Miserable experience

[Type3G]

Sorry if this is in the wrong place.

I’ve had type 3c following pancreatitis for a couple of years. My blood sugars are erratic but I’ve learned to manage them quite well. I take creon as well.

Today I had a hypo at work, not really ever happened before; not sure why my Libre alarm didn’t go off. It came on so quick (3 minutes I think), suddenly I was drenched with sweat and feeling hideous. Someone noticed I was struggling and I had to explain why. I felt trapped in a way as well as I felt I needed access to my snacks/rescues rather than take myself off to another room.

(I’m a chartered accountant and work in an open office).

I’m sure it happens to people all the time but I just feel so anxious, embarrassed and worried about it. I don’t know why I feel this way. I’m worried that managers will bring it up - though I am sure it would be unreasonable if they did it bring it up in any negative manner.

Anybody else ever feel like this?

 

[Natalie123]

I felt trapped in a way as well as I felt I needed access to my snacks/rescues rather than take myself off to another room.

Sorry to hear that your hypo has made you feel anxious and worried, that's totally understandable especially as you haven't had one like this before. You shouldn't feel embarrassed though, easy to say, I know, but it's a medical condition and you need to do what you need to do to manage it. As for what you said above about feeling like you need your snacks on you rather than in another room - you are totally right! You should have your hypo treatment and suitable snacks with you at all times, and you shouldn't be made to leave the office to treat a hypo, it is much safer to stay sitting at your desk especially when your hypo symptoms are bad. Are your work place not allowing you to keep your hypo treatments with you or is it that you don't feel comfortable in the office when you're hypo? If it's the former, your work should make reasonable adjustments and allow you to treat your hypo in the office, if it's the latter, I totally understand but try not to worry about what others think, your health is much more important and I'm sure they would understand.

 

[Inka]

Welcome @Type3G 🙂 It’s completely normal to feel embarrassed in that situation, but I doubt anyone is thinking badly of you because of the hypo. If you saw someone having a medical issue at work, you’d be sympathetic and patient, I’m sure. If anyone does mention it or ask how you are, see it as a teaching opportunity: just explain briefly about hypos and show them your hypo treatments.

What do you have the Low alarm set at on your Libre? It’s always better to set it higher, so you have warning. When I had the Libre, my Low alert was usually 5.6.

Definitely keep the hypo treatments with you. I used to put a packet of Dextro and my snack box on my desk by my drink. I also had spares in my drawer and in my bag.

Don’t let this experience shake you too much. It wasn’t your fault and it happens to the best of us.

 

[Lucyr]

I felt trapped in a way as well as I felt I needed access to my snacks/rescues rather than take myself off to another room.

(I’m a chartered accountant and work in an open office).

You should keep your meter and carbs on you at all times. Even if you go to a meeting room or something unless it’s very close to your desk. There’s nothing about being an accountant in an office that should prevent you from having carbs in your pocket or in a bag and eating them wherever and whenever needed

 

[soupdragon]

Welcome @Type3G from another 3c due to pancreatitis.
I was very worried about hypos when I went back to work and was very pleased that I had Libre 1 at the time (no alarms but I did a lot of scanning back then). I have stashes of hypo treatments in every location I'm likely to be in and also carry testing kit and dextrose with me whenever I leave my usual work area.
I agree with @Inka about setting the alarm on Libre. I always had mine set on 5.6 when I was away from home. I find my glucose levels can drop pretty quickly (especially with any amount of exercise) and that sometimes Libre doesn't keep up.
Before I went back to work I made sure that colleagues in my department knew where my extra hypo treatments could be found in case there was a situation in which I couldn't get to them myself. This was appropriate for my work situation and I felt happier knowing that people were aware of possible issues and how I deal with hypos.
(management and HR are also aware that I have diabetes and might need to manage hypos).
I hope you're feeling a lot better now. It's not nice having to manage hypos in a work environment but, unfortunately, they sometimes happen (however hard we try to avoid them).

 

[rebrascora]

Sorry to hear you had a nasty hypo at work.

As others have said, you should always have hypo treatments within reach. I keep little pots of 2 or 3 jelly babies on me rather than a bag. That way the packet doesn't rustle and it doesn't look like I am eating sweets without passing them round. Glucose tablets are also a good way of treating hypos and look more medicinal rather than guzzling sweets. Lift chewable tablets come in easy to carry tubes and keep well probably for years, so handy if you only rarely have hypos.

Do you think your phone lost connection with the sensor and that is why you didn't get the alarm?
Is this your first hypo?
How long have you been using insulin?
Setting your low alarm higher as mentioned is helpful to give you more notice of levels dropping. 4.5 works for me, but other people find higher better for them. If I set mine at 5.6 I have more hypos because I don't want to treat at 5.6 and then I forget to keep an eye on it after and if it drops further I don't get another alarm, so you have to find a balance of what works for you as an individual but I think most of us agree that somewhere above 4 is helpful rather than the preset 3.9

 

[everydayupsanddowns]

Welcome to the forum @Type3G

Sorry to hear you had such a nasty low at work - those ones that crash into your day without warning or any apparent cause are horrid. And I think many of us will have had an embarrassing one that really took the legs out from under us in our time.

I agree with others that you shouldn’t be asked to travel to a different room before treating low blood glucose. Wandering about in that state is the last thing you want to be doing! Keep your BG meter, and hypo treatment with you, so that you can treat the low wherever you are. I’ve had to dive into my pockets mid-meeting before now!

Diabetes is covered by the Equality Act, so employers are obliged to make ‘reasonable adjustments’ to support people with diabetes. It might be worth discussing any adjustments that would make your life easier with your employer.

 

[everydayupsanddowns]

There is some general information about your rights and responsibilities at work on this page which might help?

Work and diabetes

This information is about how to manage diabetes at work and to support you in knowing your rights at work. Jump to:

www.diabetes.org.uk

 

[Wendal]

Sorry if this is in the wrong place.

I’ve had type 3c following pancreatitis for a couple of years. My blood sugars are erratic but I’ve learned to manage them quite well. I take creon as well.

Today I had a hypo at work, not really ever happened before; not sure why my Libre alarm didn’t go off. It came on so quick (3 minutes I think), suddenly I was drenched with sweat and feeling hideous. Someone noticed I was struggling and I had to explain why. I felt trapped in a way as well as I felt I needed access to my snacks/rescues rather than take myself off to another room.

(I’m a chartered accountant and work in an open office).

I’m sure it happens to people all the time but I just feel so anxious, embarrassed and worried about it. I don’t know why I feel this way. I’m worried that managers will bring it up - though I am sure it would be unreasonable if they did it bring it up in any negative manner.

Anybody else ever feel like this?

Welcome @Type3G
So sorry to hear about your experiences and like yourself developed Type 3c almost exactly 2 years ago following a bout of pancreatitis.
I think the advice to set your alarm higher to better forewarn you of an impending hypo is very sound as others have suggested.
Personally have never had what I would term a clinical hypo like you have experienced. However it is something I am acutely aware of in terms of avoiding if possible as I spend a lot of time driving on my own.
In fairness I can normally feel myself going low and it is important to retain your hypo awareness but it is certainly not something that you should feel embarrassed about and your employer should take all reasonable actions to allow you to manage your condition.
Again I am very lucky in that my employer is very supportive and as I work in a healthcare setting where most of my colleagues have a good understanding of diabetes but also are aware of my condition.
It is a feature of Type 3c that your diabetes can be more brittle as your pancreatic damage can affect your glucagon as well as insulin production so you can be more prone to hypos but as I have said I have managed to avoid a clinical one so far.
BW

 

[Type3G]

Thanks everyone. To be clear, I felt like I could not leave my desk - I had nowhere to go that was private - that still had access to my rescues. I was not forced to do anything.

Nothing has been mentioned at work, I was probably worrying for no reason.

My employer is generally fine, I am just an anxious person.

I think I felt foolish, caught out as much as anything.

I’ve repacked rescue remedies today and gone back at it. Strange, though I felt horrendous all day, was in bed by 8pm. I worried how I would feel today.

Thanks for listening to me vent.

 

[Type3G]

Welcome @Type3G
So sorry to hear about your experiences and like yourself developed Type 3c almost exactly 2 years ago following a bout of pancreatitis.
I think the advice to set your alarm higher to better forewarn you of an impending hypo is very sound as others have suggested.
Personally have never had what I would term a clinical hypo like you have experienced. However it is something I am acutely aware of in terms of avoiding if possible as I spend a lot of time driving on my own.
In fairness I can normally feel myself going low and it is important to retain your hypo awareness but it is certainly not something that you should feel embarrassed about and your employer should take all reasonable actions to allow you to manage your condition.
Again I am very lucky in that my employer is very supportive and as I work in a healthcare setting where most of my colleagues have a good understanding of diabetes but also are aware of my condition.
It is a feature of Type 3c that your diabetes can be more brittle as your pancreatic damage can affect your glucagon as well as insulin production so you can be more prone to hypos but as I have said I have managed to avoid a clinical one so far.
BW

Hi, I am very naive with all this. I was diagnosed with diabetes after pancreatitis while in a full blown DKA.

I was prescribed insulin by the hospital but never saw a diabetes specialist until two years later who said I was on the wrong insulin!

I did not know the type 3c had other issues. What do you mean by ‘brittle’?

 

[Wendal]

Hi, I am very naive with all this. I was diagnosed with diabetes after pancreatitis while in a full blown DKA.

I was prescribed insulin by the hospital but never saw a diabetes specialist until two years later who said I was on the wrong insulin!

I did not know the type 3c had other issues. What do you mean by ‘brittle’?

Normally Insulin deficiency as a result of the Pancreatic Beta cells not producing enough insulin is associated with Type 1 an auto immune response but your Type 3c is similar just a different cause so damage to your Beta-cells as a result of your pancreatitis.
In addition your Alpha cells produce Glucagon so that normally kicks in to counteract your bag dropping the same way insulin normally kicks in when your BG rises.
So if your Pancreatitis has damaged your Alpha as well as the Beta-cells then it becomes slightly harder to manage your BG and that is what I mean by “ brittle”.
I am assuming that you are on insulin as some 3cs can be managed without it depending on extent of damage to your Pancreas.
Then of course you have the extra dimension of the Creon which can effect food digestion and breakdown which can impact on your BG keels and how your body responds.
There really is no need to be extra anxious about this but appreciate it may feel so as Type 3cs can usually manage their diabetes pretty well after pancreatitis normally still have some endocrine activity as compared to this who have had their pancreas removed as a result of surgery etc.
Please ask away and we will try and answer any questions you may have.
BW for the future

 

[Lucyr]

Thanks everyone. To be clear, I felt like I could not leave my desk - I had nowhere to go that was private - that still had access to my rescues. I was not forced to do anything.

Why do you need somewhere private? Why can’t you use a meeting room or a prayer room?

 

[Type3G]

Normally Insulin deficiency as a result of the Pancreatic Beta cells not producing enough insulin is associated with Type 1 an auto immune response but your Type 3c is similar just a different cause so damage to your Beta-cells as a result of your pancreatitis.
In addition your Alpha cells produce Glucagon so that normally kicks in to counteract your bag dropping the same way insulin normally kicks in when your BG rises.
So if your Pancreatitis has damaged your Alpha as well as the Beta-cells then it becomes slightly harder to manage your BG and that is what I mean by “ brittle”.
I am assuming that you are on insulin as some 3cs can be managed without it depending on extent of damage to your Pancreas.
Then of course you have the extra dimension of the Creon which can effect food digestion and breakdown which can impact on your BG keels and how your body responds.
There really is no need to be extra anxious about this but appreciate it may feel so as Type 3cs can usually manage their diabetes pretty well after pancreatitis normally still have some endocrine activity as compared to this who have had their pancreas removed as a result of surgery etc.
Please ask away and we will try and answer any questions you may have.
BW for the future

Hi yeah I’m on humulin 11 units twice a day. Creon I take about 6 35,000s with meals.

So glucagon helps when blood sugar goes low but this can be compromised in type 3c is how I read this. Interesting. I’ve had a couple of very bad hypos before a while back, ambulance out and they gave me some injection which I thought was glucagon but maybe I’m getting confused (I felt rotten for several days after though!).

I think it’s clear I need to self-educate a bit more…

 

[Type3G]

Why do you need somewhere private? Why can’t you use a meeting room or a prayer room?

I’m not coming across properly - I do not need somewhere private.

The point I was making was that I felt trapped to some extent because I could not go anywhere else without being away from people (which I was worried about if I passed out) and that my desk has all my snacks/rescues in. At the same time I felt very self-conscious with the state I was in.

 

[Robin]

Hi yeah I’m on humulin 11 units twice a day. Creon I take about 6 35,000s with meals.

So glucagon helps when blood sugar goes low but this can be compromised in type 3c is how I read this. Interesting. I’ve had a couple of very bad hypos before a while back, ambulance out and they gave me some injection which I thought was glucagon but maybe I’m getting confused (I felt rotten for several days after though!).

I think it’s clear I need to self-educate a bit more…

Yes, that would be a glucagon injection you received. Glucagon makes the liver release glucose into the system, bringing you out of hypo territory, so is used when someone is so badly hypo that they can’t swallow their usual hypo treatment without risk of choking.
It happens to Type 1s as well, if they go badly hypo, because the balance of insulin/glucagon is dysfunctional so doesn’t always get them out of trouble..
I’ve never had to have recourse to a glucagon injection, but I gather they normally make you throw up, and can make you feel really rough afterwards.

 

[Wendal]

Hi yeah I’m on humulin 11 units twice a day. Creon I take about 6 35,000s with meals.

So glucagon helps when blood sugar goes low but this can be compromised in type 3c is how I read this. Interesting. I’ve had a couple of very bad hypos before a while back, ambulance out and they gave me some injection which I thought was glucagon but maybe I’m getting confused (I felt rotten for several days after though!).

I think it’s clear I need to self-educate a bit more…

So Robin is right re dysfunction.
In Type 1 diabetes, alpha cells are not destroyed by the autoimmune attackin the same way that beta cells are. While beta cells, which produce insulin, are the primary target of the immune system's destruction, alpha cells, responsible for glucagon production, are relatively spared. However, alpha cells do experience dysfunction in Type 1 diabetes, impacting their ability to properly regulate blood glucose levels.
I was trying not to over complicate it but they are all interactive in terms of the effect they have.
So you are on Humulin 2x a day so are you on a basal ( long acting insulin) and do you have only two meals a day hence Humulin and do you take 11u every time or does it depend on how many carbs you are eating.

 

[rebrascora]

So you are on Humulin 2x a day so are you on a basal ( long acting insulin) and do you have only two meals a day hence Humulin and do you take 11u every time or does it depend on how many carbs you are eating.

I am guessing the OP's insulin is Humulin I which is an intermediary insulin the nearest equivalent to Levemir as a basal insulin as it is taken twice a day.
It sounds like there is no bolus (meal time) insulin in use in this case.

@Type3G Can you confirm that it is Humulin I? The i at the end is usually in green which makes it easy to overlook
Had you done an increased amount of exercise/activity before the hypo, possibly even the day before as that can have a lowering impact on your BG levels during the following 48hours?

Do you know how to adjust the low alarm on your Libre?

Learning about managing your own individual diabetes and how best to use the insulin(s) you have for your lifestyle and diet is really important for good diabetes management because only you live with yourself every day and know what you ate and drank and how much exercise you did and when and how well you slept and several other factors which affect BG levels. Insulin isn't like other medications where your doctor tells you a dose and that dose will always be right for you. There are so many factors which can make that dose too little or too much so gaining knowledge and understanding is important to keep yourself safe.

This forum is a goldmine of knowledge and information and practical tips but there is also a book called Think Like A Pancreas which is highly recommended by many insulin dependent people on this forum..

 

[Lucyr]

I’m not coming across properly - I do not need somewhere private.

The point I was making was that I felt trapped to some extent because I could not go anywhere else without being away from people (which I was worried about if I passed out) and that my desk has all my snacks/rescues in. At the same time I felt very self-conscious with the state I was in.

Sorry it’s probably my difficulty understanding then. You don’t need to go anywhere else and you don’t want to go anywhere else so what’s the problem? Carry your kit with you at all times and do whatever is needed wherever you are. If you need to test and eat at your desk, in a meeting, wherever, that’s what you do.

 

[soupdragon]

Thanks everyone. To be clear, I felt like I could not leave my desk - I had nowhere to go that was private - that still had access to my rescues. I was not forced to do anything.

Nothing has been mentioned at work, I was probably worrying for no reason.

My employer is generally fine, I am just an anxious person.

I think I felt foolish, caught out as much as anything.

I’ve repacked rescue remedies today and gone back at it. Strange, though I felt horrendous all day, was in bed by 8pm. I worried how I would feel today.

Thanks for listening to me vent.

I know what you mean about feeling caught out by falling blood sugar at work. There's no reason to feel that way but sometimes it's hard not to.
Hoping today was a much better day for you.