Type 1's - Hypo unawareness

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mum2westiesGill

mum2westiesGill

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Relationship to Diabetes
Type 1
Does anybody have any tips for loss of hypo feelings?
My target range is 5mmol - 8mmol - should this be changed?
Would it be worth me using my freestyle libre with the low signal alarm on?

I've been Type 1 diabetic since 1992 and I know that after several years you can loose your awareness.
 
You need to run slightly higher than the ‘perfect’ range @mum2westiesGill I’ve had Type 1 a similar length of time to you and I’ve always had good awareness but it does lessen slightly so I’ve made a point of staying above 5 and it’s sharpened it right up. Initially I aimed to be above 6.

So yes, I’d change your target range slightly. If you can manage weeks of not dropping below 5-6 your awareness should improve.
 
I seem to remember you were stressed by the Libre? But you could only use it for alarms if you want, and still finger prick.
 
mum2westiesGill said:
Does anybody have any tips for loss of hypo feelings?
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I think the advice is still to avoid going low too much. If you've lost some sensation (as I have, more than once) there's a good chance that after a few weeks it'll return if you don't go hypo. And if that means you need to be a bit higher than usual for a while, then it's worth it.

As others have said, Libre provides an obvious tool to help. (I imagine part of the reason for the advice about <5% lower than 4.0 in the time in range guideline is about reducing the risk of losing hypo awareness.)
 
Inka said:
You need to run slightly higher than the ‘perfect’ range @mum2westiesGill I’ve had Type 1 a similar length of time to you and I’ve always had good awareness but it does lessen slightly so I’ve made a point of staying above 5 and it’s sharpened it right up. Initially I aimed to be above 6.
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How did you manage to aim to be above 6? Did you change your target range?

Inka said:
So yes, I’d change your target range slightly. If you can manage weeks of not dropping below 5-6
your awareness should improve.
Click to expand...
My target range at the moment is 5-8mmol so middle of my range is 6.5mmol. I know you're not medically trained but what would you be tempted to change it to?
 
Inka said:
I seem to remember you were stressed by the Libre? But you could only use it for alarms if you want, and still finger prick.
Click to expand...
Yes that's correct I used to get stressed by using all the arrow readings compared to my blood glucose readings. If I could just use it as a warning for hypos which might be occuring in-between meals or coming up to a meal and still do my blood glucose and finger pricking for before meals that would be great. Obviously I would do finger pricks if the libre was saying I'm hypo. I wouldn’t mind scanning as often as possible. It would probably help with overnight basal testing if I made sure to scan around 10pm or later then scan again at 6am ish
 
I don’t use any special app or meter - just my brain to calculate things 🙂 I lowered my basal slightly, and for meals where I tended to go below 6 at some point afterwards, I either reduced my meal ratio or stopped the drop by testing and eating a small amount of carbs to keep me up in the 6s and 7s. Even if I was just about to eat a meal, I still had a few carbs to push me into the 6s if necessary. My aim was to spend as little time as possible below 6, so if I spotted I was, say, 5.3, I ate enough carbs to push me up a bit.

If your target range of 5-8 is in your meter/app, and the meter/app is using that to work out your doses, I’d adjust it by making the lower limit higher eg I’d have it as 6 or 6.5, then I’d maybe put the higher limit as 10. You could also look at your ratios. The simple aim is to be above 6 as much as you can.

You could finger prick and just use the Libre alarms to alert you to lows and highs you’d have to set your Low alert high enough to warn you so you didn’t drop below 6. You’d only have to scan it often enough so that it keeps it’s records.
 
Inka said:
I don’t use any special app or meter - just my brain to calculate things 🙂 I lowered my basal slightly, and for meals where I tended to go below 6 at some point afterwards, I either reduced my meal ratio or stopped the drop by testing and eating a small amount of carbs to keep me up in the 6s and 7s. Even if I was just about to eat a meal, I still had a few carbs to push me into the 6s if necessary. My aim was to spend as little time as possible below 6, so if I spotted I was, say, 5.3, I ate enough carbs to push me up a bit.

If your target range of 5-8 is in your meter/app, and the meter/app is using that to work out your doses, I’d adjust it by making the lower limit higher eg I’d have it as 6 or 6.5, then I’d maybe put the higher limit as 10. You could also look at your ratios. The simple aim is to be above 6 as much as you can.
Click to expand...
So the middle of my range if I changed it to 6-10 would be 8

Inka said:
You could finger prick and just use the Libre alarms to alert you to lows and highs you’d have to set your Low alert high enough to warn you so you didn’t drop below 6.
Click to expand...
What would you set the low alert to?
Inka said:
You’d only have to scan it often enough so that it keeps it’s records.
Click to expand...
How often would you scan?
 
You could do 6-10 to start with and then after a few weeks, reduce the top number eg 6-9 if that’s how it works.

The Libre needs scanning every 8 hours so it doesn’t lose its memory, so you’d only have to do that. You wouldn’t even need to look at the number when you scanned on these occasions.

I don’t know if there are limits on what you can set the Low alarm to but you could try somewhere between 6-6.5 and see how that goes. It depends how accurate your Libre is and how often the alarms are going to sound. You want to be alerted but not if that means it’s beeping at you every few minutes!
 
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