Classification of a 'Hypo' ?

[RJ84]

Hi, first post on here in a while...anyway

I always classed a hypo as when you 'wake up' with a couple of paramedics and half of your family standing round you - all with various types of sugar/glucose etc etc in their hands.

But Doctors and Diabetes Nurses tend to class them as whenever your blood sugar is below 3. Never mind if you felt your blood sugar going low and 'caught it'(lucozade or whatever), this is still a hypo!

Just wondering what you think about this ?

When you're asked, whether by a Diabetes Nurse, Doctor or Some type of Diabetic specialist "what have you been like with hypo's ?" Do you take into account the times when you 'caught it' or just the times when you were really bad ?

Thanks

 

[daisy1]

The forum monitors have written some advice on hypos which could include the type of information you are looking for. Here is the link and I hope it answers your questions:

viewtopic.php?f=20&t=18529

Some members who have frequent hypos will no doubt share their experiences with you later.

 

[Sid Bonkers]

Hypo or Hypoglycaemia is just the name for low blood sugar / blood glucose so does not just mean when you need help. Most medical papers will say that hypoglycaemia is any level of bg below 3.9mmol/L which is why all 'best advice' states 4 is the floor. Anything under 4 should be treated with some fast acting carbs ie 3 X glucotabs, 100ml of lucozade or 3 Jelly babies etc every insulin dependant diabetic seems to have their own sugar kick. The bg should then be tested again every 10 to 15 minutes if levels do not rise then the treatment should be repeated, when levels appear stable a carby snack should be taken to keep the glucose level up, a slice of bread or toast is usually sufficient.

When I was on insulin I found the temptation was to 'over do' the snack and end up with high levels or not to treat it with fast acting carbs but a drink of milk instead, these are classic symptoms of confusion and should be put to the back of your mind you should always treat hypos as serious and treat quickly with the appropriate fast acting carbs.

So, when asked about hypos by a health professional they will generally want to know how your hypo awareness is and if you are able to spot hypos quickly and sort your self out. Hope that helps

 

[alaska]

This is a question I dislike being asked.

I try to keep my blood sugars under 7.5 mmols/l where possible, as a result I'll get hypos on a near daily basis. When I say this, I mean a hypo as a level below 4.0.

When doctors see a bunch of low blood sugars, they sometimes go off into a long explanation of why hypos are so bad.

No wonder really, as they have incentive to make sure their patient doesn't die (of hypo) under their care.

I'm always very cautious of what I say when they ask me how many hypos I have.

 

[SophiaW]

A hypo is any reading below 4 mmol/L. I've read somewhere in the past, but now I can't remember where, that a hypo has different severities:

Mild hypo - person is able to treat the hypo themselves.
Moderate hypo - person is conscious but may need the help of another person to treat it.
Severe hypo - person is unconscious and needs the help of a paramedic.

 

[Levy]

I have always been told by my nurses that a hypo is a bloodsugar of below 4 mmol/l, which then needs to be treated. This is also the point where I usually start to feel shaky and sweaty and my eyes start to go funny

Have you ever got to that point where you wake up from a severe hypo? Do you not feel any symptoms before? I know I have lost some of my hypo awareness since my average glucose levels have come down a bit, it can be quite scary sometimes.

 

[noblehead]

RJ84,

A hypo is classified as any reading under 4, I've never come across a consultant or dsn who has said that a hypo is anything under 3 and you would do well to ignore this as a type 1.

I try to keep my blood sugars under 7.5 mmols/l where possible, as a result I'll get hypos on a near daily basis. When I say this, I mean a hypo as a level below 4.0.

alaska, I also try and keep my bg normal and aims for a level of no more than 8.5mmol one hour postprandial and below 7 mmol two hours after. Daily hypo's would indicate that your control needs adjusting to avoid you losing your hypo awareness symptom's, I suffered regular hypo's before doing the DAFNE course and now have as little as one a week thanks to it's teachings, if you haven't already done a DAFNE course then I can wholeheartedly recommend it.

Nigel

 

[bowell]

RJ84 : See what your getting at

From my experience like Sid said GP ,consultant DN more than likely want to know
the ones you have treated ,felt low and corrected the interest is in your Hypo hypo awareness
also the ones you did not resolve without help .

However when answering questions for DLA or ESA from there so called heath care professionals
I found only wanted the times you fell flat on your back or carted off to A&E :?:

 

[T1RMH1985]

I think 3.9 mmol/l or below is officially defined as hypo. However, for people who's overall control runs on the higher side they can feel hypo at say 6 or 7. Similarly, for people with very tight control they may not notice any symptoms until they've gone below 3 which of course is dangerous.

 

[cugila]

I always classed a hypo as when you 'wake up' with a couple of paramedics and half of your family standing round you - all with various types of sugar/glucose etc etc in their hands.

But Doctors and Diabetes Nurses tend to class them as whenever your blood sugar is below 3. Never mind if you felt your blood sugar going low and 'caught it'(lucozade or whatever), this is still a hypo!

It's little wonder that so many Diabetic's get confused if the 'specialists' can't get things right when explaining hypo's to patients ! This seems to crop up here quite often, hence the reason we posted about hypos in the 'Greetings and Introduction' section for new members to read. There is a difference between a 'Clinical' diagnosis of Hypoglycaemia which can be unrelated to Diabetes and the normal everyday self diagnosis of a Hypo for a Diabetic.

The simple fact is that anything below 4 mmol/l is considered to be a hypo. The levels you drop to would dictate as to the severity, as one member posted mild/moderate or severe. That would also dictate how you, or if you required assistance, someone has to be deal with it.

The normal treatment for a mild hypo is some fast acting carbs such as Glucose Tabs etc then test after 15 mins. If the level has risen to safe numbers (over 4 mmol/l) then a small carby snack or a meal should normally deal with things and stabilise levels. If the levels are still low after the first 15 mins then the procedure is to repeat the fast acting carbs and test again until such time as normal levels are achieved. Do this as often as required, however do not over correct.

What some seem also to forget is that you should have warnings that your Bg levels are getting low BEFORE you enter the hypo zone, below 4 mmol/l. That could possibly be between 4 - 5 mmol/l. If you don't get this warning then your hypo awareness is not good and needs addressing.

If you drive then that too is something you need to be aware of as you should notify the DVLA if you have 'impaired hypo awareness.' Those that have hypo's on a daily or frequent basis need to look to their Bg control as it is obvious that something is amiss, unless there is some medical reason which is undetected........

 

[viviennem]

Good to have you back, Ken. We've missed you!

Viv

 

[cugila]

Thanks Viv......much appreciated.

 

[sugar2]

Good to have you back Ken!

i agree with SophiaW, with the mild, moderrate severe classification, and this is how I explain them to the consultanat.

I think saying that having a BG of, say, 3.5, and saying this is not hypo, is a bit like people who get into a car after a couple of drinks and say they are not drunk. No, they are not drunk, they can function well, and talk and act normally...BUT, they are certainly not safe to drive, as their reasoning isn't right. and whilst they aren't drunk, their bodies are impacted by alcohool. Obviously, it effects us all a bit differently, but it does have an impact.

To me, a hypo, involving paramedics is a really severe one...a, hmm, a feel a bit funny, better test my blood and dig out the glucose tablets" is a mild hypo, which, when caught early, doesn't really impact my day...but it is still a hypo. The only thing that stopped it becoming a meeting with the paramedics is that I felt it and acted on it. The reason I was given a pump was becasue my frequent, minor hypos were deemed to be negatively impacting my life.

 

[cugila]

Thanks sugar2.......glad to be back.

I like the analogy with the drinker and driving .......spot on ! Had a few hypo's like that myself and I definitely don't function well at around 3+ !! Even worse when down in the 2's......

 

[Patch]

I think there's work to be done on the definition/description of a hypo. It could easily be argued that a hypo could also be described as an overdose...

Now, you're gonna go hypo if you starve and don't inject - but how likely is that in todays society? Food is cheap and abundant.

[EDIT: Welcome back to Ken and Sue! It was starting to feel like Lord of the Flies around here! :lol: ]

 

[RJ84]

Thanks for all the replies, they're really appreciated.

A quick correction on my original post, I may have gotten it wrong when I said;
"Doctors and Diabetes Nurses tend to class them as whenever your blood sugar is below 3"...

It was a paramedic that mentioned it but he could of actually said 3.9, it was the other day after my first severe hypo(first time since being diagnosed about 7 years ago that I've needed the paramedics) and I was still a bit 'confused' to say the least.

 

[viviennem]

Who's got the conch, Patch?

Viv :lol:

 

[Patch]

Just call me Piggy...

 

[michelejane]

Re hypos and earling signs'

I decided yesterday after 'hypoing' on my bicycle that for me at least; when I start to think of sweet foods, chocolate, sugary coffee etc my blood sugar is probably between 3-4, but when the thought of food of any kind makes me feel totally unhungry AND I feel unsteady, it may mean my blood sugars are lower, like in the 2's
I didn't pass out or anything I hasten to add, I knew it was time to stop and test, and my husband likes to cycle behind me so he can keep an eye on me, but I stopped and it was 2.6 so I drank a little carton of orange juice, broke a piece of a wispa bar off and ate that as well, tested again and when I did get going again I sped up the hills on the country lane no problem!
Just made me contemplate how we measure our hypo state that's all. Anybody else have any similar ones which work for them? roblem: