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Hypo recovery .... how many carbs do you need to eat?

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- from these it appears that the hypo occurs within just a 'few' hours e.g.when there is still bolus unused. But for this to happen you must have made a big miscalculation of either carbs or bolus, or had some unplanned exercise
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I don't entirely agree with this Jonty - hypos can occur unexpectedly due to a mis-timing between the insulin peaking and the food digesting/converting to glucose i.e. the insulin peaks before the glucose does. This is extremely difficult to predict due to the variability of speed of digestion. I suspect many people largely avoid this risk by injecting closer to the time of eating, allowing the blood glucose to rise long before the insulin peak, and most likely therefore peaking higher than desirable (in a perfect world!).
 
I hold my hand up as one of the ones who said I went hypo if I had unused Bolus.
I don't see this as a 'big miscalculation' though. A unit of insulin will drop me 3.0 BG units, therefore if I'm out by just half a unit, instead of ending up at 5 at the end of the Bolus, I would be 3.5, but the 'drop' seems to happen suddenly in the middle.
It's difficult to be completely accurate at all times, given that a I don't have a rigid daily routine, sometimes I will have just been more active than usual during the day, sometimes I will be having a higher carb meal than usual, to fit in with the family, and although I weigh the amount of spaghetti I'm cooking, when it comes to sharing it out, unless I put everybody's plate on the scales, by which time it would be cold, I'm going to have to do it by 'eye' and it's easy to underestimate my smaller portion.
It doesn't happen very often, but despite writing everything down and weighing everything, I don't always get it right, nor will I beat myself up about it, given the variables I have to factor in.
The other reason for my hypos, (gardening, snow shovelling, and long walks) is weather dependent! If and when the Met office can forecast the weather with total accuracy, maybe I'll manage to eradicate my exercise hypos accordingly!
 
Robin said:
I hold my hand up as one of the ones who said I went hypo if I had unused Bolus.
I don't see this as a 'big miscalculation' though. A unit of insulin will drop me 3.0 BG units, therefore if I'm out by just half a unit, instead of ending up at 5 at the end of the Bolus, I would be 3.5, but the 'drop' seems to happen suddenly in the middle.
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I understand, particularly when you need so little insulin. I need a massive amount of insulin to overcome the other autoimmune disease 'vasculitis' that I currently still have, and so my ratios are: Breakfast: 1u for 1g, Lunch: 1u for 0.7g, Dinner: 1u for 2.5g. So you can see that Breakfast is about 10 times the normal default of 1u to 10. Also 1u will drop my BG by only 0.3 mmol/L, so I need about 3u to drop my BG by just 1.0 mmol/L. Once I reach remission, I suspect this values will return to nearer 'normal' but it has been 2.8 yrs so far.

I'm lucky that I'm retired and so have a steady lifestyle and prepare all my own food. The only meal I share with my wife is dinner and we have always weighed the main carbs (potatoes or pasta) for the last 46 yrs, but still have to estimate how much spaghetti on each plate, but only on two plates. So it is easier but I have always maintained the same procedure even when my wife was cooking for four of us for the first 20 yrs, and it seems to have paid of with generally good control & most importantly ... no complications. So it is very much about 'managing' your life to ensure that diabetes does not take control. But I've had my share of scary hypos, sometimes at work, or when travelling abroad on business, and in particular when I lost my hypo awareness about 10 yrs ago and drove off the side of a UK motorway but luckily no damage to either me or the car. Those were in the days prior to MDI basal/bolus regimes. But I've learnt so much more since joining online groups about 3 yrs ago, and have put all I've learnt into practice. I'm a great believer in 'continuous improvement', and have recently purchased a Dexcom CGM and now have a much better understanding about post prandial peaking profiles. These devices should clearly be covered by the NHS in the future to allow all T1s the opportunity to characterise how carbs & insulin works for them!

As a matter of interest what is your HbA1c and do you consider yourself 'well controlled'?
 
My last HbA1c was 6.5 ( 48 for anyone using the new system, which I can't quite get used to), and yes, I do consider myself well controlled. I agree with you about CGMs, I bought a Freestyle Libre earlier in the year, and use a sensor as often as I can afford to. It shows up exactly where my insulin profile isn't matching the food profile and helps iron out spikes. It also showed me what a dip and rise I had during the night. I think my HbA1c is probably better now than my last test shows, since using it.
I consider myself lucky in that I don't have any other autoimmune condiditons that affect my blood sugars ( eczema and hay fever don't tend to!) you and so many others on here have double trouble to deal with.
 
I'm with you Robin - I may well be retired - but frankly D has to fit in with ME not me with it !

Jonty, I feel like you have smacked me in the face - I expect there are people (well no - I know there are quite a number of them) - who are forever having repeated hypos and/or repeated highs - but I don't think you'll reach many of them on forums such as this or diabetes-support.

Those who are here you see, have recognised they don't know everything and want to improve their knowledge - most of us only joined a forum (or a Newsgroup, back in the day) because we had a problem we knew we couldn't solve on our own and, most likely, that their HCPs either weren't available for them or if they were, hadn't got any more of an idea how to solve it than they had.

You need first to invent a way of 'engaging' people with their diabetes - then they will WANT to find out, won't they?

And I have some ideas about it - but as I shall be presenting these to the NHS locally next week, I ain't discussing it here because none of us can deliver it to the folk that need it, whereas the NHS itself, can!
 
I agree Trophy, very much agree. I'd like to add to that that the language of "success" and "failure" doesn't help much. I can pat myself on the back for my HBA1C of 40, because yes it involved work, but it also involved my sensitivity to insulin. If I'd tried just as hard but got a 60, what then. We all do it, we congratulate the effort and the success, but what of those who put in the effort and don't get the success. They're not going to rock up and say I'm trying my absolute damnedest but can't make it work are they? Doctors do it too, if you're hitting the target it's because you're working hard, but if you're not you must be doing something wrong because their treatment can't be wrong now can it. I'm not saying we shouldn't congratulate effort, just that the language of compliance is destructive. Nobody with diabetes walks around thinking, "I really want to be out of control and feeling like poo" now do they. The medical folk need a different approach, this is a battle we fight ourselves but not everyone knows how to fight, doesn't mean they won't fight, doesn't mean they should end up on the PITA pile, just they need more help. Rant over....for now.
 
Can someone tell me what LADA is please? I have been told to use lucozade followed by a piece of toast. Ok if at home, if out I use lucozade and crackers or a nutrigrain bar to see me through til I get home. My body seems to process crackers better and quicker than a cereal bar. I also carry Jelly babies, and previously used to eat 5. I do think it depends when the next meal would be. I'm still learning and tend to overtreat because i'm scared, but I am gradually reading my body and its need better.
 
LADA - Latent Autoimmune Diabetes of Adulthood
 
LADA stands for 'Latent Autoimmune Diabetes in Adulthood' - it is a kind of slow-onset Type 1 where the pancreas gradually loses its ability to produce insulin. It's often mistaken for Type 2 because the people are older and they are managing without needing insulin initially. However, there are tests they can do to determine what type it is 🙂
 
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