hypos - how many is too many?

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ruthelliot

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I know this is a difficult question to answer as everyone's control is different but as a general rule of thumb how many hypos a week would be considered excessive? Our 3yr old's latest hba1c was 8.4 and we were told this would be just about acceptable given his age as long as he isn't having an unacceptable number of hypos - until the last week or so he averaged one a day. Tiny changes to his ratios have reduced the number of hypos - he's only had 2 in the last four days but he is having more highs. Even despite all the hypos I really think his hba1c will be higher when we get it checked on Tues. Our team have been talking about trying to get funding for a pump and I know one of the criteria in the NICE guidelines (assume the sign guidelines for Scotland are similar) are that if in order to get tighter control on the current regime there would be an unacceptable number of hypos - so that brings me back to my question - what do most people class as too many?
 
It is a very tricky one I think, especially where such a young child is concerned. I was having quite a few hypos in the early days after diagnosis, but being an adult I could rationalise and recognise them and treat them without too much fuss. I might have a dozen in a week, but a lot would be borderline i.e. in the 3.5-3.9 sort of range. Now I'm better controlled I get maybe two or three a week. I'll update my software tomorrow and come back with some numbers! I get the impression from doctors that a dozen a month would be seen as unacceptable, but they don't really live in the real world, especially if you're still getting used to things.
 
at the moment I hypo on average 5 times a day, sometimes more sometimes less but I have at least one a day right now. The total per week with me is probably well above 30...hence insulin pump therapy 😛
 
My son is 14, on a pump for a year, and probAbly has about 5-10 hypos a week, almost all in the borderline range of 3.5-3.8. It is very variable though, and he can have whole days of fighting lows...His last HbA1c was 6.8. He has MANY fewer proper low hypos since going on a pump, but it is a fairly unusual day that doesn't have a mild one.

We are lucky in that he usually manges a good hba1c - before pump though, it sometimes felt at the high cost of big swings, distressing and probably no better fir him than a slightly higher one. Good luck getting the pump; we have found it completely transforming.
 
Well, I have just looked back and about 10% of my readings have been hypo, with 5% below 3.5 mmol/l - that's over the past 10 months. I would say that this is an 'acceptable' level, and it works out at about 15-20 hypos a month, so perhaps you can look at Ben's and see if it is greatly in excess of that 🙂
 
for me I would say that more than 2 hypos a week is too many. I generally don't have that many, but recently have been getting some night ones which is frustrating, think I had 3 last week. For me that was too many so made a change to my insulin.
 
Thanks for the input everyone I guess it just goes too show how much variation there is between everyone. Northerner I loooked back and it was 30in the last month but looking just at mealtime readings less than a third fall in range so I guess maybe that number of hypos would be ok if we had good control the rest of the time. Will let you know what the magic number is on Monday though I have a sense of impending doom! Dont know what else we can do though!
 
I try to avoid them like the plague, but don't imagine many type 1's won't have the odd low reading from time to time. Last month I went 3 weeks without a hypo, but last week had 3 in one week, but normally only have 1 possibly 2 hypo's a week.
 
I think we have to divide hypos into those that need help from another person and / or have a serious effect on life eg waking from sleep, and those that the person can deal with themselves. All hypos experienced by a 3yr old will need attention from parents / nursery staff etc. No hypos experienced by myself, diagnosed in young adulthood, have ever required intervention from another person. So, I'd be unhappy with having to eat extra sweets more than a couple of times a week, but I wouldn't want to comment about how many are too many for a 3 year old child.
 
Copepod said:
I think we have to divide hypos into those that need help from another person and / or have a serious effect on life eg waking from sleep, and those that the person can deal with themselves. All hypos experienced by a 3yr old will need attention from parents / nursery staff etc. No hypos experienced by myself, diagnosed in young adulthood, have ever required intervention from another person. So, I'd be unhappy with having to eat extra sweets more than a couple of times a week, but I wouldn't want to comment about how many are too many for a 3 year old child.
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Good point Copepod. I've only had one hypo where I felt it sensible to go and ask my neighbour if I could sit with her as my usual treatments did not seem to be taking effect. I was OK eventually, but it was the only time I've felt really scared and that I was losing control. It must be extremely difficult where a child is concerned, who can't really explain what is happening.
 
Wow Toby, that's impressive. Out of interest, what was your last HbA1c?
 
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