Feeling Hypos?

[Matthew James Hardy]

Hi everyone not posted on here for a while hope everyone is doing okay just wanted to ask a what stage should you feel a hypo was told below 4 however I’ve had a couple of 3.8 on the rare occasion and haven’t felt them not suffered a real hypo for good 2 months or more now

 

[pav]

I tend to feel hypos around 3.7, when they creep up on me slowly, other times I feel them coming on in the low 4.0's. With myself I tend to have sudden drops in levels like from the teens to around the 5 mark within a couple of hours and know something is going on.

One thing that can make it difficult for me is my hypo symptoms have changed from a few years ago before my levels sky rocketed, and I am relearning what to look out for.

 

[Matthew James Hardy]

Luckily so far my levels have never been high since I was diagnosed in February probably highest is 11ish but not regular usually in normal ranges now

 

[trophywench]

Well this soon after diagnosis Matthew I would certainly have expected your hypo symptoms to be much more noticeable to you. After all - having low BG is completely alien to your body - or at least it should be.

You really have to tell your clinic about this because if you don't have good symptoms this early on - it could become dangerous to you later.

 

[everydayupsanddowns]

I agree with TW, at this stage in your diabetes ‘career’ you want to avoid hypos as much as you can it your symptoms can take a real dent and cause serious problems later.

Having said that the difference between 3.8 and 4.0 is a hair’s breadth, and could be down to meter inaccuracy so try not to panic about it. Additionally, I’ve seen enough Libre/CGM traces from non-D people to know that nonnies can and do drift into the high 3.8s 3.9s without necessarily feeling massively out of sorts. Of course it’s no bother for them as they are unlikely to dip much lower and won’t have injected insulin pushing their BG down into more dangerous territory.

To properly protect hypo warning signs I would recommend treating anything at or below 4.5 or 5.0 with 10g of fast carbs and rechecking in 30 mins or so.

Edit: after Juliet’s comments this should probably be 5-10g of fast carbs. Just enough to give you a bit of wiggle room. YDMV 😉

 

[TheClockworkDodo]

To properly protect hypo warning signs I would recommend treating anything at or below 4.5 or 5.0 with 10g of fast carbs and rechecking in 30 mins or so.

That wouldn't work for everyone, Mike - if I had 10g fast acting carbs when my bgl was 5, it would very likely shoot up to 12 rather than the 6 or 7 I was aiming for! But I'd definitely have a Hobnob or something of that sort to try to stave off a hypo.

I'd also say how soon you feel a hypo varies from hypo to hypo - I've lost a lot of hypo awareness, so I might not feel a very gradual hypo until my blood sugar was down to 2.5 or even lower, but if my blood sugar was going down very fast I would probably feel hypo before it got down to 4. So the gradual ones are more difficult to detect. But as Mike says, the difference between 3.8 and 4.0 is quite likely to just be meter inaccuracy, so - given that you don't have lots of hypos and should still have hypo awareness - if you don't feel hypo it might be worth doing a retest to check your meter reading.

 

[everydayupsanddowns]

Interesting that a Hobnob (approx 10g of fairly fast acting carbs) affects you so differently to 10g of somethng high glucose Juliet! Must be very difficult for you. Interestingly I have been thinking for a few years that my BG responses seem to be more a matter of ‘push’ and ‘pull’ at any moment, rather than specifically whole-dose-ratio-factor reliability.

Yes, as always YDMV (your diabetes may vary) and you have to find a system that works for you as an individual. ‘Officially’ 10g is supposed to raise my BG by 7, so *should* take my BG neatly from 4.5-5 to 7.5 or 8, but I’ve never found ‘Diabetes maths’ to be quite so accurate or predictable either, and nudging with 5g doesn’t seem to register so much.

Perhaps I should try 7g? 🙂

 

[SB2015]

I find it can depend on what I am diong vas to whether I notice the hypo and when.

In theory I was told that a hypo is anything below 4. However I often feel them at 4.2ish. Having looked at the Libre that is more likely when I am dropping more rapidly. This is often linked to when I am being more active.
If my levels are dropping more slowly I don’t pick them up until about 3.8, and on some occasions later. I was reassured when I was told that the DSN was only worried when I did not pick it up below 3.5.

 

[SB2015]

I agree with TW, at this stage in your diabetes ‘career’ you want to avoid hypos as much as you can it your symptoms can take a real dent and cause serious problems later.

I was interested In your comment about treating if below 5 and the long term consequences of frequent hypos. I had understood that the main consequence was the loss of awareness. Are there others?

 

[everydayupsanddowns]

Any hypo puts stress on the brain. There are indications that they are also inflammatory which is not ideal for heart health. They can also cause heart arrhythmia once they get nastier. There are also implications for brain function/memory over the long term I think.

I spent many years (decades?) thinking they were the better option and not much to worry about. More recently I am reading more and more about the possible problems that could be associated with repeated exposure to abnormally low BG as well as the more obvious loss of warning signs.

Rock and a hard place eh!

 

[TheClockworkDodo]

My cognitive function - which was already poor because of my ME - has become considerably worse since I had one particularly bad hypo (drifting in and out of consciousness for several hours), and I think my frequent hypos and loss of hypo awareness mean that I'm not recovering from this as I might otherwise have done. There's a thread here about hypos and memory loss - https://forum.diabetes.org.uk/board...y-hypos-have-caused-severe-memory-loss.71996/ - I keep meaning to post a reply to it, but ironically haven't managed to get my brain in a functional enough state to post something coherent about mine ...

I have arrhythmia too - also caused by ME rather than diabetes - but that tends to make itself felt when my blood sugar is high rather than when it's low!

Re the Hobnob, a lot of the time I have to guess whether my blood sugar is going up or down, Mike - if down from 5 a Hobnob is ideal, but if up I will likely end up on 12 anyway. At 4.5 I might have a few raisins or a dried apricot, which is fewer grams of carbs than a Hobnob, but will send my blood sugar up faster. Hypo treatments like grape juice or glucose are saved for readings under 4 - much over that and they'd really spike me - though occasionally I might treat a 4.1 or 4.2 if I feel hypo. Once I'm hypo I don't have to worry about going up to 12, I have to worry about going back down below 4, as one hypo often leads to another.

 

[trophywench]

Well I suppose that's why the old-fashioned advice was always to treat a hypo with fast acting glucose or equivalent, and also to follow that up with some slower carb? probably more people had hypos like that years ago and like a lot of old advice I suppose they chucked it out with the dirty bath water not realising there are still people who need that treatment!

If my BG is eg 4.3, I'm about to eat and I don't feel hypo - I don't treat. However if I'm 4.2 and I DO feel hypo - even with my dinner immediately to hand - I have literally a good swig of Lucozade before I eat. It means I'm plummeting like a felled tree if I'm over 4 and feel it. I obviously (I hope it is anyway!) always treat anything under 3 whether I feel it, whether my dinner is going cold, whatever. I rarely disastrously over treat for the simple reason I know very well I am - but Hang it! - I'd forgotten how much I like these biscuits! So I'm going to enjoy them, so there! LOL

 

[TheClockworkDodo]

I always follow up with slower acting carb once my blood sugar's back over 4 (or sometimes if it's got up to 3.8 or so after a long hypo and I've got fed up with re-testing), though not the 15g they used to recommend, I think that's a bit excessive. I'd usually have a TUC biscuit or two, but if I'm out I'd have a Ryvita (more carb = less likely to hypo again), and after a particularly bad hypo I might have a Hobnob.

 

[DaveB]

I can start feeling a hypo coming on when I'm below 5 and virtually always when below 4. If I'm driving of course I will take some glucose tablets when below 5. 10gm of glucose i.e. 1 Dextrose tablet will increase my BS by 0.5 to 1 mmol.

 

[miguel81]

Whilst I am awake I can feel a hypo coming on. Eyesight - or lack of it - is the main warning. I get a glaring white spot in both of my eyes - right in the centre. I also get flashes which can best be described as a 'bar code' in both eyes. Also I get what I call 'retina retention' I look at an object and then look away and the object is still there. In extreme cases I get a bit wobbly and I just know that it is a hypo in the making. Night time is very different - intense sweating which luckily wakes me up and I reach for the remedies on my bedside table, jelly babies, a biscuit or better still a chocolate and biscuit bar which I can buy here in Aldi in Spain called a chateau biscuit - they are SO brilliant and I buy 10 packs at a time each pack containing 9 biscuits. The real problem for me at night is that the temperatures here at night can cause the sweating rather than me having a hypo - but I take the remedy anyway. I'd rather wake up to higher BG's than not wake up at all!

 

[SB2015]

Any hypo puts stress on the brain. There are indications that they are also inflammatory which is not ideal for heart health. They can also cause heart arrhythmia once they get nastier. There are also implications for brain function/memory over the long term I think.

I spent many years (decades?) thinking they were the better option and not much to worry about. More recently I am reading more and more about the possible problems that could be associated with repeated exposure to abnormally low BG as well as the more obvious loss of warning signs.

Rock and a hard place eh!

I think I too had been assuming that it was better to hover round hypo rather than hyper.
Some food for thought.

 

[C&E Guy]

I've had test results below 3, and have felt perfectly normal. Not a hint of a hypo at all.

Over a year ago, I had a very low 1.8, and had to react very quickly. But, at the exact moment of testing, I didn't feel anything wrong.