Okay, who's nicked my hypo warnings?

[Snapsh0t]

For the last 21 years I've been on mixed insulin, initially Humalin M3 then Novomix 30, and my hypo warnings were spot on. When my bg dropped below 4 in the early morning my body would wake me up and tell me it wasn't happy. A finger-prick test would confirm things but wasn't really necessary.

Two weeks ago I switched to basal/bolus and have not felt any of the hypos I've had until I've dropped below 3 and it still wasn't as definite as before. Just as well I'm now using a Libre and testing often....

 

[trophywench]

Ah, well - just one of the things that tend to happen when you've had T1 a fair few years so I imagine it happens to anyone using insulin for a good-ish while. To regain hypo warning systems, just run your BG a bit higher for a month or two.

 

[everydayupsanddowns]

I tend to agree. But that’s probably because I know my own hypo warning signs took a real dent after years of fairly frequent low-level dips below 4.

The body learns to adapt to ‘cope better’ with lows over time and the brain physically changes, altering/reducing the hormone response that is triggered by low BG.

Minimising time spent below 4.0 for 6-12 months is the best way to attempt to restore hypo warnings in most people. As Jenny says, sometimes it helps to run BGs a little higher than you would normally.

 

[Pumper_Sue]

You need to sort the problem asp if you drive, because your licence is now invalid due to no hypo warnings

 

[rebrascora]

It may be that the bolus insulin is dropping you quicker than your previous mixed insulin and your body is not getting time to heed the warning before you drop lower still. You should have the option to revert to your previous insulin regime if you preferred it but I would give the basal/bolus system a bit longer, especially as you have a Libre to keep track of things.

 

[everydayupsanddowns]

You need to sort the problem asp if you drive, because your licence is now invalid due to no hypo warnings

Only if you have absolutely no hypo awareness at all. You can continue to drive as long as your Dr considers your level of awareness is safe.

They may use checks like the ‘Clarke’ or ‘Gold’ score to measure how effective your warning signs still are.

 

[Pumper_Sue]

Only if you have absolutely no hypo awareness at all. You can continue to drive as long as your Dr considers your level of awareness is safe.

They may use checks like the ‘Clarke’ or ‘Gold’ score to measure how effective your warning signs still are.

Impaired awareness of hypoglycaemia – ‘hypoglycaemia unawareness’
Group 1 car and motorcycle
Group 2 bus and lorry
Must not drive and must notify the DVLA. Driving may resume after a clinical report by a GP or consultant diabetes specialist confirms that hypoglycaemia awareness has been regained.
Must not drive and must notify the DVLA. The licence will be refused or revoked. Refer to the requirements for insulintreated diabetes on page 71.
Page 74 also page 71 https://assets.publishing.service.g...o-drive-a-guide-for-medical-professionals.pdf

As OP is dropping below 3 then he has to inform the DVLA and should not drive according to the link provided.

 

[Snapsh0t]

Thanks for the comments, everyone. I'm going to knock a couple more units off my basal tonight as my morning score is still lower than recommended by the DSN. Hopefully, I'll move out of the hypo zone once I get it properly tuned.

On an unrelated note but I have to put it somewhere - my CABG is 20 today!

 

[Amity Island]

Thanks for the comments, everyone. I'm going to knock a couple more units off my basal tonight as my morning score is still lower than recommended by the DSN. Hopefully, I'll move out of the hypo zone once I get it properly tuned.

On an unrelated note but I have to put it somewhere - my CABG is 20 today!

Hi Snapshot, you started by saying that your lack of hypo awareness started at the same time your insulin changed. As Rebrascora mentioned too. It may well be the result in the change in insulin. My hypo symptoms changed when my insulin changed also. I didn't lose my symptoms, but they DEFINITELY changed.

 

[Snapsh0t]

My levels are currently much lower than they were on Novomix (apart from my breakfast spike) so I'm hoping things will improve once I bring them up a bit.

 

[Pumper_Sue]

My levels are currently much lower than they were on Novomix (apart from my breakfast spike) so I'm hoping things will improve once I bring them up a bit.

What levels are you achieving on MDI now and what were you running at before?