First hypo and Insulin

[Purls of Wisdom]

I can understand your dilemma.

The reply from @Lucyr at post #16 is very valid, but perhaps a little hard. You started this thread asking for advice, after the event and I think that was a good call by you. My first hypo was horrible and while I tried to work out 'why', my DSN later just told me they 'happen' , treat and move on; and I remember thinking 'but what's the answer to why....'. I hadn't found this forum at that time. My circumstances were rather different in those early days.

I hope you've now got a better feel for how to manage your next hypo, alas there will be a next!

Hypos are horrible, at first frightening, but manageable and less frightening once you realise they generally DON'T kill you. The incidence of that is extremely small, in practice. The short term problems that can arise are broadly two-fold:
repeated frequent hypos can lead to a loss of hypo awareness;
and over-responding with too many dextrose tabs or JBs etc, can start you onto the 'roller coaster' of low/ too high/ back to hypo.
In the longer term hypos can be damaging to you, which is also a good enough reason to avoid them!

I still don't have a specific answer to the nub of your original question. Yes, take insulin with your next meal (lunch in this case). But how much? You are still on fixed doses and not yet carb counting; and how much hypo response had you taken - ie what accumulation of carbs was now in your system? Rhetorical question, since you aren't carb counting. How big was your lunch going to be? Would your fixed dose normally match your normal lunch? More rhetorical questions. You need to ask your DSN.

After a hypo, after the initial treatment and initial recovery, I take some more lower GI carbs about 15+ mins later (eg a biscuit of 6-12 gms) to consolidate the recovery. However if it were my due lunch time, I'd eat that as planned. But how much bolus would depend entirely on: how deep had the hypo and response been; how big the lunch was going to be and hence how much my bolus would have been; then adjust by either reducing my bolus by a couple of units or having a supplement to my lunch. For me, if only finger pricking was available, this would be a trial and error lesson. Today, because I have Libre I can monitor simply and painlessly and adjust my lunch strategy accordingly; but that is no help to you just now!

Please don't be put off asking questions. How else do we learn?

There is no chance of not learning from the way you explained. Your knowledge, understanding and compassion are very valuable for a newbie. My salutations!

 

[Lucyr]

I can understand your dilemma.

The reply from @Lucyr at post #16 is very valid, but perhaps a little hard.

I don’t think it was harsh. The question was who to call in situations like this - having your lunch ready and not knowing whether to bolus. The honest answer is that there is absolutely no one you can call for professional medical advice in the moment. Yes you can ask here afterwards or speak to your DSN afterwards but the OP wasn’t asking who to ask afterwards, they were asking about in the moment.

 

[nonethewiser]

Oh no, you mean induced hypo?

That's correct.

 

[rayray119]

First one is very frightening, all one big learning curve how to treat & prevent them as much as possible.

Back in day had to have first hypo before leaving hospital as you were admitted for few days then when diagnosed, so felt sort of safe being there with help around.

This seems interesting I discharged me from hostptal while I was still high(I think my last blood suger check was something like 14) I guess times haved changed how long did you tend to stay in at those times)

 

[nonethewiser]

This seems interesting I discharged me from hostptal while I was still high(I think my last blood suger check was something like 14) I guess times haved changed how long did you tend to stay in at those times)

It was 5 days, in on Monday out Friday evening.

See we didn't have bg testing devices then so needed to know what hypo felt like, sure that was reason or could be totally wrong.

 

[rayray119]

It was 5 days, in on Monday out Friday evening.

See we didn't have bg testing devices then so needed to know what hypo felt like, sure that was reason or could be totally wrong.

Ah that makes sense. I was in 4 nights in the end(was supposed to be discharged the night before but had a bit of dimlia getting home) however my blood suger was 35 and was in dka when I went in(and probably was in for least a few days before) so could have been shorter if not for that.

 

[rayray119]

Sorry I'll stop taking over this theard now I just got interested by something that was mentioned

 

[Purls of Wisdom]

I have always been told when you have a hypo..
1. treat hypo
2. test and check that you have recovered (BG above 4.0)
3. make a mental note to understand why it occurred and what to do different next time. If I don't know, I make a written note to ask my DSN.
4. continue to dose and eat as usual.
5. keep a closer eye on levels for the next day as one hypo can follow another.

As predicted it happened again today. Another walk, 6,500 steps. Another hypo. Thanks to a lot to all the folks who responded and prepared me in advance, I was better prepared this time. I do not get any significant warning signs yet. Same as before, it was approaching lunch time, I tested and it was 3.6. Took Glucose Tabs, waited and re-checked and the BG had improved to 5.4. Took insulin and ate straight away. Checked an hour later, shockingly, 16.4. Did not panic. Saved questions for Tuesday's appointment with the Nurse and Dietitian. Thank you all for the heads up.

 

[rayray119]

As predicted it happened again today. Another walk, 6,500 steps. Another hypo. Thanks to a lot to all the folks who responded and prepared me in advance, I was better prepared this time. I do not get any significant warning signs yet. Same as before, it was approaching lunch time, I tested and it was 3.6. Took Glucose Tabs, waited and re-checked and the BG had improved to 5.4. Took insulin and ate straight away. Checked an hour later, shockingly, 16.4. Did not panic. Saved questions for Tuesday's appointment with the Nurse and Dietitian. Thank you all for the heads up.

It might be a good idea to test before a long walk and snack depending on the number. For example if I was In the 5 or 6s before a long walk I would eat something.