Hypos

[keith2904]

I am about to embark on my insulin treatment plan. I am worried because people say that hypos are unavoidable and they make you feel dreadful. I did have hypos when I was taking Gliclazide but people say that insulin hypos are much worse. Is it true that they are unavoidable and that they are very bad? Thanks.

 

[eggyg]

Hypos aren’t inevitable. I’ve had about three in 6 years, and they were easily sorted at the time. What type of insulin are they starting you on? I see you’re type 2 so guessing mixed once a day? Give us some more info and we will be able to give you some guidance.

 

[helli]

The "good" thing about hypos is most are fixed quickly and easily.
Always carry fast acting carbs (e.g. orange juice or Dextrose tablets or jelly babies) and consume them as soon as you detect (and test) your blood sugars are falling.
And when I write "always", I mean always even if hypos are very rare for you. This means keeping hypo treatment in your car, coat pocket, next to the bed, ... The secret is to treat hypos fast and you don't want to be running around in the middle of the night, for example, when your blood sugars are falling and you feel off.

 

[keith2904]

Hypos aren’t inevitable. I’ve had about three in 6 years, and they were easily sorted at the time. What type of insulin are they starting you on? I see you’re type 2 so guessing mixed once a day? Give us some more info and we will be able to give you some guidance.

Thanks. The nurse hasn't told me yet about the type of insulin. She was talking about 2 injections per day but I really want 1 x day. She is ringing me tomorrow to discuss then I can get back to the thread asking for valuable advice. K

 

[keith2904]

The "good" thing about hypos is most are fixed quickly and easily.
Always carry fast acting carbs (e.g. orange juice or Dextrose tablets or jelly babies) and consume them as soon as you detect (and test) your blood sugars are falling.
And when I write "always", I mean always even if hypos are very rare for you. This means keeping hypo treatment in your car, coat pocket, next to the bed, ... The secret is to treat hypos fast and you don't want to be running around in the middle of the night, for example, when your blood sugars are falling and you feel off.

Thanks. I was never prepared when I was on Gliclazide. But I will be from now on.

 

[Kaylz]

There isn't really one you can do just once a day to cover background needs and food needs, even mixed insulins are generally done twice daily, once in the morning and once in the evening
xx

 

[eggyg]

Sounds like a basal ( or background) insulin) if it’s twice a day. It will most probably be fixed doses and you will start with low doses at first I would think. I was terrified at first too even though I only started on two units once a day! I’m now on a basal/ bolus regime ( slow acting and fast acting, taken with food, dose dependant on what I’m eating). Try not to worry as @helli above said, make sure you have plenty of hypo remedies with you, test, test and test again and you will become more confident, I promise. 🙂

 

[Inka]

I think there are hypos and hypos. That’s to say that if you’re only a little below normal blood sugar, you probably won’t feel too bad, but if you have a sudden drop to a very low blood sugar, yes you can feel rough.

As said above, the trick is to carry hypo treatment everywhere. It’s also important to test regularly and frequently. Then you’ll spot a falling blood sugar before it gets too low.

Getting your insulin doses right too is crucial, of course. Have a pen and paper ready to write down any questions ready to ask the nurse, and also to write down what she tells you even if you think you’ll remember.

Don’t worry - I’m sure you’ll be ok. 🙂

 

[everydayupsanddowns]

Hope you get on well with your transition to insulin therapy @keith2904

Hypos are unpleasant, and certainly not inevitable, but the closer to ‘non-diabetic’ BG ranges you are aiming for - the closer you are to occasionally dipping into low BG or full-on hypoglycaemia.

Being prepared is certainly key.

Don’t be afraid of additional jabs too. In time the added precision and flexibility and accuracy of extra doses and/or different types of insulin may mean that you decide 4-5 injections a day are much better than 1.

The fewer doses you have, sometimes can mean that in order to have good BG levels *there* you have to have too much insulin circulating *there*, because it’s all or nothing.

More jabs can feel scary, but can mean you are more in control and can adjust things more subtly.

And the needles are tiny and pretty much pain-free.

Let us know how you get on. It feels much scarier before you start than it will end up being in reality 🙂

 

[keith2904]

There isn't really one you can do just once a day to cover background needs and food needs, even mixed insulins are generally done twice daily, once in the morning and once in the evening
xx

OK thanks for the info. Nurse mentioned once a day but I think she has changed her mind.🙂

 

[grovesy]

I have not been on Insulin , but for me Gliclazide gave me unpredictable hpyos, which often quick and I was on slow release.

 

[Kaylz]

OK thanks for the info. Nurse mentioned once a day but I think she has changed her mind.🙂

Its a doddle to do so don't stress about it as that's when most panic etc, being Type 1 I do at least 4 a day xx

 

[Becka]

The problem I had with Gliclazide hypos was the complete unpredictability too. I could eat nothing and be fine, or have a big meal and later hypo, yet another day have the same big meal and be fine. So all the advice of carrying glucose and a tester everywhere you go is something you should have already been doing anyway. At least for me it was a necessity.

How bad they felt unsurprisingly depended on how low the levels got. I would guess with ones that came on more quickly you felt the fall so caught them in the high 3s. They just felt like a having an extra sense. But the horrible ones were in the low 2s, which I assume is because the levels fell so slowly it was only when the symptoms kicked it you knew it.

 

[keith2904]

I have not been on Insulin , but for me Gliclazide gave me unpredictable hpyos, which often quick and I was on slow release.

Same for me. Used to get them in the middle of the night when on Gliclizide.

 

[rebrascora]

I don't find hypos that unpleasant now, sometimes they are even a bit of a relief if my levels have been stubbornly high for a few days.
The first few hypos I had after starting on insulin, when my BG levels had been high and then came rattling down from mid teens to 4 felt far worse than a low 3 does now because my body is used to running at more normal levels, so a 3 is probably no different to someone who has spent a whole day hiking or at the end of a marathon. Thankfully, despite having quite regular dips below 4 I detect them pretty well and very rarely get anything below 3 and if I do it is my own silly fault. I can usually carry on working (manual work) once I have taken my treatment, so I don't find them overly debilitating.
The fear of them and panic is worse than the reality in my opinion and dropping fast definitely feels worse than a slow decline.
I think having a realistic approach to how frequently they might happen is helpful. I naively thought that 1 or 2 a year was normal and it freaked me out when I had 2 in a fortnight, but now I might have 2 a day occasionally and other than figuring out why it happened and trying to prevent it next time, I just don't worry about it.

 

[keith2904]

I don't find hypos that unpleasant now, sometimes they are even a bit of a relief if my levels have been stubbornly high for a few days.
The first few hypos I had after starting on insulin, when my BG levels had been high and then came rattling down from mid teens to 4 felt far worse than a low 3 does now because my body is used to running at more normal levels, so a 3 is probably no different to someone who has spent a whole day hiking or at the end of a marathon. Thankfully, despite having quite regular dips below 4 I detect them pretty well and very rarely get anything below 3 and if I do it is my own silly fault. I can usually carry on working (manual work) once I have taken my treatment, so I don't find them overly debilitating.
The fear of them and panic is worse than the reality in my opinion and dropping fast definitely feels worse than a slow decline.
I think having a realistic approach to how frequently they might happen is helpful. I naively thought that 1 or 2 a year was normal and it freaked me out when I had 2 in a fortnight, but now I might have 2 a day occasionally and other than figuring out why it happened and trying to prevent it next time, I just don't worry about it.

Thanks for your info. When I was on Gliclazide a couple of years ago I used to have a number of hypos in a week but was never prepared for them. Even had them in the middle of the night. I'm hoping I can manage them better if/when I get them when starting insulin. Looks like they can just become part of life and should be OK. I'm wondering about my diagnosis. Even after losing almost 5 stone and losing most of the carbs and exercising more my BG has been increasing for a while (102) so I'm wondering abaout late onset type 1. Nurse not interested in finding out though. Best wishes. K

 

[rebrascora]

It sounds very much like you might be LADA and if that is the case, then you should be going onto a basal/bolus insulin system, not a mixed insulin. You would have a chance of getting Libre on prescription too as a Type 1 and maybe a pump at some point in the future, so having the correct diagnosis can have an impact on the treatment you receive.
They should be expressing concern if your HbA1c has gone up to 102 despite reducing your carbs and I think you would be within your rights to push for testing or referral to a consultant.

 

[keith2904]

Thanks. I have asked for a consultant referral but have been refused. I will ask her about testing/proper dagnosis when I speak to her next week. She is not seeing anyone in person but I will speak to her on the phone. Thanks for your information. K

 

[Becka]

Why are you no longer taking Gliclazide?

For me it just stopped working for me. Because of that my G.P. agreed when I asked for a C-peptide test, which apparently showed my output is lower than it should be. I have an upcoming appointment with the diabetes clinic so will find out where I stand on diagnosis and treatment then.

But if you have stopped taking it for the same reason, then it is appropriate for those responsible for your care to know the cause. It might be insulin resistance, but it might be loss of production. There is no way of knowing without testing, and this affects both the appropriate treatment and access to services.

If they refuse I can only think you need to change to a different surgery because they could be risking your health.

 

[keith2904]

Yes all the oral meds ceased to have an effect. So instead I was prescribed Ozempic injections. Described as a wonder drug it had no beneficial effect after 8 months apart from making me feel ill all the time. So that is why I am embarking on insulin. I asked for a test to find out about insulin production (didn't know what the test was called) but she said it wasn't necessary as the treatment would be the same! Think I may need to change surgeries but want to be put on some form of insulin before doing this. Thanks.