Hypos and treatment time

[Hayli]

Hi, I am new to this forum but have been T1 for 25 years now.

I've found recently that its taking about 40 minutes for any hypo treatment to work and wondered if anyone else had this problem? I have tried apple/orange juice, dextrose tabs and sweets... on speaking to my nurse she said juice is too slow (this is not what I was told before!) It also means I usually end up over treating them which is a pain.

Any advice from anyone who had had this? Thanks

 

[Juicyj]

Hi there @Hayli welcome to the forum

How are you testing your BG levels, libre/meter ?

 

[Antje77]

Hi @Hayli , welcome to the forum!

I've found recently that its taking about 40 minutes for any hypo treatment to work

May I ask, does it take this long before you feel out of hypo or to test above 4?
For me, it takes longer to feel right again than it takes for my blood glucose to go up.

Second question, does it take 40 minutes according to a fingerprick or according to a Libre/CGM?
For me, it can take half an hour for my sensor to read above 4, after a fingerprick has long confirmed I'm in the safe zone again.

 

[Hayli]

Hi there @Hayli welcome to the forum

How are you testing your BG levels, libre/meter ?

Thankyou! Yes testing on a libre.
After so long testing manually I very very rarely use my monitor now! The other issue I've had on occasions is even after treatment and getting the numbers up, it has dropped again within an hour!

 

[Hayli]

Hi @Hayli , welcome to the forum!

May I ask, does it take this long before you feel out of hypo or to test above 4?
For me, it takes longer to feel right again than it takes for my blood glucose to go up.

Second question, does it take 40 minutes according to a fingerprick or according to a Libre/CGM?
For me, it can take half an hour for my sensor to read above 4, after a fingerprick has long confirmed I'm in the safe zone again.

Thankyou!
Yes that's for it to come up on the Libre. I don't take my monitor out with me anymore but sounds like maybe I should? Even if my Libre shows over 4, it often drops down again very quickly to the 3's (within 10 minutes) and as I said above, I can then hypo again within an hour.

I'm playing around with my bolus to try and avoid hypos all together as I was having about 4 a day over the past week!

 

[Antje77]

Yes that's for it to come up on the Libre. I don't take my monitor out with me anymore but sounds like maybe I should?

I'd definitely test 15 minutes after treating the hypo to see what a fingerprick says, you might find the treating is working just fine.
I'm thinking the glucose goes to important parts first, brains, organs, fingertips. I would imagine the interstitial fluid right under the skin of the back of my arm is not very high on the list.
However, that's just the kind of thought I have when having a hypo, could be complete balderdash.

Even if my Libre shows over 4, it often drops down again very quickly to the 3's (within 10 minutes) and as I said above, I can then hypo again within an hour.

It is often advised to first treat a hypo with something quick acting (juice, dextro tabs, sweets) and follow up with something slower acting like biscuits or bread or something once you're above 4 again to prevent dropping again.

 

[Hayli]

I'd definitely test 15 minutes after treating the hypo to see what a fingerprick says, you might find the treating is working just fine.
I'm thinking the glucose goes to important parts first, brains, organs, fingertips. I would imagine the interstitial fluid right under the skin of the back of my arm is not very high on the list.
However, that's just the kind of thought I have when having a hypo, could be complete balderdash.

It is often advised to first treat a hypo with something quick acting (juice, dextro tabs, sweets) and follow up with something slower acting like biscuits or bread or something once you're above 4 again to prevent dropping again.

Ah yes so this is another thing I should have mentioned! So I was preliminary diagnosed with Coeliacs literally less than a week ago (waiting for a biopsy for the official outcome) which I have just learnt means you don't absorb nutrients very well? Plus the biscuits probably weren't doing me any favours!
I don't know if this would have an effect on treating hypos but my gp thinks I have probably had it for a really long time and this 40 min average is pretty new.
I will start taking my monitor with me to see if I get different results next time!

 

[Juicyj]

Hi @Hayli

As you know libres are 15-20 minutes off the boil, so always test a hypo with your BG meter for accuracy, you'll find your hypo isn't lasting that long if checked on a BG meter. If you are diagnosed coeliac then it shouldn't affect the length of time you experience a hypo, but using a CGM is fine for seeing when you are starting to go low or high again but not as an accurate measure for hypo timing.

Also continue with the glucotabs/jelly babies/juice, all are the best/quickest fast acting treatment, never treat a hypo with anything else, as Antje has said check every 10-15 mins and if not above 4 then re-retreat until you are above 4 on your meter. When you are above 4 then eat 10g of carb to keep levels stable, also take care as after having a hypo we can dip again later on as the liver restocks glucose stores so keep a careful eye on your levels.

Personally I find CGM's are useful for checking patterns and seeing what's going on, direction of BG changes and speed, but I never use them for checking against a hypo, it's vital to use a meter when going low, also sense check yourself too, can you feel a hypo coming ? We rely on tech but it's vital you can feel them coming too

 

[Hayli]

Hi @Hayli

As you know libres are 15-20 minutes off the boil, so always test a hypo with your BG meter for accuracy, you'll find your hypo isn't lasting that long if checked on a BG meter. If you are diagnosed coeliac then it shouldn't affect the length of time you experience a hypo, but using a CGM is fine for seeing when you are starting to go low or high again but not as an accurate measure for hypo timing.

Also continue with the glucotabs/jelly babies/juice, all are the best/quickest fast acting treatment, never treat a hypo with anything else, as Antje has said check every 10-15 mins and if not above 4 then re-retreat until you are above 4 on your meter. When you are above 4 then eat 10g of carb to keep levels stable, also take care as after having a hypo we can dip again later on as the liver restocks glucose stores so keep a careful eye on your levels.

Personally I find CGM's are useful for checking patterns and seeing what's going on, direction of BG changes and speed, but I never use them for checking against a hypo, it's vital to use a meter when going low, also sense check yourself too, can you feel a hypo coming ? We rely on tech but it's vital you can feel them coming too

 

[Hayli]

Thanks! Yes I can always feel a hypo coming on which is good as I find the alarms can be fairly unreliable on the Libre.

Fingers crossed I've had no hypos for the past 2 days so hoping the changes in my insulin are correct. I will start taking my monitor with me again but just got out of practice after getting the Libre.
My nurse recommended glucose juice as a quick treatment but its fairly expensive and I was a bit annoyed when she said orange juice was too slow as I've always been told to use that!

 

[EllieM]

My nurse recommended glucose juice as a quick treatment but its fairly expensive and I was a bit annoyed when she said orange juice was too slow as I've always been told to use that!

I love my dexcom (had to stop using libre when I became allergic to it) but though it is great at hypo warnings when my bg is 4.4 it is pretty useless once I go below 4.

I have a tub of glucotabs that live on my bedside cabinet and I hit them if I go low.

 

[Rokaab]

So I was preliminary diagnosed with Coeliacs literally less than a week ago (waiting for a biopsy for the official outcome) which I have just learnt means you don't absorb nutrients very well?

Well I know when I was still eating gluten whilst being coeliac (undiagnosed), it actually caused what i believe was malnutrition for me (despite eating loads) so yes undiagnosed coeliac I'm pretty sure can cause problems with absorption, however once I went gluten free it sorted itself out and now afaik I absorb stuff perfectly fine (I can tell cos I put weight on if I eat too much now, never used to)

 

[Hayli]

I love my dexcom (had to stop using libre when I became allergic to it) but though it is great at hypo warnings when my bg is 4.4 it is pretty useless once I go below 4.

I have a tub of glucotabs that live on my bedside cabinet and I hit them if I go low.

Yes my nurse said the dexcom is alot better than Libre for early warnings.
It makes me laugh sometimes, I will test if i feel low- THEN the alarm comes up when it's already in the low 3s! but I cant complain my HBA1c has been its best ever since getting the Libre

 

[Hayli]

Well I know when I was still eating gluten whilst being coeliac (undiagnosed), it actually caused what i believe was malnutrition for me (despite eating loads) so yes undiagnosed coeliac I'm pretty sure can cause problems with absorption, however once I went gluten free it sorted itself out and now afaik I absorb stuff perfectly fine (I can tell cos I put weight on if I eat too much now, never used to)

Thanks this is useful to know. I have no obvious signs of malnutrition (weight has always gone up rather than down so I hope that doesn't get worse now!) I am GF now as my gp advised getting straight on it as i will have to wait a while for the official test due to covid delays

 

[Antje77]

I will start taking my monitor with me again but just got out of practice after getting the Libre.

Check the date on your teststrips!

 

[Deleted member 527103]

I don't take my monitor out with me anymore but sounds like maybe I should?

If driving in the UK, Libre reading are acceptable to DVLA but you must carry finger pricking tester with you as well. I assume this is in case your Libre fails.
The strips that come with the Libre reader are useful as they do not come in a tub but individually wrapped. Whilst annoyingly unenvironmental, it does mean I can chuck the meter and a strip of strips in my purse when I head out.

 

[LionChild]

Hi, I am new to this forum but have been T1 for 25 years now.

I've found recently that its taking about 40 minutes for any hypo treatment to work and wondered if anyone else had this problem? I have tried apple/orange juice, dextrose tabs and sweets... on speaking to my nurse she said juice is too slow (this is not what I was told before!) It also means I usually end up over treating them which is a pain.

Any advice from anyone who had had this? Thanks

There is a juice called LIFT which comes in small bottles, although it is rather expensive at £1.55 a bottle, but I have found this works better than anything else to bring BG levels up quickly. You can get it from chemists. I don't understand why your nurse says juice is too slow. In my experience it is faster than anything else I have tried, liquid or solid!

 

[Hayli]

There is a juice called LIFT which comes in small bottles, although it is rather expensive at £1.55 a bottle, but I have found this works better than anything else to bring BG levels up quickly. You can get it from chemists. I don't understand why your nurse says juice is too slow. In my experience it is faster than anything else I have tried, liquid or solid!

Thanks yes I was using the lift tablets for a while but found they work about the same as the dextro ones. I'll see if I can get some of the liquid!
I am now testing on my meter ALOT more and as most of you said- the figures are alot more reliable than my libre post hypo. Had a reading of 2.9 on the libre and 5 on my meter the other day!