My first "hypo"

[BenjaminRWT]

Like the thread title says. Although the way it's worded makes it sound like a children's book!

But yes, this morning, for the first time since I was diagnosed, my levels dropped below 4. I know this because the alarm on my Libre 2 sounded. I checked and sure enough, reading was 3.8. I'd say it woke me up but I'd be lying, because toothache kept me awake most of the night. I have the day off work today and tomorrow.

So as soon as I did the reading, I had a small carton of orange juice. Did another reading, back up to 4.8, and just had a couple of biscuits.

It's 7.3 as of right now.

Anyway, when I heard the alarm, I didn't feel "unwell" really. Bit headachy this morning but I put that down to lack of sleep.

I wish this didn't happen today, though. I'm going to Bristol to see a gig tonight. Staying overnight, coming home tomorrow morning (today is a normal day off for me and I booked tomorrow off as well. Working Saturday) . So it's made me a bit worried now. I will be keeping an eye on things today. I'm also concerned now because of the gig I'm attending I'll be taking my insulin slightly early - I'm only on a basal insulin right now, 8 units of Lantus at 8pm, which for tonight, upon advice from the diabetic department at the hospital, I'll be doing at 6.30, then heading out (gig starts at 7.30). Venue is only about 10 minutes from the hotel, too.

Obviously I carry hypo treatments with me all the time now - a tube of chewable glucose tablets - this hasn't happened to me before, but it's always better to have something and not need it, than to need it and not have it. And I have the libre app on my phone in additon to the reader, just in case something happens to either. Not even going to try getting down the front tonight either. It won't be a particularly crazy gig, not one of those bands, but I don't think it's a good idea for me right now until I've even more of a handle on things.

Again keeping an eye on this all day now. Gonna have something to eat before I head out, too. Should be okay, but this has got me so paranoid.

 

[Inka]

A first hypo is always scary @BenjaminRWT In a way, it’s good though because you now have an idea what to expect and know how to sort it. So, although I can understand you’re worried about the gig, better that you had the hypo now than then.

Perhaps your restless night caused the hypo, or perhaps you simply need less Lantus and small amounts of bolus (I might have said that to you before because it’s a bête noire of mine).

Try not to worry too much about the gig. I’ve been to loads, including very rough ones and all’s been well. If anything, I find the heat and stress raises my blood sugar a bit normally. Take plenty of glucose with you and some carby snacks eg biscuits or cereal bars. Mainly, enjoy the gig. Remember you have the Libre. For decades we only had meters so no alarms at all, and we’ve been ok. Eat well today and just keep an eye on things. Better to be a little high than go low.

 

[BenjaminRWT]

Plan right now is to have lunch before I go to the hotel, and have dinner there before I'm about to do my injection and head out. I'll be doing plenty of readings today as it is.

If I'm travelling for a gig and staying overnight, I usually end up having time to kill before I can check in, so I'm usually looking around shops etc. I'm not doing it that way this time. Especially where I'm going, one of the shops is quite a way away from the city centre.

I'll get a packet of biscuits or something to have when I get to the hotel. I usually like to have a cup of tea when I get back to my room after a gig anyway, so something to go with that.

My levels shot up to within range pretty quick. 6.8 right now. Not even had breakfast yet. Want to go and drop off a repeat prescription at the chemist before I leave anyway. They're just round the corner where I live, thankfully.

I've got today planned out, and this shouldn't derail that.

My Libre goes off at anything below 3.9, so 3.8 while still below that, I'm just putting it down to the restless night and hopefully this won't be too common. Still good learning experience, I suppose.

I've got an appointment in a few weeks, I really should bring up my current insulin doses. I've said a lot of times, I have novorapid in my fridge and it's going unused. That's still baffling to me.

I'm going to a wrestling event in London later this summer and that's an earlier start than this gig tonight. I'll at least need advice for that, too.

I've been told more than once that my dosages will change as time goes on and it's still early days for me as it is. Maybe they will decide to start me on ths novorapid by then.

 

[helli]

@BenjaminRWT if you are concerned about having a hypo, why don't you increase the level your Libre alarm goes off so you can fend it off before it happens.
I know quite a few people set their alarm at 5 so that they can have a jelly baby. That way, the hypo is less likely to occur.
As @Inka said, it is good that you know what to expect. The fear of the unknown is often the worse thing. One of the best pieces of advice I received in the early days was to force myself to hypo at home with someone I trust in a safe environment. I know it's not for everyone but it really helped me.
Again I agree with Inka about gigs being a safe place for diabetes and should be nothing to worry about. I too found the extra bit of stress raised my levels a tad.
Enjoy your gig and enjoy Bristol. It's a cool city I often visit.

 

[Tdm]

When you are on novorapid i suggest you set your libre to a little higher perhaps 4.5 or even a smidgen higher - changes can happen quicker on blus insulin and it gives you more time to correct a fall

 

[BenjaminRWT]

That's definitely something to consider if/when they start me on novorapid.

I've kept the alarms at their default and that's worked so far. Usually my levels are about 5.5 give or take first thing in the morning and aside from ups and downs after meals and such will settle back to around 5 or 6 on a good day. If there's a chance my levels could drop more with that, then being able to "pre-empt" a hypo would be a good idea.

 

[Inka]

@BenjaminRWT When I had a Libre, I set my alarm at 5 minimum. When I was out or doing something energetic or different, I set the Low alarm to 5.6. I could then get good notice of any drops and it made it so much easier to ward off hypos.

I would push a bit harder for the Novorapid. What you’re experiencing is too common and it annoys me so much. You’ve previously mentioned going higher in the afternoon after lunch. The Lantus is not to cover food and using it to do so hardly ever works out. In addition, because the dose you’re on is more than likely wrong (because they’re trying to make it cover your meals when it’s not supposed to) you run the risk of both hypos and highs.

 

[RBZ5416]

This is not medical advice as I'm not qualified to give it. But if it were me, I'd consider postponing the insulin dose until after the gig, rather than bringing it forward. Taking the dose early, although not by a huge amount, will be adding to what you have onboard. I would suggest that's possibly not the best strategy following a hypo. As @Inka said, better to run a little high for the evening than risk another hypo.

Will you be drinking alcohol as that can also lower your levels?

 

[Lucyr]

Anyway, when I heard the alarm, I didn't feel "unwell" really. Bit headachy this morning but I put that down to lack of sleep.

Did you fingerprick to check the hypo? Libre can read a bit low when sleeping especially if you lie on it etc.

I keep my alarm at 5 to try and prevent hypos rather than waiting until I’m actually low and then treating it.

 

[helli]

This is not medical advice as I'm not qualified to give it. But if it were me, I'd consider postponing the insulin dose until after the gig, rather than bringing it forward. Taking the dose early, although not by a huge amount, will be adding to what you have onboard. I would suggest that's possibly not the best strategy following a hypo. As @Inka said, better to run a little high for the evening than risk another hypo.

Will you be drinking alcohol as that can also lower your levels?

When only taking basal once a day, would not really be adding to what is on board, especially with Lantus that does not really last a full 24 hours.

 

[rebrascora]

I would agree about taking your basal later rather than earlier. The peak of the activity from the Lantus will probably end up kicking in when the effect of the exercise (and any alcohol) from the gig is also kicking in during the small hours and put you at more risk, so I would take the Lantus as late as possible before you go to sleep rather than earlier, especially given that you had a hypo this morning.... assuming it was a genuine hypo and not just a compression low. It sounds like your body is still producing quite a bit of insulin itself if you are not yet using bolus insulin and getting readings like that, so there is no real concern of high levels and potential DKA so running your levels a bit higher would be preferable to risking another hypo during the gig or more likely during the early hours of the morning.
My Libre low alarm is set at 4.2 which still gives me enough time to prevent a hypo with a jelly baby or 2 because I know I react very quickly to JBs, but there is no harm at all at setting it at 4.5 or higher. Prevention is better than cure as they say and when you have a device which can help you prevent a hypo happening, why would you not set it so that you can prevent it, rather than wait for it to happen.
As regards not feeling the hypo, it is often harder to feel hypos when you are lying down and asleep (eyes closed so you can't detect visual changes, no wobbly legs etc.) and with it being a hypo caused by your basal (assuming it was a genuine hypo and not a Libre compression low) then your levels likely descended very slowly into the red so it is not as obvious to your body as it would be during the day when you are up and about and doing things and using glucose for your muscles so a low level is usually more obvious.

As regards the gig tonight, I imagine it will be loud and you will be dancing and singing so you may not hear your Libre. I know I don't when I am hoovering or cutting the grass..... the latter being a prime candidate for dropping my levels. I find that having it tucked down my bra enables me to feel the vibration, so whilst I am guessing you are a man and probably don't wear a bra, you might want to think about where you can safely locate the Libre reader where you can feel the vibration if the alarm should go off at a noisy gig.... and make sure the vibration is turned on of course.

 

[BenjaminRWT]

This is not medical advice as I'm not qualified to give it. But if it were me, I'd consider postponing the insulin dose until after the gig, rather than bringing it forward. Taking the dose early, although not by a huge amount, will be adding to what you have onboard. I would suggest that's possibly not the best strategy following a hypo. As @Inka said, better to run a little high for the evening than risk another hypo.

Will you be drinking alcohol as that can also lower your levels?

No, I don't drink. Never have, actually.

I've just tried ringing the diabetic department at the hospital, same ones who advised on taking it earlier when I called the other day. I've had to leave a message, waiting for a response. Hopefully they'll get back soon and be able to advise.

As regards the gig tonight, I imagine it will be loud and you will be dancing and singing so you may not hear your Libre... you might want to think about where you can safely locate the Libre reader where you can feel the vibration if the alarm should go off at a noisy gig.... and make sure the vibration is turned on of course.

The band I'm seeing, they're almost entirely instrumental and it's not the sort of music you'd dance to. It will be loud, though.

Need to make sure I keep the libre where I can feel it go off, if it does.

 

[helli]

I would agree about taking your basal later rather than earlier. The peak of the activity from the Lantus will probably end up kicking in when the effect of the exercise (and any alcohol) from the gig is also kicking in during the small hours and put you at more risk, so I would take the Lantus as late as possible before you go to sleep rather than earlier

Sorry, but I disagree. Lantus has a bit of a spike at about 4 or 5 hours.
If taken as late as possible, there is a risk this spike could lead to a night time hypo, especially after the gig,

The OP has been advised by their DSN and has a plan sorted. I don't think it is right to suggest they go against that advice,

 

[BenjaminRWT]

Sorry, but I disagree. Lantus has a bit of a spike at about 4 or 5 hours.
If taken as late as possible, there is a risk this spike could lead to a night time hypo, especially after the gig,

The OP has been advised by their DSN and has a plan sorted. I don't think it is right to suggest they go against that advice,

I had a plan, but this morning has made me want to seek further advice in light of this. Just to be Sure if I should stick to the plan or change.

As I explained, I usually take it at 8pm. I plan to make my way over to the gig at 6.30, ticket says the start time is 7.30.

It's only a diffence of 1 1/2 hours, but I don't fully know just how much of a difference that will make. That's why I'm waiting for someone to call me back. They're going to know more than me.

 

[helli]

I had a plan, but this morning has made me want to seek further advice in light of this. Just to be Sure if I should stick to the plan or change.

As I explained, I usually take it at 8pm. I plan to make my way over to the gig at 6.30, ticket says the start time is 7.30.

It's only a diffence of 1 1/2 hours, but I don't fully know just how much of a difference that will make. That's why I'm waiting for someone to call me back. They're going to know more than me.

I don't think Lantus lasts a full 24 hours. For most of us it lasts 20 to 22 hours so it is quite forgiving if you take it a couple of hours early.
I used to follow this approach when I travelled overseas to deal with the time difference.

The other thing to remember is that the start time for gigs is usually the time the doors open. The band usually get on stage an hour or so later. Do you should have some leeway with your arrival time. Unless it is a classical concert. They seem to have their own rules.

 

[nonethewiser]

Strange thing to say but always good to get your first hypo out of the way so you know what symptoms to spot next time, first is always most scariest.

 

[BenjaminRWT]

I don't know if I had any symptoms. Like I say I wasn't sleeping well at all anyway, so I was always out of sorts.

Anyway, I got through to the diabetic nurse, and they said to stick to my plan to take it early. Just had something to eat now, so it's up a little anyway, and I'm about to do my injection in a bit before I head out. May have a few extra biscuits before I do, just in case.

I'm taking my Libre, and always carry something in case of a hypo, so I should be okay for a few hours...

 

[helli]

Enjoy the gig @BenjaminRWT

 

[BenjaminRWT]

Enjoy the gig @BenjaminRWT

I'm back at my hotel now. And I can say that I did!

I ended up right down the front as if nothing was wrong, and to be honest I was fine. Was practically leaning on the stage. Managed to snag a plectrum at the end!

Left the gig with the usual bad back, legs and ringing ears, but otherwise fine.

 

[BenjaminRWT]

I don't think Lantus lasts a full 24 hours. For most of us it lasts 20 to 22 hours so it is quite forgiving if you take it a couple of hours early.
I used to follow this approach when I travelled overseas to deal with the time difference.

This was something I was told when I was looking for guidance prior to going to the gig, as it happens.

I would push a bit harder for the Novorapid. What you’re experiencing is too common and it annoys me so much. You’ve previously mentioned going higher in the afternoon after lunch. The Lantus is not to cover food and using it to do so hardly ever works out. In addition, because the dose you’re on is more than likely wrong (because they’re trying to make it cover your meals when it’s not supposed to) you run the risk of both hypos and highs.

The last few days, I REALLY do need to push for this. I went into work yesterday, and something must have happened as I nodded off for a bit on the bus (journey takes 45 minutess), and it completely skyrocketed to 13.7, setting off my libre sensor. Worse, I didn't have my stuff to do fingerprick tests to test for ketones, even if I was in a place where I could do it.

Happened again after lunch in the afternoon. Even worse it went off as I was dealing with a member of the public (without going into detail on what I do, because I can't, my job now involves occasionally processing payments from the public), because when I'm on that part of the job, I'm mainly stuck in a small back office. My other duties, I usually get to move around a bit more but not with this.

And I tried to explain this while other things were going wrong to one of my team leaders, but all I get is a "Calm down" or "Take a deep breath" which is easy to say when you know something is wrong personally and work-wise and there's little you can do about it.

By the time I got home it had gone back down to something resembling "normal" for me, so I didn't know if there was any point in any blood testing by then.

Around the time of my diagnosis, I was told I have high blood pressure too, which they're trying to get to the root of, too. So none of this has helped.

But I can't be up-and-down like this. Even if I have to slip away a little earlier to inject, it's got to be more helpful keeping things in order than how it's been lately.

I've got a Diabetes clinic I'm attending week after next, but I have a load of calls to doctors and stuff to make as it is that I may as well make one more in the morning at this point.

I know it's still early for me, but it feels like everything I do, even when I'm trying to do it right, is wrong.