Q: Hi Dr
Today my husband’s blood sugar got to a low of 58. His mental status was altered. He was not himself.
He became agitated and angry. I have seen his sugar low many times before but never with the mental status of today.
I was very very scared. Our 15 yrs. old daughter says she has seen him like that before.
One time they were at the drugstore and he was acting like a war vet. He has never seen war.
It really scared our son and me. We ended up calling 911. After about 15 minutes or so he was back to himself.
Can u please HELP ME UNDERSTAND what happened today with my husband. He is 62 and takes 3 shots a day. Thanks for your help... Tracy
A: Hi Tracy,
I am sorry to hear that you and your children are in such difficult situation. It is true that older people with uncontrolled diabetes have more chances to act as your husband did.
In fact, in a study of Ohio university, presented in the annual meeting in Honolulu, where it were included diabetics 60 years and older, it came out that those who had poorly controlled their disease were more prone to such mental disorders (called cognitive disorders, such as dementia) than other diabetics.
The crucial factor contributing in such alteration was a “Badly Controlled Diabetes”.
So, as I can see from your saying, your husband is passing too often into a hypoglycemic status.
Other times, perhaps his blood sugar will raise peak. Therefore, you should help him adjust his current glycemic situation.
Following are some potential reasons for his altered mental state and behavior during this episode:
1. Severity of Hypoglycemia: The level of blood sugar at 58 mg/dL is considered low and can cause significant cognitive and behavioral changes, including confusion, irritability, and agitation.
2. Duration of Hypoglycemia: The length of time that blood sugar remains low can intensify the effects on mental function and behavior.
3. Individual Reaction to Hypoglycemia: People can react differently to hypoglycemia, and some individuals may become more agitated or experience mood swings during episodes.
4. Previous Hypoglycemic Episodes: Repeated experiences with hypoglycemia can sensitize the body's response, potentially leading to more pronounced and alarming symptoms.
5. Adrenaline Release: The body may release adrenaline during a hypoglycemic episode, which can contribute to feelings of agitation, anxiety, and increased heart rate.
6. Stress and Anxiety: The stress of the situation, fear, and anxiety about the episode could also contribute to changes in behavior and mental status.
It's crucial to address this incident with your husband's caring doctor to ensure appropriate management and prevention of future episodes.
However, following are some recommendations:
1. Measure his blood sugar many times during the day for up to a week. Record the findings to present to his doctor. It is important to get a blood sugar test when your husband mental status is altered to better understand his sugar levels changes.
2. Talk to his doctor about the current situation of your husband. Present to him your husband’s sugar records to evaluate if he needs some adjustment in his shots (less I believe).
3. Ask your husband to have regular meals, especially when it is time for his shots. Make him understand that skipping meals will not help reduce blood glucose.
4. Discuss with his doctor what precautions you should take when your husband’s turns out altered. This is to protect you and your children in case of raised aggressiveness.
5. Emergency Plan: Develop an emergency plan with clear steps on what to do in the event of a severe hypoglycemic episode, including when to call for medical assistance.
6. With regards to what your husband said to a local drugstore, do not worry. Sometimes, children do not understand why we talk in an unusual way. Sometimes, we, adults, love to make funny of others, therefore, we can “make-up” many untrue stories.
So, Tracy, at the end, the very best thing you can do is to talk to his doctor as he/she is the only one who can evaluate your husband’s current health status.
To me, this is all we can help.
All the best!
Written by Dr.Albana Greca Sejdini, Md, MMedSc
Medically reviewed by Dr.Ruden Cakoni, MD, Endocrinologist
Last reviewed 10/17/2023