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Glp-1based Therapy For Diabetes: What You Do Not Know Can Hurt You

GLP-1Based Therapy for Diabetes: What You Do Not Know Can Hurt You Peter C. Butler , MD, Sarah Dry , MD, and Robert Elashoff , PHD From the Larry L. Hillblom Islet Research Center, Department of Pathology and Department of Biomathematics, University of California, Los Angeles, Los Angeles, California. From the Larry L. Hillblom Islet Research Center, Department of Pathology and Department of Biomathematics, University of California, Los Angeles, Los Angeles, California. From the Larry L. Hillblom Islet Research Center, Department of Pathology and Department of Biomathematics, University of California, Los Angeles, Los Angeles, California. From the Larry L. Hillblom Islet Research Center, Department of Pathology and Department of Biomathematics, University of California, Los Angeles, Los Angeles, California. Corresponding author: Peter Butler, [email protected] . Author information Copyright and License information Disclaimer Copyright 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. See the article " Incretin-Based Therapies f Continue reading >>

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  1. JuanitaK

    diabetic seizure

    Hi, everyone--
    Where to begin? The dust is settling but I'm still a bit overwhelmed dealing with something that happened to my boyfriend who is t1 controlling with insulin. Before I begin, I want to ask upfront for help and not judgment with this issue. I'm emotionally drained already and I just need help. I thank you all for understanding in advance.
    OK. So the day before I posted here (Aug 5) my boyfriend had a diabetic seizure. It started out as a hypo--he woke me up right before 6am tugging hard at the covers. I quickly realized he was low and went to get him some juice. When I returned, he was pretty pale and couldn't hold the glass and right as I was giving him a sip he began seizing. I've never witnessed this in him or anyone else. I removed the glass but he'd taken in a small amount of juice already. So now, I'm trying to turn him on his side but his whole body is rigid and I'm having a hard time. Meanwhile, he starts screaming and his hands and legs start curling up even harder, and now there's bloody foam all over his face. I tried so hard to keep him from aspirating and I'm not sure how effective I actually was. I called 911 immediately and unlocked my front door and ran back to him. He was unconscious but breathing and the dispatch stayed with me until firemen came (they're literally right around the corner). Five firemen crowded into our room and revived him. He refused to go to the ER.
    He is ok now, to all appearances. It took him a while to remember what we'd done the night before, or that he'd already called into work that night, and several other things. Eventually he did, though, and the next day he went back to work. His choice, not mine. I thought he needed to rest.
    Ok, so we had some talks since then, not the least of which is, I asked him to call his Dr. to get a glucagon shot to have here (which he did and we now have). The other thing is I said he needs to test every day upon rising, when he gets home, and before bed, at least. He rarely ever tested before. As you can imagine, he also never boluses--he guesses. I KNOW. AND, he now has fast-acting insulin available as well as his 70/30 novolin. So sometimes he stacks without bolusing. I KNOW. And, he enjoys several drinks, daily.
    I KNOW.
    So now he's being really good about testing those 3 times a day. I already eat lchf so there's that. He walks about 10 miles/day for work (mailman) which we both acknowledge is wonderful for his diabetes (which he's had for 25 years). He's still guessing his insulin dosages, and the thing that's really perplexing me is how in denial he is about the effect of alcohol on a t1 diabetic. I have read that moderate consumption is ok but 1) he's not exactly moderate (although I've seen him actually drunk exactly one time) and 2) he includes sugar (in the form of juice/sweetened alcohol like Kahlua, etc) in his drinks because he believes it offsets the alcohol. I will add, he is exceptionally careful about his doctor visits---regular and frequent and comprehensive--regular doctor, optometrist, and dental. He brushes/flosses/picks his teeth twice a day without fail. He's good about how he wears his contacts.
    This morning, during what I now refer to as the witching hour, he started twitching, a symptom that has historically usually preceded his hypos. Oh yeah, he's also not cooperative and often almost combative during those hypos, so it's kinda hard to manage. Amyway, he said he was fine (!) and he's just tired and doesn't need to test....and I'm now full of adrenaline and watching him. Felt his forehead to see if it was clammy, it wasn't. When he got up he did test and he was 210. When we went to bed last night he was 130 and so he didn't take any insulin which I'm fine with but still not happy with a 210 and neither is he. Couldn't be happier to be wrong today, but the fear is real and so is the struggle.
    How do I help him with this? I'm t2, and only ever used metformin. He is much more willing than ever to discuss and make adjustments, and yet is still in some denial. He has agreed to read any research I come up with. I know he should be doing this but for whatever reason he isn't. So I will with the caveat that he be willing to read and consider. So I need real resources for t1 diabetics. We need help. We need hope. He almost died last week and I want to make damn sure it never happens again.
    Thanks so much for reading this far, and thanks for any help.

  2. moon

    He is so lucky to have you, Juanita, and it's good to hear that he is becoming more open to information and change. Baby steps, but opening the door to that is a giant one. How terrifying for you.
    For information, you might want to get a copy of Think Like a Pancreas, and read some of Dr. Bernstein's Diabetes Solution online. Also noticed that August 31 he's having a Teleseminar/Webcast and would definitely register for that (free but limited space). Audio information/discussion might help your husband as he begins to engage.
    We're in your corner - please keep us posted.

  3. JuanitaK

    Should I post this in another forum?

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