mangobe
Active Member
- Messages
- 33
- Type of diabetes
- Type 1
- Treatment type
- Insulin
Hi @mangobe. Can I ask, what would you call a 'warning symptom' if you never had hypos before 1995? I personally think that when most people talk about 'warning' symptoms they are already in hypo territory but just not that bad. Very few of us can actually predict a hypo.
Hey @chrisopher who 'likes to be tagged in a post' - are you really chrisopher wihout a 't'?
Your question is liable to send me on a rant - this issue has had a huge impact on my life so it is not just a question of semantics in differentiating between the vastly different experiences of hypos averted and severe hypos suffered. The difference between slight tingliness at BG of 4.0 and complete absence of physical symptoms at BG of 0.8 is an entire world (a life or death difference?). For me potential hypos' were all successfully averted (for 15 years) because I had very clear warning signs that came on before my blood sugar dropped into dangerous territory, with the result that once I lost my warning symptoms and suddenly began suffering severe hypos in which I lost touch with reality and or lost consciousness with no warning, I didn't recognise or understand what was happening to me. I had had no experience whatsoever of this - I simply hadn't ever had even a minor hypo before. From this point hypos necessarily became something different and much more dangerous.
There is a very big difference between 'warning' symptoms such as tingling lips or hands, that can signal an impending hypo while blood sugar is still in acceptable range, and symptoms that are side-effects of a full blown hypo attack with dangerously low blood sugar and which may only occur very late in an attack, once one has lost consciousness. The crucial difference lies in the timing of their effect, as only early symptoms can work as essential warnings, while obviously late side-effects can't. If you lose those early warning symptoms you will have severe hypos and then discover that even symptoms such as profuse sweating may now only happen so very late in the hypo process, when blood sugar has dropped below 1, that they can no longer count as warnings. As a result it is meaningless to talk about symptoms of hypoglycemia without differentiating between warning symptoms and late symptoms.
Unfortunately, since increasing numbers of diabetics started to become hypo-unaware, medical language hasn't been changed to accommodate this new reality. At every clinic appointment I'm still asked to fill in a form with a heading that declares it is interested in hypo-unawareness and is a questionnaire to establish what warnings I still have, but the questions are impossible for me to give accurate answers to. For example, my answer to 'Do you experience sweating as a warning symptom' would be No, but my answer to 'Do you experience sweating as a side effect very late in a hypo attack', would be Yes, but the question actually asked is only 'Do you experience sweating' which is quite meaningless in this context.
I have a similar issue with the new Hypo Awareness tool on this site as it too doesn't differentiate between early warning symptoms and late symptoms and is also misusing the word Hypo-Awareness, which could have dangerous consequences. For a long time after I lost all warning symptoms I didn't encounter any doctors or nurses who had experience with this and was struggling to understand what had happened to me on my own. Hospital clinics repeatedly gave me questionnaires that asked a series of questions on Diabetes including 'Are you hypo-aware?' I interpreted this question to mean 'Do you know and understand what the warnings/symptoms of hypos are?' So I always answered 'Yes' because I WAS aware of what the symptoms were supposed to be, even though I no longer experienced them. Consequently I wasn't identified as Hypo-Unaware' or needing help with hypo-unawareness and didn't receive any help. For a long time I didn't know that 'Hypo-Unawareness' was already recognised as a distinct separate condition that greatly impacts diabetic control. Today it is still poorly understood by those who don't have it, so misusing its name to describe a tool meant to educate people about the warning symptoms of hypo-attacks is a VERY bad idea. I can see all the confused diabetics who've used the tool and now think they are well-educated about hypos and fully hypo-aware, answering Yes to that very same question even when they lose all warning symptoms.
I should probably post this in a more appropriate place but didn't want to stop while the ranting bit was between my teeth