Type 1 Anyone Losing Hypo Awareness?

catapillar

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3,390
Type of diabetes
Type 1
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I take degludec n novo rapid

Have you done a DAFNE course or a carb counting course? On a properly working basal bolus regime you shouldn't really need a lunchtime deadline. The whole point of basal bolus is flexibility so you should be able to miss meals.

Have you done a basal test to check if you're on the right dose for you?

If regaining hypo awareness requires not going hypo then you need to see if you can figure out what's causing your hypos and adjust things to stop them so you can run in a range something more like 5- 10.
 

petepontiac

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Lost mine years ago told it was due to the length of time I've been diabetic, told running levels higher may help but didn't for me, feel exactly the same at 5.8 and 2.0 it's a good job my wife can tell when I'm low lol.
Same here
 
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Tinyface

Active Member
Messages
32
Type of diabetes
Type 1
Have you done a DAFNE course or a carb counting course? On a properly working basal bolus regime you shouldn't really need a lunchtime deadline. The whole point of basal bolus is flexibility so you should be able to miss meals.

Have you done a basal test to check if you're on the right dose for you?

If regaining hypo awareness requires not going hypo then you need to see if you can figure out what's causing your hypos and adjust things to stop them so you can run in a range something more like 5- 10.

Do you know I have no idea what a basal test is..no courses have been offered to me but I am going to write this all down..I can't believe how ignorant I am..I did see my doctor tonight and he has prescribed 150 meter strips per prescription ..he said to test test test..soo that was great..
 

db89

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Messages
1,134
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Type 1
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Do you know I have no idea what a basal test is..no courses have been offered to me but I am going to write this all down..I can't believe how ignorant I am..I did see my doctor tonight and he has prescribed 150 meter strips per prescription ..he said to test test test..soo that was great..
I used this link when testing basal. The units aren't the ones we use in the UK but there is a converter here.

That's good news that your prescribed test strips have been increased. :)
 

Scott-C

Well-Known Member
Messages
2,474
Type of diabetes
Type 1
Definitely try to get yourself on a DAFNE course. It gives a lot of good fine tuning tips even for people who have been T1 for a lomg time. There's usually a long waiting list for them, though, several months or a year.

We can't give dosing advice but I don't suppose the DAFNE people will mind me quoting from their guidance which says that as a very general rule or starting point that 1 unit of insulin will lower blood glucose by 2 to 3 mmol/L, and 10 grams of carbs will raise it by 2 to 3 mmol/L. They'll generally suggest that 1 unit will do for each 10g of carbs. Works for some people, but others find it's more,say 1.5 units for each 10g - needs a bit of experimenting, they'll suggest trying the same meal a few days running on 1 to 10 and if going too high or low later, tweak it up or down.

I think a lot of us end up on a rollercoaster because we more or less guess insulin, go hypo and then take way too much sugar to correct. DAFNE guidance says take 10g for a hypo and wait ten minutes then repeat if it's not sorted. You'd be surpised by how little glucose is needed to sort a hypo but we often (and this included me before my DAFNE course) just eat till we feel better and that's usually way too much, and then you're correcting to try and bring it back down. Th e reason waiting ten minutes is important is that glucose takes some time to get from your stomach into your blood stream. It's difficult when you're panicking but try to be patient.

I've lost a lot of hypo symptoms but still notice a feeling of lightness,so maybe it's a case of watching out for subtler signs.

If you're hypos are getting really bad, ask about funded CGM. If you can't get it, maybe think about buying a Freestyle Libre. Each sensor lasts 2 weeks and costs about £50. You don't need to use it all the time. Even just a couple of weeks shows a whole lot of stuff you'd never know by just using strips. By far and away the best bit is that because it's reading sugars constantly, it shows a downward arrow if you're dropping quickly. That way,if you're at, say, 5 or 6, with a downward arrow, you can start thinking about sorting out a possible hypo before it happens.
 
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Lyndseyx

Member
Messages
7
Type of diabetes
Type 1
After 40yrs. I've lost hypo-awareness. Even as low as 1.7, Run my sugars between 8 & 12. Recently changed Insulin from Lantus to Tresiba, which seems to decrease hypo's
 

KarenAdamson

Active Member
Messages
26
Type of diabetes
Type 1
Treatment type
Insulin
Hi Tinyface. I've been T1 for 45 years and lost my hypo symptoms a few years ago. I was put forward for a pump because of that but after the 4 full day pre-pump course at my local hospital my control was a lot better and I decided against a pump. The course I did was brilliant and covered all aspects of being a T1 including how to check your basal dose and then sorting out your carb ratio for the quick acting. ( I think this will be the same as the DAFNE (Dose Adjustment for Normal Eating) elsewhere in the UK. Because I have no hypo symptoms most of the time I always leave a small bottle of Lucozade in most rooms in my flat. I always take a small bottle in my handbag as well. Once you get your insulin doses sorted out you shouldn't need a deadline to eat lunch. If I have lunch then I take some quick acting and if I don't have lunch then I don't. I do however need a small snack four hours after my breakfast and always carry a snack with me as well. I always wear Diabetic ID and bought an ICE card which included Key ring tag and Phone sticker that says I am a type 1 Diabetic. If you live on your own and you are worried about being hypo and needing help, as I was, I bought a 40 pound mobile with an SOS button so that if hypo and unable to move then I just press a big button on the phone which dials the Emergency services. I phoned 101 the non emergency police line and gave them my name, address and that I was a T1 Diabetic and they have tagged my phone so if I cannot answer the emergency services they will send an ambulance and know which neighbours have keys to my front door. It stopped me worrying that if my husband was on a night shift and I had a bad hypo they would know what to do to reach me. If you need details of the SOS phone let me know
 

KarenAdamson

Active Member
Messages
26
Type of diabetes
Type 1
Treatment type
Insulin
Forgot to say - If you adjust your fast acting insulin ratio then drop it slightly for three days to see if you have less hypos. Also remember that if you have one hypo then you often have another one a few hours later so eat a bit more than normal. This is because on your first hypo your liver dumps Glucogen into your blood and later that day it will use some of the carbs you eat to replace the Glucogen in your liver. Just remember that everyone is different with how much insulin they need and that at various times of the day you may need more or less insulin. For me I have 1u Novorapid for 5 carbs in the morning but in the afternoon and evening it is 1u for 7 carbs. It's something that your DSN can help you work out. If you are having constant hypos then either your basal insulin is too high and/or your Basal Novorapid ratios are wrong.
 
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noblehead

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Hi Tinyface. I've been T1 for 45 years and lost my hypo symptoms a few years ago. I was put forward for a pump because of that but after the 4 full day pre-pump course at my local hospital my control was a lot better and I decided against a pump.

Hi @KarenAdamson

There's a member on the forum who had lost his hypo awareness symptoms but they gradually returned once he started on a pump, I'll tag him in the hope he might reply to the thread at some point @yingtong
 

yingtong

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Hi Tinyface,I've been T1 for 55 years,and 4 years ago I totally lost my hypo awareness after 40 years of good control,I did,as advised I run BS at10 for9 months but to no avail and I was offered a pump,which I accepted and after about 6 months my hypo awareness started to return and I am back to 90% of what I used to be,albeit the symptoms are completely different,but I am aware of hypos.I had many incidents of where I need third party assistance ,which I had never previously need.Please talk to your diabetes team,mine was of tremendous help.I wish you the very best of luck.
 

Tinyface

Active Member
Messages
32
Type of diabetes
Type 1
Definitely try to get yourself on a DAFNE course. It gives a lot of good fine tuning tips even for people who have been T1 for a lomg time. There's usually a long waiting list for them, though, several months or a year.

We can't give dosing advice but I don't suppose the DAFNE people will mind me quoting from their guidance which says that as a very general rule or starting point that 1 unit of insulin will lower blood glucose by 2 to 3 mmol/L, and 10 grams of carbs will raise it by 2 to 3 mmol/L. They'll generally suggest that 1 unit will do for each 10g of carbs. Works for some people, but others find it's more,say 1.5 units for each 10g - needs a bit of experimenting, they'll suggest trying the same meal a few days running on 1 to 10 and if going too high or low later, tweak it up or down.

I think a lot of us end up on a rollercoaster because we more or less guess insulin, go hypo and then take way too much sugar to correct. DAFNE guidance says take 10g for a hypo and wait ten minutes then repeat if it's not sorted. You'd be surpised by how little glucose is needed to sort a hypo but we often (and this included me before my DAFNE course) just eat till we feel better and that's usually way too much, and then you're correcting to try and bring it back down. Th e reason waiting ten minutes is important is that glucose takes some time to get from your stomach into your blood stream. It's difficult when you're panicking but try to be patient.

I've lost a lot of hypo symptoms but still notice a feeling of lightness,so maybe it's a case of watching out for subtler signs.

If you're hypos are getting really bad, ask about funded CGM. If you can't get it, maybe think about buying a Freestyle Libre. Each sensor lasts 2 weeks and costs about £50. You don't need to use it all the time. Even just a couple of weeks shows a whole lot of stuff you'd never know by just using strips. By far and away the best bit is that because it's reading sugars constantly, it shows a downward arrow if you're dropping quickly. That way,if you're at, say, 5 or 6, with a downward arrow, you can start thinking about sorting out a possible hypo before it happens.

My doctor says I have to test test test..he said they only give funding for a CGM if you are going unconscious with hypos..he said about the cash strapped nhs...thank you for all the great advice will spk to my diabetic nurse and ask about DAFNE course...
 

Tinyface

Active Member
Messages
32
Type of diabetes
Type 1
Hi Tinyface,I've been T1 for 55 years,and 4 years ago I totally lost my hypo awareness after 40 years of good control,I did,as advised I run BS at10 for9 months but to no avail and I was offered a pump,which I accepted and after about 6 months my hypo awareness started to return and I am back to 90% of what I used to be,albeit the symptoms are completely different,but I am aware of hypos.I had many incidents of where I need third party assistance ,which I had never previously need.Please talk to your diabetes team,mine was of tremendous help.I wish you the very best of luck.

Thank you and am soo glad you're back on tract..
 

Tinyface

Active Member
Messages
32
Type of diabetes
Type 1
Forgot to say - If you adjust your fast acting insulin ratio then drop it slightly for three days to see if you have less hypos. Also remember that if you have one hypo then you often have another one a few hours later so eat a bit more than normal. This is because on your first hypo your liver dumps Glucogen into your blood and later that day it will use some of the carbs you eat to replace the Glucogen in your liver. Just remember that everyone is different with how much insulin they need and that at various times of the day you may need more or less insulin. For me I have 1u Novorapid for 5 carbs in the morning but in the afternoon and evening it is 1u for 7 carbs. It's something that your DSN can help you work out. If you are having constant hypos then either your basal insulin is too high and/or your Basal Novorapid ratios are wrong.

Thank you Karen..my nurse told me to get Id but not where to get it from..been on phone to nurses but to be honest I have had more information here..they have not told me about any of the things you have mentioned but next week I will have a lot more questions he x
 

Tinyface

Active Member
Messages
32
Type of diabetes
Type 1
Thank you Karen..my nurse told me to get Id but not where to get it from..been on phone to nurses but to be honest I have had more information here..they have not told me about any of the things you have mentioned but next week I will have a lot more questions he x

Also yes think I should deffo get one of those phones .where do they sell them?
 

novorapidboi26

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2,828
Type of diabetes
Type 1
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Pump
one reason i was given as a child was that I may occasionally produce my own insulin, but after 50 years of diabetes I can't see that still happening.

And yet its still happening.....

I would some research to be done on this kind of thing....
 
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philchap1

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Messages
3,730
Type of diabetes
Type 1
And yet its still happening.....

I would some research to be done on this kind of thing....
I was diagnosed in 1967 after being knocked off my bicycle by a car (Yes there were a few cars then lol) there was and still not any other type 1 diabetics in the family, i have always wondered if my pancreas was damaged in the accident rather than my own immune system causing the problem, at the time of the accident i wasn't taken to the hospital as the local doctor came to the house and said that I would be fine in a few days, i have asked my consultant this question but i don't think they can really answer it.
 
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mazza31

Member
Messages
6
Type of diabetes
Type 1
Treatment type
Insulin
Currently getting loads of hypos no awareness took me 3hrs to get this mornings hypo to rise to 7 now being told by nurses again to run blood sugars higher again! Anyone else fed up of this cycle! 12 yrs down the line same old story