hypoglycemia, hypothermia or both?

December 19, 2010 3:51 PM

I have unmanaged type 2 diabetes. in the last 2 weeks i have had 2 episodes of what i would call mild hypothermia (shivering, chattering teeth, etc) is this the same shaking that is linked to hypoglycemia or is it directly related to the cold?

the first time was on a very cold night where it was probably 60 degrees in the house i was sleeping in and occurred in the middle of the the night the second happened after coming inside from being out in very cold weather and feeling chilled down to my core. each time lasted about 20 minutes untill i could warm up and calm down using breathing techniques. they were also followed by 2 days of muscle pain and headaches. my research has shown that it is easier for diabetic people to get hypothermia. please do not just tell me to go to the doctor, i have an appointment at the free clinic later this week.

posted by BSummers to health & fitness (13 answers total)

Are you taking insulin? I'm not sure why your blood sugar would go low (hypoglycemia) otherwise.
posted by yarly at 3:57 PM on December 19, 2010

no when i was previously being treated i took medicine and used diet and exercise over the last 2 years of unemployment and unstable living conditions i have not been able to keep that up as best as i should.
posted by BSummers at 4:05 PM on December 19, 2010

I doubt very much it was hypoglycemia since your Type II is not being managed, and I also assume you are not taking insulin or other potent drugs to lower blood sugar. It is possible you were mildly hypoglycemic if there was a rebound from producing excessive natural insulin but I rather imagine you were cold and/or getting sick and or apprehensive once the symptoms occurred I am glad you have an appointment and hope you follow the appropriate management plan
posted by rmhsinc at 4:10 PM on December 19, 2010

I've gotten that too. I always attributed it to mild hypothermia. And I even use the same words to describe when its happening: chilled to the core.

Other possibility: you have the flu.
posted by gjc at 4:39 PM on December 19, 2010

Is it possible you need salt? After a bad run of severe dehydration as a consequence of some recent health issues, I would often wake in the middle of the night in a cold sweat with scary and uncontrollable bouts of shivering, despite being under three layers of blankets. Once I stopped drinking water and started drinking chicken stock with extra salt, the shivering would slowly stop. After a few days of this, I went in for IV fluids, which helped get things under better control.
posted by Blazecock Pileon at 5:01 PM on December 19, 2010

Glad to hear you're getting to the clinic! A lot of chain pharmacies/grocery stores have free or very cheap metformin prescriptions now. Check it out. Also, some studies recently came out showing that weightlifting is very effective for controlling blood sugar, if you can access any sort of community gym.
posted by yarly at 5:51 PM on December 19, 2010

I'm not diabetic, but this happens to me in the winter from time to time. In fact, just last night I was sitting on the couch watching TV and started shivering uncontrollably. It wasn't too cold in the house (65-ish) but I couldn't get warm at all, even under a blanket. It took about 20 minutes under an electric blanket with my icy cold feet on my poor, long-suffering boyfriend before I was warm enough to even think about sleeping. I don't think it's anything to worry about. And good call with the free clinic. I'm in TN, and here the local Heath Departments offer free supplies to diabetics (test strips and such) and they do low or no-cost prescriptions like metformin, too.
posted by kella at 6:19 PM on December 19, 2010

Did you take your temperature during any of these shivering episodes? Your body will shiver when you are approaching hypothermia, as you suppose, but it will also shiver when you have a fever because it's trying to keep your temperature higher than normal. The muscle aches also make me wonder if there might have been a fever involved.

It seems unlikely that you have hypoglycemia if your diabetes in unmanaged -- typically an unmanaged diabetic will see abnormally high blood sugars (hyperglycemia), not abnormally low (hypoglycemia). I haven't heard of hypothermia being a symptom of either of these conditions, though. I'm glad to hear you're going to the clinic.
posted by vytae at 7:42 PM on December 19, 2010 [1 favorite]

i did not take my temperature but i did not feel cold to the touch. slightly warm if anything but that could be from the blankets. my family are the ones who are most worried about it being dibetes related and are freaking out pretty hard about it.
posted by BSummers at 8:08 PM on December 19, 2010

Anecdotally, I have never noticed hypothermia during an a low blood sugar incident. Usually hot sweats, trembling, mental confusion, weakness, unable to stand. I agree with vytae that you're unlikely to have low blood sugar unless you aren't eating and doing excessive unaccustomed physical activity. I hope you can get a meter and some test strips. Some manufacturers have offers for a free meter with at least a few free strips so you could test when you or you family are worried.
posted by a humble nudibranch at 10:08 PM on December 19, 2010

I did not take my temperature but i did not feel cold to the touch. slightly warm if anything but that could be from the blankets.

If you have a fever, you're going to feel warm to (someone else's) touch. Touching yourself is pretty much useless, because both your hand and your forehead (or wherever) are warmer than normal, and you'll only notice relative warmth.

It does sound a lot like you were sick. This is important because when diabetics get sick, their blood sugars get out of control. (However, their blood sugars get higher, not lower.)

I know you said you're "unmanaged," but I'm not sure if that means that you're not taking drugs or if it means that you don't even have a way to check your blood sugars. If you do have a way to check your blood sugar, I would keep a more careful eye on it during days when you have symptoms like this (but again, because you're likelier to have high blood sugar, not because you're likely to have low blood sugar.)

You should also mention this at your appointment at the free clinic. They are likely to check your blood sugar to get an idea of how diabetic you are, and if you are sick, they're not going to have an accurate idea. That could lead to overtreatment.
posted by nathan v at 6:13 PM on December 20, 2010

It's not hypoglycemia. That's low blood sugar, and it's a risk for diabetics who are on insulin. If your diabetes is uncontrolled, your blood sugar is dangerously HIGH, not low.

That's not to say that the problem isn't related to your diabetes in some other way.
posted by kestrel251 at 7:50 PM on December 20, 2010

I highly doubt the episodes are related to your diabetes; I am also type 2 and could be in better control. I have had occasional low blood sugar episodes but they were more like what a humble nudiebranch mentioned. I have, however, had a few episodes like you described. In all except one I ended up very ill with the flu.
posted by deborah at 10:08 PM on December 20, 2010