Diabetes & the midnight sweat-storm

photo: Creative Commons CC0(Sounds like a band name, doesn’t it?)

Here I went tempting fate again. In a recent poem I mentioned coping with waking in the night to find my husband far into an insulin reaction and soaked in sweat.

So guess what happened tonight? I’m writing this at 2:30 am, and he’s sleeping now, if a bit mumbly and restless. He’ll ache in the morning. I always try not to think too hard about what might happen one of these times when I’m not here.

[If you live with an insulin-dependent diabetic, please read on: you need to learn more about this!]

Some doctors we’ve talked to have downplayed this phenomenon. The medical term for what’s going on is nocturnal hypoglycemia, and it’s pretty common: the diabetic wakes at night or (more often) in the morning sweaty, headachy and poorly rested. Oh, dang, their blood sugar dropped in the night, how annoying. Often we have stretches where I get up to use the bathroom and find the shirt my hubby went to bed in draped damply over the shower curtain rod.

Severe hypoglycemia, meaning an episode where the diabetic needs help to fix it (a.k.a. “diabetic shock”) is rough enough by day. But it’s much more dangerous at night, mainly because it often won’t wake the person up. Which, unchecked, can make them very sick or – in bad cases – lead to seizures, coma, or even death. (Oh, thank you downplaying-doctors!)

Our adventure tonight

The first thing I know is waking because my husband is muttering unhappily about being overheated and unable to get back to sleep.  I offer to get him half an atavan and turn on the fan, but when I reach over he is damp and clammy, not warm at all; even his hair is wet and curling with cooling sweat. His shirt and the bedclothes feel like someone had upended a glass or two of water over him. Okay, so sleep is out of the question; I shake myself awake.  I know exactly what this is.  Oh, boy, do I.

He is having a “severe” nighttime reaction, though not so bad as some he’s had.  His body actually got him half-awake — too confused to figure out what was happening, but enough to wake me.  (And thank God for that.)

Stage one: confirm (as if there were much doubt) that it’s the blood sugar, and not some crazy fever or something.

  • “Hon, where’s your test kit? Is it in the bathroom, or downstairs?”
  • (mumble)
  • “What?”  (pause)  “Sweetheart, what?”
  • (mumble) “… here …” (mumble) “… ‘ll gettit …”
  • (long pause — he doesn’t move)
  • “Okay, should I get it for you?”
  • (mumble, groan) “… I’ll … get … mmphmmm..
  • (Another long pause. I’m glad he’s still able to speak — sort of — but now I realize he’s barely awake.)
  • “Hon?” (He starts.) “You’re having an insulin reaction. I’ll get your kit. Can you sit up?”

But I’m already moving. (Sad to say, I’m an old hand at this part.) I bring his glucometer; he hasn’t moved, but flops a hand out for me – bad sign that he doesn’t sit up and insist on doing it himself, but good that I don’t have to try to convince him he needs to test; sometimes screwy blood sugar makes my gentle man illogical and belligerent.  I carefully poke his finger, smear the blood on the test strip and watch the meter anxiously: 54.

Okay, it should be between 80 and 120, so pretty low, but not oh-my-God-he’s-about-to-lose-consciousness low. Not seizure-pending-time-to-get-the-glucose-syringe low. No paramedics tonight. (He hates when they find him unconscious in his underwear. But he’ll have a good laugh with them about it after.  EMT humor.)

Stage two: get carbs into him.

As I said before, when his reactions are mild, he usually wakes, gets something to eat or drink to fix it, waits a bit to make sure his blood sugar has come up, and then comes back to bed. Occasional insomnia aside, when I do sleep I’m not a light sleeper. Unless he wakes me (when I’ll get up and drowsily sit with him), I mostly sleep right through it.

Tonight, though, I am wide awake and the combination of adrenalin and long experience has me moving quickly but not frantically. I get a bowl of cereal and milk, and a big soup spoon — so he expends less precious energy if his coordination is messed up, plus gets the food in faster. After the sixtieth time, you really think of these things.

I also bring a cup of juice, for the short-term hit of sugar. It will take longer for the cereal to kick in, so this will get things started.

[If you’re ever unsure what to give a disoriented diabetic, orange juice is a good fall-back. If you’re wrong about the blood sugar, little harm done, and if you’re not it could make all the difference.]

Back upstairs, he’s managed to sit up, and I’m flooded with relief. It won’t be one of those nights. I give him the juice first, take back the cup, make sure he can balance the cereal bowl, and then sit beside him and joke lightly as he painstakingly begins to eat, intent as a toddler who just mastered the spoon. Our little cat, Ada, winds around us on the bed, purring, hoping for milk dregs. Sorry, old girl – next time.

Stage 3 – get him dry and warm.

My sweetheart is starting to speak more coherently. When he can stand (only staggering a little), he towels off and changes into dry things. I quickly strip the soaked sheets — damn, the mattress pad’s damp, too. No time to do anything about it so I lay out a thick, clean bath towel and make the bed right over it. Shivering now, he climbs back under the covers and tucks his hands in; they’re like lumps of ice. His pillow was soaked, so he gets my extra one. I cover him with a second comforter, our light down one. He’ll need it for the next few hours.

Finally, I can turn out the lights. I climb in and curl my body around his chilled one.  I press my face into his neck.  Even his ears are cold.  I reach over and cradle his other cheek in my warm hand.  He sighs, I sigh … and we stay like that, safe now, talking softly.

He’s himself again: “Honey, I’m so sorry you had to deal with all this.  Especially after your rough day.” He kisses my hand — chivalrous goof that he is. “But this just shows how much you’re needed. I need you. You know that, right?”

God, how I love this man.

Now he falls asleep, murmuring softly. Okay, snoring. I don’t care a bit.
For tonight, another storm has past.


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