Hypo Anxiety

[louis_byrne]

Hello,

I was diagnosed with type 1, when I was 15 (8 years ago). When I eat carbs such as wraps and pasta for dinner, instead of rice or potato’s, I suffer with hypo anxiety at night.

There is an inevitable dip in glucose reading (around midnight or later) when I eat wrap or pasta for dinner and this causes hypo anxiety.

I am aware of the causes of hypo anxiety but not aware of how to prevent this, apart from the obvious answer of not eating certain carbs, but I do not understand the science behind the issue.

I had registered for a DAFNE course but this was inevitably placed on hold and I am consciously trying to improve my knowledge of T1.

Any advice would be really appreciated 🙂

 

[SB2015]

Welcome to the forum Louis. Sorry to hear about the anxiety that you feel regarding hypos in the night.

I am glad to hear that you have been booked for a DAFNE course but sorry that it has been delayed. In the meantime there is the Bertie course available online which might be helpful, although this does miss out on the chance to talk to others. However that is where the forum can be so helpful.

If there are certain foods that trigger your anxiety, perhaps it is worth avoiding those for now. I have taken pizza off the menu for me as it was just too much hassle. Strategies that I did try which have worked for others are splitting the dose of insulin, but I found I just forgot to do the remainder bit and ended up sky high. Even with a pump I haven’t cracked Pizza and so just don’t bother to eat it.

If you are concerned about night hypos, although it is a hassle, it may give you more restoverall t9 set an alarm for around the time that the lows hit you, so that you can test and eat if necessary. I find the odd Jelly Baby in the middle of the night goes down well.

Also it would be useful to talk to your DSN as you might find that a Libre could help you or even a pump.

Keep in touch. It is good to be incontact with others and I find that there is a wealth of knowledge on here.

 

[Inka]

@louis_byrne You mentioned a DAFNE course - are you counting carbs and adjusting your mealtime insulin according to what you eat at the moment? If not, that could be part of the issue.

Pasta is usually slower to absorb so people often find they go higher a few hours after eating it, but everyone is different.

What time do you eat your evening meal? What’s your blood sugar before you go to bed after eating pasta or a wrap? When you drop how low do you go? And how does that compare to when you eat potatoes.

What basal insulin do you take and when? Have you done a basal test recently to make sure that’s at the right dose?

@SB2015 Is right about setting an alarm to test during the night. I do that if I have any concerns about my blood sugar. I find waking and testing helps me relax to go back to sleep. So although it’s a chore, it’s a very worthwhile one IMO as I get peace of mind.

 

[everydayupsanddowns]

Welcome to the forum @louis_byrne

Sorry to hear about the difficulties you are having.

Are you actually going hypo, or just anxious that you might?

How long after the meal are you seeing the ‘inevitable dip’?

How are you calculating your meal dose?

What basal insulin do you use, and when do you take it?

Sorry for all the questions!

 

[Squirrel768]

Welcome, @louis_byrne - evn after 8 yeas, T1 will still be a challenge. 32 years and counting, and I'm still learning 🙂 Just recentlystarted with Libre, and I've found it a game-changer ... control has always been pretty good, but now Time in Range has improved so much.

I've found not so much the 'dips' in my case (although I do get them) but a post-breakfast spike, which I wasn't detecting between finger-pricks. Now, I'm working to keep that spike in range 🙂

You may find that, if you think you may get a potential low, to do a few tests leading up to it and get a better picture of how it works - is it a spike that then drops, in which case, adjusting insulin would best be a chat with your DSN, or is it a 'plateau' that just tails off?

Never easy, but always feel free to ask in here for ieas or advice 🙂

 

[Squirrel768]

What basal insulin do you take and when? Have you done a basal test recently to make sure that’s at the right dose?

Hi @Inka - I've never done or been offered a basal test in 32 years since diagnosis, and certainly not since starting MDI around 2000. Previously on Levemir twice daily, along with Novorapid, then back in February switched to Tresiba. Taking a lot less Tresiba, and after being advised to start with 20, brought it down to 16. Then, since starting Libre 5 weeks ago, edged it back up to 20, which so far is looking reasonable.

Wondering what the basal test consists of? I was taught in the beginning how to manage food and doses (no such thing as Dafne and relatives back then), and it has always served me well with pretty good control, but always open to anything that may help towards even better control 🙂

 

[silentsquirrel]

Hi @Inka - I've never done or been offered a basal test in 32 years since diagnosis, and certainly not since starting MDI around 2000. Previously on Levemir twice daily, along with Novorapid, then back in February switched to Tresiba. Taking a lot less Tresiba, and after being advised to start with 20, brought it down to 16. Then, since starting Libre 5 weeks ago, edged it back up to 20, which so far is looking reasonable.

Wondering what the basal test consists of? I was taught in the beginning how to manage food and doses (no such thing as Dafne and relatives back then), and it has always served me well with pretty good control, but always open to anything that may help towards even better control 🙂

Here you go....


Basal testing (Checking your basal insulin is set right helps all other doses work correctly):
http://www.diabetes-support.org.uk/info/?page_id=120

 

[Inka]

Hi @Inka - I've never done or been offered a basal test in 32 years since diagnosis, and certainly not since starting MDI around 2000. Previously on Levemir twice daily, along with Novorapid, then back in February switched to Tresiba. Taking a lot less Tresiba, and after being advised to start with 20, brought it down to 16. Then, since starting Libre 5 weeks ago, edged it back up to 20, which so far is looking reasonable.

Wondering what the basal test consists of? I was taught in the beginning how to manage food and doses (no such thing as Dafne and relatives back then), and it has always served me well with pretty good control, but always open to anything that may help towards even better control 🙂

@silentsquirrel beat me to it 🙂 Basal testing is just to see if your basal insulin is keeping you steady in the absence of food. There’s no need to starve yourself for 24 hours as you can split the day/night into segments and test one segment at a time.

If your basal dose is off it makes it harder to get everything else right. It’s surprising how little tweaks can help. Like many people, my basal needs change according to the season, temperature and a whole lot of other things, so I tweak it a few times a year.

 

[Squirrel768]

Here you go....


Basal testing (Checking your basal insulin is set right helps all other doses work correctly):
http://www.diabetes-support.org.uk/info/?page_id=120

Thanks, @silentsquirrel and @Inka - that is a very interesting article. I've never done the basal testing like that, just used my experience over the years to fine tune it once I'd move from Insultard twice daily (for the first 12 years or so) to Lantus x1, then advised to use Lantus x2, then switched to Levemir x2, and back in February, to Tresiba x1, which I'm finding is working well for me, especially on the occasions when my bedtime Levemir was accidentally Novorapid (oops!!!). Recently tweaked it back to 20, but have been thinking of going to 21 or 22 and see how it goes. Control has always been pretty good (medics have always been happier with it thn I am LOL) but now, having just started Libre as well, I'm loving the extra visuals to know what is happening during the day 🙂

Guess I would sum up my current regime as a sort of 'manual open loop' LOL - and wondering about the next level of technology