Query on coming out of a hypo.

[gillrogers]

Keep meaning to ask this. So i read that after a hypo (so ive had the hypo treatment) i then need to eat something carby but have never told how much and if I need to bolus for it.?

When ive had hypos i eat my glucose and get on with the high i get from it. Usually they've been during lunch or just after. And when ive had them at night ive got up and had breakfast as usual. So cant see how the need extra carbs after recovery fits in?

 

[helli]

The rule is 15/15/15.
15 minutes of fast acting carbs
Wait 15 minutes
If recovered*, 15g slow acting carbs.

Something like a biscuit or one finger of Twix is close enough to 15g.

If I am about to eat anyway, I will not bother with the additional 15g slow acting as that is included in meal.

* If not recovered, another 15g fast acting carbs
Wait another 15 minutes
If recovered, ...

 

[rebrascora]

I personally find that 15g of fast acting carbs is too much for me let alone having some slower acting carbs afterwards, but if you need the slower acting carbs after the initial fast acting hypo treatment, then no, you don't bolus for them.

 

[gillrogers]

The rule is 15/15/15.
15 minutes of fast acting carbs
Wait 15 minutes
If recovered*, 15g slow acting carbs.

Something like a biscuit or one finger of Twix is close enough to 15g.

If I am about to eat anyway, I will not bother with the additional 15g slow acting as that is included in meal.

* If not recovered, another 15g fast acting carbs
Wait another 15 minutes
If recovered, ...

Yup i knew that but none of that said if i need to bolus with the slow acting carbs. 15g of carbs are way way too much for me. Ive found if i work on what my insulin to carb ratio for the time its happening then i dont spike so massively high.

 

[gillrogers]

I personally find that 15g of fast acting carbs is too much for me let alone having some slower acting carbs afterwards, but if you need the slower acting carbs after the initial fast acting hypo treatment, then no, you don't bolus for them.

Yip me too. So you dont necessarily have to have the slow carbs afterwards?

 

[rebrascora]

Yip me too. So you dont necessarily have to have the slow carbs afterwards?

Any guidance with diabetes is just guidance. It is usually erring on the side of caution, to keep people safer. When learning how to manage your diabetes, you try that guidance, see how it pans out and if it doesn't fit with your body responses then you carefully adjust to what works for you. This doesn't just apply to treating hypos but all aspects of diabetes management. The guidance is not "law" or strict rules. Obviously, if you repeatedly ignore that guidance and end up repeatedly hypo or whatever because you ignore it, then that is silly and irresponsible, but you are certainly able/allowed to adjust that guidance to suit your body and it would be crazy to blindly follow it if it causes you more BG disruption, like going from a hypo to a hyper every time.

 

[helli]

none of that said if i need to bolus with the slow acting carbs.

Sorry, I thought by not saying “bolus” it was clear that none is to be taken because it is part of your hypo treatment.
The purpose of the 15g of slow acting carbs is to maintain the higher BG following recovery on the assumption that the low may be caused by too much basal. For example, if the hypo was after (or during) exercise.

But with everything diabetes management related, this is a starting point and we need to work out for ourselves what our body needs. Because every body is different.

 

[gillrogers]

Any guidance with diabetes is just guidance. It is usually erring on the side of caution, to keep people safer. When learning how to manage your diabetes, you try that guidance, see how it pans out and if it doesn't fit with your body responses then you carefully adjust to what works for you. This doesn't just apply to treating hypos but all aspects of diabetes management. The guidance is not "law" or strict rules. Obviously, if you repeatedly ignore that guidance and end up repeatedly hypo or whatever because you ignore it, then that is silly and irresponsible, but you are certainly able/allowed to adjust that guidance to suit your body and it would be crazy to blindly follow it if it causes you more BG disruption, like going from a hypo to a hyper every time.

Thanks Barbera

 

[gillrogers]

Sorry, I thought by not saying “bolus” it was clear that none is to be taken because it is part of your hypo treatment.
The purpose of the 15g of slow acting carbs is to maintain the higher BG following recovery on the assumption that the low may be caused by too much basal. For example, if the hypo was after (or during) exercise.

But with everything diabetes management related, this is a starting point and we need to work out for ourselves what our body needs. Because every body is different.

Oh Helli, its me having to be sure. Ohh I've started my phsycology treatment and itturns out that my approach to all this is down to how i was treated as a child by doctors and what i now know to be a gluten intolerance. So as a child i was told there was nothing wrong with me and it was all in my head. Mother told me i was an inconvenience for feeling so ill and having an upset stomach all the time. Over the years i had to cope with it myself and ended up learning to live with it until things got toobad to carry on and even then the docs did tests and came back with nothing. Read up on coeliac , knew it wasnt that but discovered you can have a gluten intolerance. Then decided mysrlf to cut out gluten and it worked. So the upshot is i have an unwitting distrust of what im told until i can actually see it work for myself. So things take a long time for me to work out how its working. Then one day all of a sudden the penny drops and things fall into place. It also explains why i feel like im not listened to. Its like my head is unwittingly saying to me that no one had believed you for all these years so why should it be any different now. ‍♀️‍♀️.

Anyways now we know where its coming from and my therapist can rewire me!

 

[AndBreathe]

Oh Helli, its me having to be sure. Ohh I've started my phsycology treatment and itturns out that my approach to all this is down to how i was treated as a child by doctors and what i now know to be a gluten intolerance. So as a child i was told there was nothing wrong with me and it was all in my head. Mother told me i was an inconvenience for feeling so ill and having an upset stomach all the time. Over the years i had to cope with it myself and ended up learning to live with it until things got toobad to carry on and even then the docs did tests and came back with nothing. Read up on coeliac , knew it wasnt that but discovered you can have a gluten intolerance. Then decided mysrlf to cut out gluten and it worked. So the upshot is i have an unwitting distrust of what im told until i can actually see it work for myself. So things take a long time for me to work out how its working. Then one day all of a sudden the penny drops and things fall into place. It also explains why i feel like im not listened to. Its like my head is unwittingly saying to me that no one had believed you for all these years so why should it be any different now. ‍♀️‍♀️.

Anyways now we know where its coming from and my therapist can rewire me!

Nothing to do with hypos in my post. I just wanted to say I'm so pleased some things are falling in to place for you, relating to how your deal with "stuff".

One thing I will say about the rewiring is that your therapist will help and guide you through the process, but it is you who will do the rewiring. It's a subtle difference, but it means you, hopefully, will emerge from this tranche of your treatment empowered with tools address any similar challenges you might face along the way.

I often say my dreadful anorexia was the making of me. Not the fact I almost killed myself in the process, but the things I learned about myself and my place in the world - mainly, but not exclusively on the way back to health. It is hard work, but extremely rewarding and so worth it.

Good luck with it all.

 

[gillrogers]

@AndBreathe thank you

 

[everydayupsanddowns]

One of the things about hypos is that they often come in waves. And (as one consultant once put it) “hypos breed hypos”.

Once you’ve dipped into hypo territory once in a day, you are statistically more likely to have another.

The follow-up slower carbs were an attempt to reduce that risk, but really date from a time when insulins (and dose strategies) were a bit less finessed, and more basic. Plus it was before widespread CGM and the hypo-dodging opportunities that allows.

So you *may* find follow-up carbs helpful as a regular part of your hypo treatment, as an occasional add-on in certain circumstances, or not at all.

Sorry to hear about the difficulties you experienced as a child. So pleased you are working through those issues with a therapist now.