Hypo 'addiction'

[Curlypark]

Moderator Note: These newer posts were split into their own thread, from an older thread here: https://forum.diabetes.org.uk/boards/threads/hypo-addiction.71188/

My situation is most bizarre and seems connected to past alcohol dependency and what now seems mental cross-wiring.
I've always been a very anxious type with an element of OCD which resulted in alcohol abuse as a coping mechanism to a level that injured my pancreas and ultimately made me insulin dependent. Later occasion of drink dependency hospitalised me again, but I now seem in control of that. The simple act of eating even with appropriate bolus makes me sluggish, lazy and anxious. I have a pretty good judgement on doses to keep BG around normal but I find eating, even healthily, makes me more than hungry; insatiable craving for food. I risked testing alcohol to see if it placated the cravings, but no, and I couldn't even finish the drink. The only time I don't feel anxious, hungry and sluggish is when I am actually hypo, even if not clear headed, and Im starting to enjoy the sensation of an empty stomach and hypo symptoms as if I'm addicted to it. I had a couple of phases of anorexia while dry in the past because I just felt more comfortable, calm and devoid of the insatiable need to eat even when fully fed and watered.
Very strange. It's hard to be taken seriously by GPs over the years as they are rightly loathe to prescribe anything to someone with a clearly addictive personality. I'm going to try to explain it all again in full to a different doc now I'm dry, hope I'm taken seriously and some course of action may be tried as it's draining what's left of my sanity

 

[Chris88]

Sorry to hear of your suffering.
When I first started insulin I was offered access to a psychologist who worked within the hospital diabetes team. I wonder if your local diabetes team could offer this service to you?

 

[Proud to be erratic]

Hello @Curlypark, welcome to the forum.

You happen to have caught on to an old thread, from Jan 2018. Nothing wrong with that, the discussion remains wholly valid today. I don't recognise some of the names participating, including the original poster (OP); so your post now might stimulate a fresh dialogue on a very valid and slightly different twist about managing D.

I can't offer much input to this topic. I don't like being either hypo or hyper. My concern is principally that either state can be adding to my inner concern about doing anything that could impair my cognitive ability as I get older. That concern gives me incentive to keep working at this D malarkey

What meds are you on? Do you have CGM such as Libre? I hope you can find a sympathetic doc who can listen - they seem to be rare these days. Let us know how you get on. You have "tugged" at a very valid thread.

 

[Inka]

Welcome @Curlypark 🙂 Sometimes hypos can give an almost numb, sedated feeling and that can be addictive - like a drug. As you’ve mentioned previous anorexia, I strongly suggest you seek help from your GP or BEAT to nip this in the bud. Hypos can cause subtle damage to the brain and sometimes cardiac issues. They’re best avoided as much as possible.

Re the hunger, is that physical or psychological? If you eat and control your blood sugar well, then I would suggest the “sluggish, lazy and anxious” feelings you get might be psychological and connected to the anorexia. Finally - daft question - but are you eating enough and is your BMI ok? Very final question - what insulins do you take?

 

[rebrascora]

This is a really interesting thread and I am pleased it has been resurrected as I was just looking at my TIR and I am averaging 7% below range over the last 3 months and it is not unusual to have 2 or 3 dips into the red a day for me, so I am definitely one of those who dislike being high more than being low. Let's face it, it is very easy to consider it far nicer to eat a sweet treat than stick a needle in yourself (or several needles in my case since I need stacked corrections of Fiasp to bring my levels down once I get above 10), plus it is frustrating when they don't respond to the first or second correction, so yes, I am probably guilty of running low to avoid going high.

I am generally very disciplined about treating hypos and usually just one or two jelly babies does the trick and I very rarely get that overwhelming urge to "eat the kitchen" and I am never tempted to eat JBs at other times and have come to view them as "medication" (particularly the green ones 🙄 which constitutes my definition of a bad hypo.... ie. One that has to be treated with a green JB Yuk!.... rather than a really low hypo.) I have tried other sweets but can't be nearly as disciplined with them and will dip into them when I am not hypo, but I am never tempted with JBs, not even the red or black ones. However, if I am at my partner's house where there are lots of goodies (I follow a low carb way of eating so, no goodies in my house) then I am tempted to raid his cupboards for "a treat" to treat my hypo even though I have JBs with me..... so there can be a reward element to treating hypos. I should say that I was a sugar addict pre-diagnosis, so my low carb diet is as much about keeping me on the straight and narrow with that as managing my diabetes, probably more so and has had other health benefits for me, but perhaps that sugar addiction subconsciously manifests in being a bit careless about having hypos.

For me hypos are usually very easily treated and 5-10g carbs does it and mostly hypos do not phase me at all, even nocturnal ones where I will wake up, pop a jelly baby in my mouth and be back to sleep in less than 2 minutes. Hypers on the other hand, are very resistant to responding to insulin and often take hours and multiple injections to come down and I have to monitor my levels quite closely once I have stacked insulin. There is more thought involved, more decisions more time and more frustration.

 

[everydayupsanddowns]

I’ve split your posts into a new thread @Curlypark - so that members can reply to you directly. 🙂

 

[rebrascora]

I’ve split your posts into a new thread @Curlypark - so that members can reply to you directly. 🙂

Mike, could you put my post back with the original thread as I feel it pertains more to that than to this current offshoot thread, thanks. I don't feel that my post contributes here to what I believe may be a much more complex issue.

 

[everydayupsanddowns]

Do you wear a glucose sensor like Libre? Sometimes I find rapid changes in glucose levels (in either direction) trigger very strong hunger pangs, almost like my body goes into panic mode if levels are dropping (Help! I need fuel!!) or rising (Help! I can’t access the energy in this food!!)

Hope you can get some further support for the psychological and addictive aspects you are facing, and very well done for taming your alcohol dependency and getting dry.

 

[everydayupsanddowns]

Mike, could you put my post back with the original thread as I feel it pertains more to that than to this current offshoot thread, thanks. I don't feel that my post contributes here to what I believe may be a much more complex issue.

I was in the process of linking back to the old thread for reference, but didn’t want members who didn’t notice its age replying to 2018 posts from members who no longer frequent the forum 🙂

 

[everydayupsanddowns]

I am definitely one of those who dislike being high more than being low. Let's face it, it is very easy to consider it far nicer to eat a sweet treat than stick a needle in yourself (or several needles in my case since I need stacked corrections of Fiasp to bring my levels down once I get above 10), plus it is frustrating when they don't respond to the first or second correction, so yes, I am probably guilty of running low to avoid going high.

I was of that mindset too for the best part of 2 decades. For many of the reasons you mention. Complications fears, quicker and more pleasant to treat etc etc.

The problem is that my body got used to it, and gradually, over time stopped bothering to alert me until I was much lower. And sometimes really really low. I never collapsed or needed Paramedics / glucagon, but I did need help from Jane a few times. Then a few more times… then more and more often (But I hardly remembered them, so diminished those events).

It’s a dangerous path, and repairing your warning signs once they have become impaired is a lengthy, frustrating, process.

I’d urge anyone who knows they “prefer to run on the low side” to avoid hypos as much as they possibly can. Far better to have one or two dips to 3.8 a week (or month) if you can, than 2-3 of those same dips a day. I know. I’ve been there, and it was a hard road back.

 

[rebrascora]

I think my mental attitude is not helped by Libre reading lower than my Caresens BG meter often by 1 mmol and whilst I cannot say which is more accurate I have had my BG meter longer and use it as the ultimate reference, so tend to think of it as being closer to the truth. So this morning for example, Libre dropped to 3.4 after I got up. I didn't feel hypo so I checked with my Caresens and it gave me a 4.4. I took 5g carbs anyway but later a felt a bit of a wobble and Libre showed I was 3.3, so I didn't check that one and just had 8 more grams of carbs. I rarely double check the hypos Libre reports because my Caresens meters are temperamental and insist on being warmed up before I use them, so I just have 5-10g carbs depending on the Libre readings and don't bother to double check.
I always assumed Libre was just reading lower than my actual BG, which may be the case as other people seem to find that too and as a result I felt I was justified in not worrying too much about the amount of time I spend below range as long as it doesn't become ridiculous. However last year I bought some Freestyle Optium test strips to use in my Libre reader and was quite shocked to find that they read lower than the Libre sensor by a few tenths of a mmol, but essentially corroborate the sensor readings, which then brings into question whether my official Caresens meter is as dependable as I thought or if I really am having as many hypos as Libre reports, when my attitude has become a little blase about them, because I felt it was "crying wolf" rather too often. I believe that my hypo awareness is pretty good but how can I actually be sure when there is a whole mmol difference between meters at this level and perhaps relying on my Caresens meter is not the wisest move and I may even have already eroded my hypo warnings slightly by relying on it...... but then before I got Libre I had nothing else and was very confident of those readings. I generally feel hypo warnings in the low 4s according to my Caresens but this could be low 3s if the Libre and Optium strips are correct.

If I got the the stage that I was needing assistance from someone I would be absolutely mortified .... possibly literally 😱 since there is usually no one there to offer it!! I am extremely independent and whilst I have a long term partner we don't live together so I am on my own most of the time when I hypo, or at least Libre says I am hypo 🙄. Sometimes I will spend several hours of really sound sleep in the mid 3s according to Libre and be stable at that level after a slow descent, when there is pretty well no basal in my system, which again suggests that Libre may be reading low rather than me actually being hypo. I certainly find that I have my best sleep around the 3.5-5 Libre reading range, but I do wake up when I drop lower. It really does seem to be one of those things where you have to find what is right for you but be very conscious of reassessing that situation from time to time to make sure you haven't lost your perspective. I find my annual consultant appointment quite useful for talking this over and generally he is very happy with my results even though I do have more hypos recorded than is advised and quite a few of those being nocturnal hypos.