What's the lowest hypo value you're ever had?

[joanne75]

I was only looking the other day to try and find the same answer that you have asked, I suffered a terrible hypo a couple of days ago 1.8 and thought ok so at what point would I have gone unconscious, I did ask my DSN today who said that its different for everyone but she did say that 1.8 was dangerously low. I have only ever experienced one episode of unconsciousness so am fairly lucky in the fact that it would normally wake me up and it did this time but a lot lower then my normal 3.2.

 

[Hoping4Cure]

Can I ask what is the point of the poll @Hoping4Cure ?

By way of deduction, to ascertain what the likely minimum is prior to loss of consciousness. It's a factoid that I've never come across before, and that seems odd to me.

It's impossible to measure one's blood sugars whilst unconscious, innit, at least not without a CGM which is a relatively new invention which not everyone has access to. (I don't have one). I would have thought that was obvious by apparently it wasn't.

I find it sad that my motives for creating this poll are assumed to be malign or spurious rather than out of scientific curiosity. It's an entirely voluntary poll, if people are willing to share their values then they are welcome. If not, fine too. The mods can delete this thread if they are so easily offended by earnest scientific inquiry. I hope they don't, but that's not up to me. My perspective is this: I treat others as adults (we all realize this is in fact a deadly disease, do we not?), and give them the benefit of the doubt. If people cannot handle discussing the negatives of this disease, how to avoid them, the threshold at which they become life-threatening, then this isn't serious.

 

[noblehead]

By way of deduction, to ascertain what the likely minimum is prior to loss of consciousness. It's a factoid that I've never come across before, and that seems odd to me.

The point is, if the loss of consciousness is sudden then it's unlikely that the person tested their bg levels prior to the event, so a poll is never going to be scientific in any sense.

Not being picky just merely pointing this out to you @Hoping4Cure

 

[TheBigNewt]

The LOC in a low is not sudden. The glucose drops gradually. And sure people can function, make perfect sense, appear "normal" at quite low sugar levels. My friend's daughter wasn't answering her phone recently, she called a friend asked her to go over and check on her, they did, left, said "she seemed OK". Well soon thereafter the needed the paramedics. The thing is you get too confused to help yourself even if you physically can. To me it's like I'm in a fantasy land, it's rather pleasant at times, scary at other times. If it's pleasant I am at a danger to ignore that I'm low and continue on. If there's no one around to notice I'm a gork, that's when it gets dangerous. When your BS is 3 you may be OK but you don't have much leeway if you get lower.

 

[DiabeticDadUK]

I'm not offended by this but I don't think it's especially scientific or hugely beneficial beyond general interest.

I ask a consultant many years ago; "what's the lowest I can go without going face down into the carpet?" His response was the same as others have experienced in that he simply couldn't say as it varies from person to person. He had seen patients totally gone with 2 and others chatting and still ok in the 1s.

I've had BG in the low 2s and been fine enough to handle it without help, if that helps or interests anyone

 

[Juicyj]

@Hoping4Cure As stated before there isn't a 'set' threshold for losing consciousness, everyone's tolerances are different then you have to factor the speed at which blood glucose levels are dropping and hence why there isn't a definite answer. A CGM is also not an effective tool to accurately measure this reading, due to the method by which it collects data from subcutaneous tissue rather than direct from blood, so this is inconclusive.

Avoiding this at all costs is of course our motivation to manage our condition effectively. I know from reading about other type 1's who have found themselves in the distressing position of being woken up in a dazed and confused state surrounded by paramedics with no recollection of what has happened and taking days to recover and so hope that none of us ever finds ourselves in this state.

 

[Hoping4Cure]

The point is, if the loss of consciousness is sudden then it's unlikely that the person tested their bg levels prior to the event, so a poll is never going to be scientific in any sense.

Incorrect.

Deducing a critical threshold, beyond which there is no data (because taking the data under that threshold cannot be done), can be achieved indirectly via a "survivorship bias":

https://en.wikipedia.org/wiki/Survivorship_bias#In_the_military

"During World War II, the statistician Abraham Wald took survivorship bias into his calculations when considering how to minimize bomber losses to enemy fire. Researchers from the Center for Naval Analyses had conducted a study of the damage done to aircraft that had returned from missions, and had recommended that armor be added to the areas that showed the most damage. Wald noted that the study only considered the aircraft that had survived their missions—the bombers that had been shot down were not present for the damage assessment. The holes in the returning aircraft, then, represented areas where a bomber could take damage and still return home safely. Wald proposed that the Navy instead reinforce the areas where the returning aircraft were unscathed, since those were the areas that, if hit, would cause the plane to be lost."

In short, it's not necessary to find the exact number, just the numbers above which, are safe. So my query is actually apt. The actual reason this is not scientific is because it relies on memory and is a voluntary poll. I never claimed it to be.

-------------------------------------------------

Besides, I find it hard to believe that I'm the only person on here who's ever looked at my sugar meter's stats in a spreadsheet and queried for the lowest value over a time range. I didn't ask for any morbid details of anyone's life experience, just a number. If I were one to take offense easily, having my motives questioned for the crime of curiosity would do it. (not saying you are doing that). These excursions are just as important as an average, and of clinical significance. People share their HBA1C here all the time, so what I asked is in no way, shape or form outside of the norm here. It is literally just a number.

I checked mine over all my many thousands of sugar readings over the past ten years and 1.1 was my absolute lowest. I suppose I must have built up a tolerance for them over the years due to having so many (and conversely, hypo unawareness). Thankfully the unawareness went away when I got my sugars under control. Now I can feel a hypo around 3.1 ish, and I wake up automatically too. I used to have an average of one severe hypo episode per day when I was a runner on a HCLF diet. Switching to LCHF cut that number down to 2-3 / month and my unawareness is gone. This probably saved my life. And yes, I do consider hypos to be deadly serious, so I actually do resent anyone implying I don't. I've woken up in the hospital several times, not knowing who I was, been in comas, crashed my car, etc.

 

[Hoping4Cure]

@Hoping4Cure As stated before there isn't a 'set' threshold for losing consciousness, everyone's tolerances are different then you have to factor the speed at which blood glucose levels are dropping and hence why there isn't a definite answer.

I never implied this poll would give me a definite answer, nor does it need to. Do you think this topic hasn't been studied? I'm sure it has, I've just never seen any results mentioned or published in the media, but I can dig deeper. People share their sugar readings here ALL the time. Frankly, I should never have asked, people are reacting to this poll emotionally, including the moderators. Having an emotional reaction to a query about the lowest value in a range is hardly appropriate (it is just a number), nor is casting aspersions as to my motives for merely having a curious mind.

I queried my own lowest sugar readings over my entire testing data, during my own hardships against hypos, and found my own answer. If others are simply not curious enough to query it for themselves, I have to wonder if this is in fact even reckless or irresponsible on their part. If as you say everyone's tolerances are different (citation needed), then they should at least be aware of their own tolerance, should they not? This is life and death stuff, you know.

 

[Drewabetic]

I think hypos are terrifying depressing and horrifying in equal measure.
I've been type 1 for 58 years I've had a few in that time.
I feel awful for days afterwards.
I'm currently getting help from my diabetologist/endocrinologist complex type 1 diabetic team at the QEHB or UHB theyre supplying CBG sensors Enlite to support my Medtronic 640G Pump. I've successfully lowered my HgbA1C from 13% old money to 7% but hospital wont fund.
NICE say diabetics of my length and instability having been SUPER stable as a child and younger adult should be supported with this technology.
I've had lots of experience but my autonomic nervous system simply won't play anymore.
Any help regarding funding streams would be welcome.
Thank you everyone who reads this.
Paul

 

[Snapsy]

On my Libre, it's read LO (not sure what that means) and I did feel quite disorientated lol.

Sub-2.2, according to the Abbott customer service guy I spoke to yesterday.

 

[Juicyj]

I never implied this poll would give me a definite answer, nor does it need to. Do you think this topic hasn't been studied? I'm sure it has, I've just never seen any results mentioned or published in the media, but I can dig deeper. People share their sugar readings here ALL the time. Frankly, I should never have asked, people are reacting to this poll emotionally, including the moderators. Having an emotional reaction to a query about the lowest value in a range is hardly appropriate (it is just a number), nor is casting aspersions as to my motives for merely having a curious mind.

I queried my own lowest sugar readings over my entire testing data, during my own hardships against hypos, and found my own answer. If others are simply not curious enough to query it for themselves, I have to wonder if this is in fact even reckless or irresponsible on their part. If as you say everyone's tolerances are different (citation needed), then they should at least be aware of their own tolerance, should they not? This is life and death stuff, you know.

Your response concerns me greatly, simply because you imply that you are testing your tolerances in regards to hypos, as a type 1 you should be avoiding hypos at all costs and should be aware of the NICE guidelines in regards to hypos, this is a sensitive discussion particularly for those who have suffered this experience and your attitude to this topic implies that no one reading this is taking this seriously - no one should be testing their tolerance in regards to hypos this is reckless behaviour.

 

[TheBigNewt]

To Hoping4Cure: you are quite fortunate that you wake up at night around 3.1. I'd give anything for that. And I think that the most important reason to mess with another device, the CGM, is to warn you when you get low, especially at night. Like I said before my friend's kid's Dexcom wakes him up via his cellphone if it goes below 4.0. It wakes my friend up too. That's a tremendous benefit IMO. No way I'd consider one that didn't offer that feature.

 

[Hoping4Cure]

I think hypos are terrifying depressing and horrifying in equal measure.
I've been type 1 for 58 years I've had a few in that time.
I feel awful for days afterwards.
I'm currently getting help from my diabetologist/endocrinologist complex type 1 diabetic team at the QEHB or UHB theyre supplying CBG sensors Enlite to support my Medtronic 640G Pump. I've successfully lowered my HgbA1C from 13% old money to 7% but hospital wont fund.
NICE say diabetics of my length and instability having been SUPER stable as a child and younger adult should be supported with this technology.
I've had lots of experience but my autonomic nervous system simply won't play anymore.
Any help regarding funding streams would be welcome.
Thank you everyone who reads this.
Paul

This seems like it's worth its own thread. Condolences for not being able to afford the gear you need, maybe people here or a community charity drive can help.

The only advice I could offer relates to my worst period, in 2011, when I was having 1 severe hypo per day on average. It turns out it was entirely due to my lifestyle and not something inherent in my diabetes being different than anybody else's. We are all more alike than different, I believe (although I agree that one size does not fit all, studies do show general trends which can inform healthy life choices).

I thought I had metabolic lability (instability) and even tried to use this fact, combined with my then-hypoglycemic unawareness, to get an islet cell transplant, but after testing they said my metabolism is actually OK and if you improve control then you will feel hypos again and their frequency will go down. Sure enough, they did. So the solution to my crisis was a LCHF diet which cut my insulin requirements and consequently cut my hypo frequency and severity dramatically, which in turn restored my hypo awareness too and my feeling safe to go to bed. My family was grateful when I told them I don't feel like the way I'll die is all of a sudden, and in my sleep, alone. It's terrifying.

So yeah....F carbs. They are literally my mortal enemy.

 

[Hoping4Cure]

To Hoping4Cure: you are quite fortunate that you wake up at night around 3.1. I'd give anything for that. And I think that the most important reason to mess with another device, the CGM, is to warn you when you get low, especially at night. Like I said before my friend's kid's Dexcom wakes him up via his cellphone if it goes below 4.0. It wakes my friend up too. That's a tremendous benefit IMO. No way I'd consider one that didn't offer that feature.

Oh sometimes I wake up with lower but avoiding hypos in the first place is the most important first step, and doing that is basically a function of avoiding insulin OD or too much IOB creeping up on you during the night (or any time really). My way of achieving that, given that I neither use a pump nor a GCM (though I agree an auto wake up is a wonderful feature), is merely through LCHF diet + GLP-1 combo + not eating after 8pm.

I also check myself when going to the bathroom at night.

If I had a CGM I think I could avoid 99% of hypos. But 2-3 minor ones per month is totally fine by me. And by minor, I mean over 3-ish, below that is when I consider it getting in the orange / red zone. In the mid-3s I don't worry and just fix it (one sip of OJ does it). Actually, my main concern with treating hypos is avoiding rollercoastering back up to a hyper. So I try to take the smallest possible means of correction.

What I find more disturbing at this point, is that I can sleep all night with high sugars without realizing it until I wake up (feeling tired like I didn't get any rest).

 

[Hoping4Cure]

Your response concerns me greatly, simply because you imply that you are testing your tolerances in regards to hypos, as a type 1 you should be avoiding hypos at all costs and should be aware of the NICE guidelines in regards to hypos, this is a sensitive discussion particularly for those who have suffered this experience and your attitude to this topic implies that no one reading this is taking this seriously - no one should be testing their tolerance in regards to hypos this is reckless behaviour.

I never suggested deliberately having hypos just to see how low one can get, please don't put words in my mouth. That's not what I wrote nor what I meant. I meant do your best to avoid them and merely checking long-term sugar data for the lowest-value excursions. There is nothing reckless about that. To the contrary, not knowing your own data range is what I consider to be reckless. Diabetics have literally one job to do: keep their sugars in range. How can you know what your range is without knowing the lowest value you got? This makes literally no sense.

In stats, the mean isn't the only significant number. Min, max, variance, all these are important.

 

[Juicyj]

@Hoping4Cure - Fortunately this is why we have meters and so all type 1's can test and manage their condition, so any responsible type 1 will know their levels at any given and tested point in time. Knowing the lowest you can go to has no bearing on your control - focusing on staying within your target range is your priority. What you cannot control is the effect of exercise, hormones and the rate at which insulin is utilised in the body, so there are variables beyond any type 1's control and so sadly hypos are inevitable. A closed loop system could mimic the action of the pancreas and reduce the level of hypos experienced. You seem a little fixated on stats, but knowing how low you can go isn't a guage to measure your control by, just focus on staying within your target range.

 

[Pauntiep]

This is a really interesting topic. I'm only just experiencing hypos , lowest 3 but I'm t2 on insulin. I'm curious about how you avoid when exercising?

 

[Hoping4Cure]

Everything you wrote is true Juicy but I'm not content with merely controlling my type 1 diabetes, I want to beat it. And to do that, knowledge is key.

Aside from this, knowing the point at which I'll drop unconscious or lose my sight could indeed save my life, and likely has a few times already. I've run out of glucose pills from a severe hypo, then had another one, while walking, exercising and even driving. Stopping your car in the middle of nowhere could result in you dying too (imagine the horror of your phone being dead too...it's happened to me, all these things going wrong at the same time), so being resilient and able to get somewhere in one piece to get a candy bar is helpful.

The body can be trained to do many things, including work under mental duress and even outright impairment. I've had cases where I was working for hours and didn't realize my sugars were low the entire time, because, let's face it, while your brain is starved for sugar it's not in a competent / rational state (in fact you could probably get exculpated for your actions in this state). When I finally fixed my sugars and reviewed my work I wondered "what is this nonsense?" This is why I check my sugars before writing any emails at work, hypo and even hyper-glycemic episodes can have a detrimental effect on your professional career if you're not careful. Getting irritated / enraged / defensive / paranoid are only some of the reactions from this disease.

So yes, absolutely, knowing more facts on the signs and effects of hypos on the body and mind can help you out of a tough spot, or even mean the difference between life and death. I've woken up in my bed after a night out, not knowing how I got there, and with bruises, cuts on my knees and torn jeans (from crawling home on my knees while semi-conscious, presumably). I never black out from alcohol, but hypos have messed me up and blocked out many memories. This has even happened to me during the day, just walking home from work, literally falling over, banging my head. So tell me again how it's not important to know when you're going to collapse so you can yell to a stranger for help or even eat a candy bar from a shoppe despite not having any money or even being able to articulate what you're doing. My worst nightmare, not being able to ask for help or explain how I need a muffin or candy from a store clerk, has happened many times. It's infuriating, frustrating, degrading. Have you ever been arrested for your diabetes? I came close, twice. Once when I crashed my car due to a sudden blackout and complete loss of vision, and the cops assumed I was drunk and made me take a breathalyzer. I lost my license as a result (I got it back later when my hypo frequency got better).

All this is to say, that yes, I do think it's significant to know the rough point at which one will collapse due to a hypo. Frankly, I find it odd that I even have to rationalize my asking. Other type 1s should know exactly how this feels. And being able to tell this information to friends and family is also vital. I've had friends who nearly came close to killing me by thinking when I passed out that I needed MORE insulin. Ignorance is not bliss, it's a killer.

 

[Juicyj]

Ok let's be clear here, as a type 1 I consider anything less than 3.8 to a hypo, however I consider using carbs at 5mmol/l, firstly because I drive so protecting my licence is critical, also because I know that I can easily drop below 5 so having say 10g of carb will keep me below 8 and within range. Reading what you have said you have experienced quite a lot of bad hypos so can you tell me that your control has been good, because it reads like you have lost control of your type 1 on many occasions so no wonder you are curious about lows.

Personally I try to remain as stable as possible which has been helped by careful carb ratio control and lots of bg testing, I haven't in 5 years suffered a severe hypo, I have had horrible hypos which have been linked to exercise, so I remain vigilant around exercise.

Have you considered using a pump at all ? I've been on a pump over a year now and very rarely have a hypo lower than 3, and no more than 2 a week on average, except for last Sunday where I had 3 and all were linked to gardening (exercise).

Knowing what triggers hypos to me is more important than gauging results as I can then take evasive action and learn how to avoid, how low I go has no bearing or influence on this.

 

[SugarBuzz]

I just had my lowest recorded bs for years and years with a 1.8 mmol reading a few hours ago - I blame the low carb diet - tingling all over - very strange hypo, I've never had one like it - zero sweat.
Anyway, I was still able to make myself some brown toast with blueberry jam and porridge whilst I tingled away. So a tasty and enjoyable end.