugary drinks, sweets, chocolate, biscuits, bananas are good. Lucozade is perfect. It must contain real sugar though, fake low calorie sugar will not do! Any food with calories is better than nothing. There is a substance called hypogel/glucogel that you can buy to put on a diabetics gums/cheek but you should only administer this if they're conscious. Never unconscious or they could choke. My husband once forgot his sweets whilst going for a countryside walk. Fortunately, it was September and the hedge was full of blackberries! It will take a few minutes for the sugar to work its way through their system, but stay with them until they’re talking coherently, and their symptoms have stopped, or their blood sugar tests above 5. If you’re at all worried, or you're not certain if they're diabetic or not, call emergency services to assist you. Other illnesses might present with similar symptoms.
I wrote this article because last night my husband’s hypo was probably the worst one yet. He actually had some sort of OBE during it and said he could see himself. It was as if he was disembodied. He can’t even recall our friends leaving. I can’t always be with my husband, but by writing this article, I’m hoping you can be the helping hand that he, or another diabetic needs, and possibly even save their life.
Watch our video below to find out how to test a diabetic's blood sugar. In this video it is too high but for obvious reasons I couldn't film it whilst he was having a hypo.