My Diabetes - A Great Night Out Clubbing Ends in Accidental Coma

In the eighties when we were both young students, D was visiting her relatives and I decided to go out on a Friday night drinking and clubbing with a friend.  I promised D that I wouldn't  drink too much and would be careful.

We had a really good night but I got just a little greedy and when offered one of the road I took it.  I got home feeling a little worse for ware, tested my urine which didn't seem too bad, so I took my insulin and had my supper and went to bed.  Then the room began to spin slowly then a little quicker. It wasn't long before I realised that I was going to be sick.

I got up and was sick, and went to lie on the bed and rapidly began to realise I was going hypo, so I went down stairs and drank some lucozade and went back to bed, only to have to visit the bathroom again.  I realised that I was alone and potentially in trouble and repeated the cycle a number of times.  The last thing I remember it was around 3 am and I was sitting on the kitchen floor, so I didn't fall over, and eating a biscuit.

When I woke I was absolutely frozen and shivering violently.  I looked up at the clock and it was around 11 am.  I was a little annoyed with myself for not foreseeing what would happen if I got sick and making plans.  I realised I'd missed my 8am insulin so the whole day would need to start from now, but I was hungry and my head was killing me.

So I decided I'd go over the road and get some fresh bread from the shop and a paper.  I asked the guy for the fresh bread and he said they only had yesterdays, which was a little unusual, and I then started rummaging through the papers.  But as I did so I got increasingly confused as the papers were not the Saturday papers I had expected, they were Sunday papers.

Then it hit me like a brick, on a winters day I had been curled up on the kitchen floor unconscious for over 32 hours in what must have been a coma, luckily the low temperature and the few carbs I had consumed must have reduced my metabolic rate and thankfully I suffered no longer term damage or worse death.
D coming back and finding me dead on the floor would not have been good.

Normally my body would have broken down the glycogen etc in liver and muscles and then the fat, but alcohol inhibits this process from happening until it has been dealt with.

Learning Points

• I realised that my youthful drinking days would have to be moderated
• I realised that a simple night out partying can rapidly develop into a medical emergency if I wasn't careful
• I realised that I was in control of the drinking, the offer of one for the road however kindly offered had to be balanced with the potential outcome
• I learned over the next few months that I didn't need to get blind drunk to have fun
• I realised that after a few drinks, any more I drank did little but to pee my money away
• I realised that the less I drank, the easier it was to get the enjoyment part of it with very small qualities, a cheap night out ;-)
• In deciding to moderate my drinking early in my diabetes,  I had accidentally prevented myself from getting some of the major diabetic complications in later life made worse by excessive drinking with diabetes
• I realised that each day was a new adventure

TBC

Exercise, Blood Sugar and Blood Pressure

Even before I was diabetic I knew that after a long run, I would look pale round the eyes despite having a red face and my hands would tremor.  This is hypoglycaemia in a non diabetic brought on by my burning of all of the bodies reserves too quickly for my body to break down its fats and other substances in the liver and muscles into usable glucose.

If I was not diabetic my body would reduce its insulin production and releases glucose for the remaining insulin to use when I start to exercise.  Insulin is like a catalyst your body needs it to break down sugars.  However as a diabetic on insulin my insulin level will be constant so if I do anything that requires extra energy, and I need to balance it with extra sugars.

Playing Squash

Before I became diabetic I liked the occasional game of tennis or squash.  I'd arranged to meet somebody, book a court, turn up with a bottle of water and play and afterwards I would have a sweet snack.

As a diabetic I can't do this:

1. To play squash I must either reduce my insulin (to prevent me burning to much carbohydrate), this requires forward planning. 
2. Or I drink a high carbohydrate drink before, during and after the game.

Okay thats seems simple enough, choose 1 or 2.  Unfortunately its not that simple.  In both cases diabetic control depends heavily on the reliability of your partner and the time of day of the game,

In both case if my squash partner doesn't arrive on time then I will have to begin exercising myself, i.e. go for a run in order to make up for the lack of a game.

All of the doctors have always told me to reduce my insulin before sport or heavy work that brings me out in a sweat.  I do this only very very occasionally, the reason is quite simple people are unreliable and get caught in traffic, forget or possibly decide not to bother to play.  I may also decide not to do the heavy work if the weather is too bad.  With little insulin in my blood my sugar will go high, and stay high for a long time.

So I tend to have a small mouthful of lucozade just before a game or heavy work and another just as it progresses.  For squash I am ready, if they don't turn up I have a modest bit of exercise to do, to get my blood sugar down.  If they do turn up i'm ready to play.

I also noted from observation, that with the reduced insulin plan it took me longer to recover and I noticed little in the way of physical benefits.  Whereas taking my normal insulin and topping up with high carbohydrate drinks to exercise, feels like watching a Popeye cartoon with spinach (if you don't know about Popeye type it into youtube).  My muscles swell and become more toned and my recovery time is vastly improved and my stamina lasts for days.

Warning, playing with my insulin level is not for the faint hearted and I acknowledge it can be dangerous, so I always have carbo's in my pockets and check my blood levels before and after sport for the some time.  Also tell the other person what you are planning to do and what to do if you start talking nonsense and falling around.

Learning Point

Reducing my insulin allows me to do exercise without lots of extra carbs

Eating or drinking extra carbs allows you to do extra exercise

Doing neither can lead to hypo if you exercise, or high blood sugar if you don't

TBC