Controlling yourself during a severe hypo?

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Austin_98

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During mild-moderate hypo's I'm pretty good at just having some fruit juice, but once it gets more severe (2.9 or less, usually) I lose control and...not BINGE exactly, but definitely eat a lot more sugar than I need in an out-of-control way. I say not a binge because it's not like I eat thousands of calories or until I am painfully full or anything, but once I'm hypoglycemic enough that I have to lie down and I'm sweaty, weak very shaky etc I feel so ill I get really desperate to get out of that state ASAP and overdo it. I often fall asleep after a hypo (once it's resolve itself) for several hours but them wake up with a BG in the low-mid 20s before I ate way too much.

Anyone have advice on how to restraint yourself in that situation?

Also, does anybody go back INTO hypo's? I had one last night (BG 2.6) and thought I'd over-compensated again, but my BG went up to 8.0 and then ~40 mins later the symptoms came back and my BG was down to 2.8 again.
 
I am different to many - I do NOT want to eat when I am hypo.
However, I think many people control themselves by keeping to the 15/15/15 rule: eat 15g fast acting carbs, wait 15 minutes (setting a timer can help to hold you back), test again. If still hypo, eat 15g fast acting carbs, wait 15 minutes. If no longer hypo, eat 15g slower acting carbs.

As for returning to hypos, yes, this happens. There maybe a couple of reasons for this
- too much bolus with your last meal so you still have fast acting insulin on board.
- too much basal. This is typically due to exercise or alcohol in the last 24 hours.
It is the reason for the 15g slow acting carbs once recovered.
 
That IS and always was THE most important thing about hypos - identifying WHY they happen - so we can avoid doing whatever it happens to be that caused them - and trying to correct the root cause so we don't have exactly the same scenario happening again.
 
Austin_98 said:
During mild-moderate hypo's I'm pretty good at just having some fruit juice, but once it gets more severe (2.9 or less, usually) I lose control and...not BINGE exactly, but definitely eat a lot more sugar than I need in an out-of-control way. I say not a binge because it's not like I eat thousands of calories or until I am painfully full or anything, but once I'm hypoglycemic enough that I have to lie down and I'm sweaty, weak very shaky etc I feel so ill I get really desperate to get out of that state ASAP and overdo it. I often fall asleep after a hypo (once it's resolve itself) for several hours but them wake up with a BG in the low-mid 20s before I ate way too much.

Anyone have advice on how to restraint yourself in that situation?

Also, does anybody go back INTO hypo's? I had one last night (BG 2.6) and thought I'd over-compensated again, but my BG went up to 8.0 and then ~40 mins later the symptoms came back and my BG was down to 2.8 again.
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Hello, I can get recurring hypos if my basal is wrong. It can need a tweak from time to time.
Night hypos I can be prone to overdoing it. During the day? It takes more like 10gs for me to fix one.
It takes time to work out a trend on the big question, “why?” Having a sensor & logging your dose along with what when was eaten can help. But I can appreciate, it’s the last thing you wish to concern with when caught in that state.
 
It's partly how it affects my heart that actually scares me. My normal resting BMP is ~65 but it can be as high as 160bpm during a hypo. I don't know how bad tachycardia has to be to be an emergency (I think ~200 is cardiac arrest) but it's scary when it beats that hard and fast. It'll also "flutter" and feel irregular.

I've tried the 15/15/15 thing but it's soooo hard to wait that long.

I often don't actually feel hungry. Like I don't have sugar cravings or hunger pains, it's more that I'm desperate to get out of the situation and know carbs are the answer.

I think one reason might be the disparity in how long it takes the rapid insulin to act? Sometimes it starts working in like 20-30 mins, but sometimes more like 90 mins (and once OVER THREE HOURS).
It seems that larger doses take longer to work?
 
Austin_98 said:
I think one reason might be the disparity in how long it takes the rapid insulin to act? Sometimes it starts working in like 20-30 mins, but sometimes more like 90 mins (and once OVER THREE HOURS).
It seems that larger doses take longer to work?
Click to expand...
Bolus insulin usually takes longer to work when your BG levels are high, because there is insulin resistance and of course those are the occasions where you are going to inject a bigger dose to correct the high as well as whatever you are eating, so it may be more to do with your BG than the actual size of the dose.
If I wake up in the 4s on a morning I can inject and eat breakfast fairly quickly. If I wake up in the 7s or 8s, I will have to wait 45-50 mins before I eat otherwise I will spike. If I wake up in double figures, then yes, it will take hours and sometimes not come down at all and I have to hit it with a second correction and I end up having breakfast at lunchtime and if I exercise when my levels are above 10 they just go higher, so that isn't a solution and the best thing is just to wait it out.

As regards treating hypos, I respond very easily to hypo treatments and I have a lot of confidence so I am very very rarely tempted to eat more than just 1 or 2 jelly Babies which is just 5 or 10g carbs and I absolutely cannot get away with follow up slower carbs as they put me into orbit and I then have to inject lots more insulin to bring it down. I keep my jelly babies in 2unit containers, so that I am not tempted to have more. When I was first diagnosed I just carried a packet and it was all too easy to just shovel them in and then because I was in hypo fog, I wouldn't know how many I had had. If I have 2 in my container it helps me to be much more focused and restrained and I have developed a real trust in them that they will bring me up. It probably helps that I follow a low carb way of eating so my levels very rarely drop fast and generally I don't need large doses, but there have been odd occasions when the heart has been racing and it is easy to panic and think you better have more and of course it is better to have more and be safe as not have enough, but as with everything diabetes related it is all about trying to find a balance. I will negotiate with myself in those situations and say, "OK, just one more then! You have never needed more than 3 so having one more will definitely be enough."
 
@Austin_98 have you tried changing your hypo treatment?
Some people find some treatments work faster than others. If you can find what works fastest for you, it may help you to recover quicker so “speed up the 15 minutes”
 
rebrascora said:
Bolus insulin usually takes longer to work when your BG levels are high, because there is insulin resistance and of course those are the occasions where you are going to inject a bigger dose to correct the high as well as whatever you are eating, so it may be more to do with your BG than the actual size of the dose.
If I wake up in the 4s on a morning I can inject and eat breakfast fairly quickly. If I wake up in the 7s or 8s, I will have to wait 45-50 mins before I eat otherwise I will spike. If I wake up in double figures, then yes, it will take hours and sometimes not come down at all and I have to hit it with a second correction and I end up having breakfast at lunchtime and if I exercise when my levels are above 10 they just go higher, so that isn't a solution and the best thing is just to wait it out.

As regards treating hypos, I respond very easily to hypo treatments and I have a lot of confidence so I am very very rarely tempted to eat more than just 1 or 2 jelly Babies which is just 5 or 10g carbs and I absolutely cannot get away with follow up slower carbs as they put me into orbit and I then have to inject lots more insulin to bring it down. I keep my jelly babies in 2unit containers, so that I am not tempted to have more. When I was first diagnosed I just carried a packet and it was all too easy to just shovel them in and then because I was in hypo fog, I wouldn't know how many I had had. If I have 2 in my container it helps me to be much more focused and restrained and I have developed a real trust in them that they will bring me up. It probably helps that I follow a low carb way of eating so my levels very rarely drop fast and generally I don't need large doses, but there have been odd occasions when the heart has been racing and it is easy to panic and think you better have more and of course it is better to have more and be safe as not have enough, but as with everything diabetes related it is all about trying to find a balance. I will negotiate with myself in those situations and say, "OK, just one more then! You have never needed more than 3 so having one more will definitely be enough."
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This was very helpful, thanks!
I think I will separate out "doses" like that. Maybe have my mum keep them lol (I live with my parents and she's retired so we're almost always at least in the same house). I have trouble controlling myself regardless of blood-sugar. I'm pretty okay in the normal range, but once it's down to 3ish I wanna eat every carb in sight. If it's high (more than 13ish) I crave sugary carbs and if it's in the 20s or 30s I crave sugar constantly. My doctor said I experience "cravings based on actual need"* (about 15% of people have this where your body craves food/drinks that contain something it needs). You'd think it would be the opposite, but apparently if your sugars are very high (my devise goes up to 32 and up until a couple months ago my BG was always too high for it to read (where it just says "HI") your body isn't actually able to absorb/use any of it so your brain thinks your starving/need glucose immediately.
I think the overdoing it may be partly because I used to be bulimic (haven't binged and purged in 4 years though! 🙂) I still do overdo it if there's foods I love, especially sweet stuff (currently obsessed with cashew butter which is very low in carbs but I can eat the little 1200 cal tub in like 15 mins) but WITH carbs, usually either spread on bread or apple slices.
But like when my mum does the "big shop" online once a week, I pretty much eat everything sweet or "nice" the instant it arrives.
I just really hope it's related to my BG and not just because I'm greedy/gross :/

*eg twice I've gone through a period of strong milk cravings, drinking like 3 pints a day and both times when I had bloods done I was severely deficient in Vitamin D. Your body also needs calcium to absorb vit d, so the milk thing made a lot of sense.
 
helli said:
@Austin_98 have you tried changing your hypo treatment?
Some people find some treatments work faster than others. If you can find what works fastest for you, it may help you to recover quicker so “speed up the 15 minutes”
Click to expand...

I find orange juice works the best. In terms of Glycemic Index, orange juice (110) gets your blood sugar up even faster than pure sugar (100)
 
Austin_98 said:
I find orange juice works the best. In terms of Glycemic Index, orange juice (110) gets your blood sugar up even faster than pure sugar (100)
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It is important to find what works for you rather than just looking at the GI as we all digest different things at different speeds. Whilst the GI is a good indicator, it is not as useful as working out what works for your body.
Have you tried things like Lift Gels? Some people use these as their extra fast hypo recovery treatment - faster than orange juice.
 
You can buy them individually (they’re 3 for 2 quite often) or get a box of them from Amazon. Each has 15g carbs:

02E3F928-2A3C-4E98-AD46-5AA2BAAF9B97.jpeg
 
Austin_98 said:
Thanks, I'm definitely gonna try them!
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Although that photo makes them look massive, they’re actually very small and are easy to put in a coat pocket. I have them dotted round the house, for reassurance as much as anything else.
 
Inka said:
You can buy them individually (they’re 3 for 2 quite often) or get a box of them from Amazon. Each has 15g carbs:

View attachment 29333
Click to expand...

They do work superfast.

Rarely get really low nowadays thanks to tech, but being extremely low is frightening so it's easy to overtreat, been there done that.

In times like that you do need something that works rapidly & suggestion by @Inka does just that.
 
Hi @Austin_98 Do you have a cgm such as Libre or Dexcom? If you have then you can set an alarm to warn you when you are going low, so that you can take avoiding action and not actually go hypo. My alarm is set at 4.2 but I know many members here set theirs higher. I now have very few hypos. If you don't have a cgm I suggest you ask your GP/consultant to prescribe them for you.

You can also get glucose gels on prescription. They come 3 tubes to a pack and are very fast.
Also, does anybody go back INTO hypo's? I had one last night (BG 2.6) and thought I'd over-compensated again, but my BG went up to 8.0 and then ~40 mins later the symptoms came back and my BG was down to 2.8 again.
Click to expand...
It could be any number of reasons, as have been sensibly suggested. I recall reading somewhere that sometimes your liver detects a hypo and releases glycogen to "help you", but when you have recovered it can reclaim the glycogen to replenish it's stocks and thus bring you low again. Wish I could recall the source of that info. Something in the back of my mind makes me think @trophywench and I discussed it at the time.
 
Austin_98 said:
Also, does anybody go back INTO hypo's? I had one last night (BG 2.6) and thought I'd over-compensated again, but my BG went up to 8.0 and then ~40 mins later the symptoms came back and my BG was down to 2.8 again.
Click to expand...

This is not uncommon. A highly regarded professor and something of a global expert on hypoglycaemia said to me that ‘hypos breed hypos’. The data suggest once you’ve had one in a day you are statistically more likely to have another.

It can depend on what caused the first, of course. But if it’s too much ‘insulin on board’, having consumed alcohol, the effects of exercise, or simply that it’s approaching Springtime and your insulin needs may be reducing… then a general downward drift may be your default (rather than pottering along roughly level).

For hypo treatments, might juice cartons work? The little ones are roughly the right carbs and as a liquid should be pretty fast acting. And they are measured out so you could have one, then make yourself wait 10 /15 minutes and recheck? It’d need to be actual fruit juice, not ‘juice-style drink’, of course!
 
Pattidevans said:
Hi @Austin_98 Do you have a cgm such as Libre or Dexcom? If you have then you can set an alarm to warn you when you are going low, so that you can take avoiding action and not actually go hypo. My alarm is set at 4.2 but I know many members here set theirs higher. I now have very few hypos. If you don't have a cgm I suggest you ask your GP/consultant to prescribe them for you.

You can also get glucose gels on prescription. They come 3 tubes to a pack and are very fast.

It could be any number of reasons, as have been sensibly suggested. I recall reading somewhere that sometimes your liver detects a hypo and releases glycogen to "help you", but when you have recovered it can reclaim the glycogen to replenish it's stocks and thus bring you low again. Wish I could recall the source of that info. Something in the back of my mind makes me think @trophywench and I discussed it at the time.
Click to expand...

That's interesting about the liver, but don't think that's what's happening with me. I have zero pancreas function, so my pancreas can't send the signal to my liver to release glycogen. That's why hypo's can be really bad with type 3C as you don't have that "safety net".
Oh, I'll definitely ask my doctor about getting them on prescription, thanks 🙂
 
everydayupsanddowns said:
This is not uncommon. A highly regarded professor and something of a global expert on hypoglycaemia said to me that ‘hypos breed hypos’. The data suggest once you’ve had one in a day you are statistically more likely to have another.

It can depend on what caused the first, of course. But if it’s too much ‘insulin on board’, having consumed alcohol, the effects of exercise, or simply that it’s approaching Springtime and your insulin needs may be reducing… then a general downward drift may be your default (rather than pottering along roughly level).

For hypo treatments, might juice cartons work? The little ones are roughly the right carbs and as a liquid should be pretty fast acting. And they are measured out so you could have one, then make yourself wait 10 /15 minutes and recheck? It’d need to be actual fruit juice, not ‘juice-style drink’, of course!
Click to expand...

You need less insulin in springtime? Why is that?

Yes, I normally use the 200ml carltons of OJ to treat a hypo (and keep a second one with me just in case).
 
Austin_98 said:
You need less insulin in springtime? Why is that?
Click to expand...

Well Your Diabetes May Vary, but many members find their insulin needs ebb and flow during the year, and often warmer months and longer days seem to associate with increased insulin sensitivity and a need for lower doses. Like many things with diabetes, it’s very individual though. 🙂
 
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