Wil Dubois

Welcome back to our weekly diabetes advice column, Ask D’Mine — with your host veteran type 1 and diabetes author Wil Dubois. This week, Wil's addressing the first of two questions relating to diabetes seizures that can be quite crippling. Take a look at what he has to say, and make sure to stay tuned for next week's related question.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

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Bill, type 2 from New Jersey, asks: What happens during a diabetic seizure? I haven’t yet been diagnosed with diabetes, but I have seizures affecting my face and can’t sit up. Or when I go to stand, I fall; or when walking after one, I bump into walls.

 

Wil@Ask D’Mine answers: Wow. Dude, you soooooo need to go to a doctor. Face-affecting, falling-down, wall-bumping “seizures” gotta be the sign of something that needs to be checked out. But on the bright side, I doubt that it’s diabetes. That’s not the way diabetes seizures work, and even if you did have undiagnosed diabetes—which you might in addition to whatever else you have—it’s unlikely you’d have a “diabetic seizure.”

Here’s why: “Diabetic seizures” are actually a medication reaction, not the result of diabetes itself. As you’ve not been diagnosed, you most likely aren’t on any diabetes medications, and therefore can’t be having a diabetic seizure.

So if you’re not having a diabetic seizure, what kind of seizure are you having? The majority of seizures, as it turns out, are associated with epilepsy—although for a list of 70 possible conditions, ranging from an acetaminophen overdose to Yellow Fever, that can cause some sort of seizure see this article on our parent site, Healthline.

Wow. That’s quite a number of possible causes of seizures. Just how many types of seizures are there, anyway? A lot, as it turns out. While there are ten primary types, broken into three categories, the Epilepsy Foundation actually lists more than forty separate and distinct types of seizures.

But we need to be careful here. Are you really having a seizure at all? Or is it something else? After all, what is a “seizure"? Actually, this is one of those rare cases in which common English and med-speak line up pretty well. Most folks would consider some sort of uncontrolled or uncontrollable body movement a seizure, and that’s medically accurate, but the formal medical definition of a seizure goes a bit farther, also laying out the universal cause. A seizure is: Uncontrolled or abnormal electrical activity in the brain, which may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms.

So it’s a lightning storm in the brain wreaking havoc on the body. That’s actually sort of cool—in an abstract sense, of course. Not so cool if it’s happening to you or to someone you love. Still, it reminds us that we are electrical beings as well as biological beings.

But wait a second… Back to those diabetic seizures. How can an overdose of medication trigger abnormal electrical discharges in the brain?

I’m glad you asked!

Here’s how it works: An excessive dose of any number of blood sugar-lowing medications can cause the blood sugar to drop too low. When this happens, the brain—which is a huge glucose hog, and needs lots of sugar to function right—starts malfunctioning. In much the same way other seizures happen, electrical activity in the brain becomes abnormal, triggering a seizure.

But to fully answer your question of what actually happens in a diabetic seizure, which would more properly be called a hypoglycemic seizure, here’s how it plays out: First, you start sweating. Then your heart starts beating rapidly. Your hands quiver or tremble. Hunger strikes. You feel jumpy. This is all caused by your brain’s stimulation of the sympathoadrenal nervous system. In other words, your brain has detected trouble on the horizon in the form of dropping but not yet dangerous blood sugar levels, and has called out the Cavalry in the form of adrenaline to try to reverse the drop. The problem is that your body is ill equipped to overcome an overdose of a blood sugar lowering medication. If it were a blood sugar drop simply caused by exercise or lack of food, the adrenaline, along with co-released glucagon from the liver, can keep things in check, but in this case it can’t reverse the tide.

Now your blood sugar, still dropping despite the adrenaline rush, nears the crisis point. As it passes below 50 mg/dL there’s a “reduction in cerebral glucose availability” called neuroglycopenia in your brain. In plain English: Your brain no longer has enough fuel to run. Like an engine starved of gasoline, it starts misfiring. You can’t concentrate. You get irritable, maybe even nasty-tempered. Then you get confused. Your motions become jerky or unbalanced as your brain fires off random signals to your body. People observing you might think you’re drunk. Hallucinations set in. Then, shortly before lights-out, hemiplegia—a paralysis of one side of the body resembling a stroke—strikes.

Congratulations. You just had a diabetic seizure. If you don’t get help at this point, you’ll drop into a coma, and, possibly, die.

What a depressing thought.

But on the bright side, whatever is going on with your body, this ain’t it. Still, all seizures have one thing in common: Something interferes with the normal electrical activity of the brain. In the case of the diabetic seizure, it’s simply a lack of glucose. In your case I don’t see any way it can be a sugar issue. But something is causing your brain to misfire.

Some of the things on that list of 70 possible causes of seizures are pretty dire: Cancers and brain bleeds. Others are simple fixes like excessive blood pressure or too much caffeine. But regardless of the cause, you really need to get this evaluated and treated, ASAP. Hopefully, the underlying cause isn’t serious, but falling? Hitting walls?

Regardless of the cause of your seizures, you’re on the fast track to getting hurt, or worse, simply from having one of these seizures hit at the wrong time: Walking down a staircase, crossing a railroad track, or while canoeing above a waterfall -- not to mention driving a call. Don’t wait any longer! Have someone drive you to see a doc today, because I don’t want you having one of your seizures by yourself on the road.

 

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.