How low can you go?

SueJB

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Just scared the sh******* out of myself, just felt a bit funny but nothing weird. Quick test 2.2
Frightened now to go to bed
How low can you go before you die?
 

Timostags

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Just scared the sh******* out of myself, just felt a bit funny but nothing weird. Quick test 2.2
Frightened now to go to bed
How low can you go before you die?
I don't think there is a specific number (I'm sure other will be able to give better info)

If it helps I had a 1.3 during the night on Friday night (libre reading) . The lowest I remember recording on my metre is a 1.1, and I managed to treat that without any assistance needed.
 
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evilclive

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I've seen 1.something on a fingerprick before. 2.2 is pretty low, but you're still conscious. Eat something, bring yourself back up (but don't overcorrect!), and bed will welcome you.

(think about why it went low - if it's just a bit too much insulin for a bit too little food or too much exercise, bringing yourself up then leaving it will be ok. If you've injected a lot too much insulin eg novorapid rather than lantus or an extra lantus dose, you'll need to keep an eye on things for longer, which probably means checking every hour till you're sure it's sorted. But it'll probably be the first type).
 
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SueJB

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I don't think there is a specific number (I'm sure other will be able to give better info)

If it helps I had a 1.3 during the night on Friday night (libre reading) . The lowest I remember recording on my metre is a 1.1, and I managed to treat that without any assistance needed.
Thanks @Timostags don't know how libre works but imagine it gives a warning bleep?
 

Timostags

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Thanks @Timostags don't know how libre works but imagine it gives a warning bleep?
You can get a device to attach to it called a miaomiao that can connect to a smart phone/watch and give you alerts.

I don't have it yet as I was awaiting to get the libre on prescription first, but I have now ordered 1 now.
 

SueJB

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I've seen 1.something on a fingerprick before. 2.2 is pretty low, but you're still conscious. Eat something, bring yourself back up (but don't overcorrect!), and bed will welcome you.

(think about why it went low - if it's just a bit too much insulin for a bit too little food or too much exercise, bringing yourself up then leaving it will be ok. If you've injected a lot too much insulin eg novorapid rather than lantus or an extra lantus dose, you'll need to keep an eye on things for longer, which probably means checking every hour till you're sure it's sorted. But it'll probably be the first type).
Thanks @evilclive yep, I'm still conscious, got myself back up to 6.3 now. Might have been food/insulin ratio but was 8.3 and dropped to 2.2 with only 1.5 units Novorapid
 

SueJB

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You can get a device to attach to it called a miaomiao that can connect to a smart phone/watch and give you alerts.

I don't have it yet as I was awaiting to get the libre on prescription first, but I have now ordered 1 now.
Don't have any of that, still using pens
 

Timostags

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Don't have any of that, still using pens
Getting a Libre seems to be a postcode lottery still at the moment.

The requirements for where I live is to have issues recognising hypo's and to have completed DAFNE.

I don't notice hypos until I'm around 2.5 normally and and doing DAFNE now (last day is this Friday).

There are a million threads about Libre on the forum if your interested
 

SueJB

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Getting a Libre seems to be a postcode lottery still at the moment.

The requirements for where I live is to have issues recognising hypo's and to have completed DAFNE.

I don't notice hypos until I'm around 2.5 normally and and doing DAFNE now (last day is this Friday).
I've done the DAFNE course which told me nothing. My pancreas is still bubbling out bits of insulin so it's unpredictable I suppose if I go hypo or not. Still sitting here wondering if it's OK to go to bed or whether I'm going to die in my sleep
There are a million threads about Libre on the forum if your interested
 

Scott-C

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Welcome to the club, @SueJB , you're fairly recently dx'd and I think we've all made those big mistakes at some point early in our careers - I certainly had a few bad un's in the first year or two, where I was scared of going to sleep.

Although a bad drop to 2, especially at night, can be barnstormingly scary, there is little chance of death.

When you drop below around 4, the body's "autonomic responses" kick in big style to make you safe: adrenalin is released to tell the liver to release glycogen, stored glucose, to nudge levels back up.

Most of the "feeling like ****" after a bad hypo is the after-effect of the adrenalin rush, not the low bg.

There are stories of "dead-in-bed" from a bad hypo, but look behind the scenes of those, and they're generally either, "we couldn't think of anything else to blame it on", or someone doing something extraordinarily stupid, like 50u.

I'd encourage you to ask your team about getting libre on script, and then blinging it with a miaomiao transmitter. It only takes up a tiny little bit of arm-space, and knowing that your phone is going to ring when you hit 4.5 or whatever you set it at, is a huge comfort blanket against nasty night hypos.

Edited by moderator to remove rude ‘us and them’ typist comment.
 
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Timostags

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I've got to admit I have found DAFNE has not helped me either with the exception of speaking to more experienced professionals than my normal DN. Who have advised me a pump may resolve alot of the issues I currently have, and that I should have access to a consultant (only seen a DN for several years who I have very little confidence in)
 

SueJB

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Welcome to the club, @SueJB , you're fairly recently dx'd and I think we've all made those big mistakes at some point early in our careers - I certainly had a few bad un's in the first year or two, where I was scared of going to sleep.

Although a bad drop to 2, especially at night, can be barnstormingly scary, there is little chance of death.

When you drop below around 4, the body's "autonomic responses" kick in big style to make you safe: adrenalin is released to tell the liver to release glycogen, stored glucose, to nudge levels back up.

Most of the "feeling like ****" after a bad hypo is the after-effect of the adrenalin rush, not the low bg.

There are stories of "dead-in-bed" from a bad hypo, but look behind the scenes of those, and they're generally either, "we couldn't think of anything else to blame it on", or someone doing something extraordinarily stupid, like 50u.

I'd encourage you to ask your team about getting libre on script, and then blinging it with a miaomiao transmitter. It only takes up a tiny little bit of arm-space, and knowing that your phone is going to ring when you hit 4.5 or whatever you set it at, is a huge comfort blanket against nasty night hypos.
Thanks @Scott-C I feel much better about going to bed with your kind words.. not just yet though. I'll give it an hour or so. Yep only had this condition for 18 months and this is an all-time low for me. Don't think I'd done anything stupid and my insulin units are tiny. I laugh when anyone mentions linking this to that and miao miaos, I've not even got a mobile which works and have never heard of purging the liver.. sounds gross. Really appreciate your message, very reassuring
 
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Scott-C

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Thanks @Scott-C I feel much better about going to bed with your kind words.. not just yet though. I'll give it an hour or so. Yep only had this condition for 18 months and this is an all-time low for me. Don't think I'd done anything stupid and my insulin units are tiny. I laugh when anyone mentions linking this to that and miao miaos, I've not even got a mobile which works and have never heard of purging the liver.. sounds gross. Really appreciate your message, very reassuring

No probs, Sue.

A couple of things to be aware of.

Because your body's adrenalin stores have maybe been depleted by that hypo and will take a few days to restock, there will be less of a response to later hypos.

And as your glyogen stores might have lessened with dealing with it, that will also reduce the ability to deal with hypos.

It's quite common for the liver to start sucking glucose out of blood to restock glycogen after a bad hypo, and, ironically, that can lead to another hypo - they often come in pairs.

The answer (there's always an answer with T1 - we deal with difficult stuff) is to rake back bolus shots and load up a bit more on oatcakes etc.
 

kitedoc

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Hi @SueJB,
Hypos can be scary.
Thar said the Chinese word for crisis is the same as for opportunity, you now have
a chance to work out how this hypo happened and how to prevent or minimise such an event in future.
Discussion with your DSN or doctor could prove useful in this endevour.
Consideration of things such as suggestions of possible causes mentioned by @evilclive above.
I note discussion above about diet too (DAPHNE) although that was in relation to qualifying for a Libre device.
The NICE guidelines for Type 1 diabetics , which are supposed to be backed by research findings do not recommend any particular diet.
Also be aware that alcohol in one's bloodstream can block the liver from releasing much needed glucose in a hypo situation, Even a glucagon injection might not work to ease the situation. In the past sometimes a diabetic has been arrested as being drunk and disorderly when in fact they have been in a hypo at the time.
But as a general premise the more insulin you are prescribed and inject the more risk of hypos and you may be able to identify, in conjunction with your DSN, the danger times. E.g. Hypos might be more likely when your insulin is working most strongly,
If you look up ' pictures of insulin profile' there are graphs ot tables showing an average or range of when a particular insulin is at its peak effect of lowering blood sugar. That peak time or a little while after might be a more likely hypo time, as well as sometimes if a meal is delayed a bit.
Lots of possibilities, hence the need to discuss it with DSN etc. Night hypos are a special category as when asleep recognition of them may be delayed. Sometimes waking in the morning with a headache and elevated bsls coukd suggest a hypo has occurred whilst asleep.
Sometimes after many hypos someone can lose the ability to detect or recognise the early symptoms of a hypo, and they are in the confusion, disorientation stage ( where the brain is struggling to keep things in order because of glucose fuel shortage). This situation is called hypo unawareness and needes careful professional management and safeguards such as no driving/ license until resolved. Therapy dogs and continuous monitoring with alarms might be needed. But when it comes to technology vs a canine, i personally opt for the canine every time.
Not sure that wondering how low someone can be blood sugar-wise before it is truly life-threatening is helpful.
One does not have to be all that low in a dangerous situation ( say, walking a tightrope, to take anextreme example,) for one to be in extreme danger, so the context/ situation also matters.
As all us TIDs do, we dust ourselves off, try to learn from each experience, repeat the good ones and avoid the bad ones.
Best Wishes and always, always carry glucose tablets or similar with you.:):):)
 
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SueJB

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No probs, Sue.

A couple of things to be aware of.

Because your body's adrenalin stores have maybe been depleted by that hypo and will take a few days to restock, there will be less of a response to later hypos.

And as your glyogen stores might have lessened with dealing with it, that will also reduce the ability to deal with hypos.

It's quite common for the liver to start sucking glucose out of blood to restock glycogen after a bad hypo, and, ironically, that can lead to another hypo - they often come in pairs.

The answer (there's always an answer with T1 - we deal with difficult stuff) is to rake back bolus shots and load up a bit more on oatcakes etc.
Morning @Scott-C and everyone. I'm still alive 4.1 but feel like pants. Sounds like I might be in for a treat, today............. hypos come in pairs!! I didn't know that and in a way, I wish I still didn't. going to worry. Yesterday I was hysterical, screaming and ranting and Mr B just didn't know what to do and this made everything worse. Hope you all stay in range
 

SueJB

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Hi @SueJB,
Hypos can be scary.
Thar said the Chinese word for crisis is the same as for opportunity, you now have
a chance to work out how this hypo happened and how to prevent or minimise such an event in future.
Discussion with your DSN or doctor could prove useful in this endevour.
Consideration of things such as suggestions of possible causes mentioned by @evilclive above.
I note discussion above about diet too (DAPHNE) although that was in relation to qualifying for a Libre device.
The NICE guidelines for Type 1 diabetics , which are supposed to be backed by research findings do not recommend any particular diet.
Also be aware that alcohol in one's bloodstream can block the liver from releasing much needed glucose in a hypo situation, Even a glucagon injection might not work to ease the situation. In the past sometimes a diabetic has been arrested as being drunk and disorderly when in fact they have been in a hypo at the time.
But as a general premise the more insulin you are prescribed and inject the more risk of hypos and you may be able to identify, in conjunction with your DSN, the danger times. E.g. Hypos might be more likely when your insulin is working most strongly,
If you look up ' pictures of insulin profile' there are graphs ot tables showing an average or range of when a particular insulin is at its peak effect of lowering blood sugar. That peak time or a little while after might be a more likely hypo time, as well as sometimes if a meal is delayed a bit.
Lots of possibilities, hence the need to discuss it with DSN etc. Night hypos are a special category as when asleep recognition of them may be delayed. Sometimes waking in the morning with a headache and elevated bsls coukd suggest a hypo has occurred whilst asleep.
Sometimes after many hypos someone can lose the ability to detect or recognise the early symptoms of a hypo, and they are in the confusion, disorientation stage ( where the brain is struggling to keep things in order because of glucose fuel shortage). This situation is called hypo unawareness and needes careful professional management and safeguards such as no driving/ license until resolved. Therapy dogs and continuous monitoring with alarms might be needed. But when it comes to technology vs a canine, i personally opt for the canine every time.
Not sure that wondering how low someone can be blood sugar-wise before it is truly life-threatening is helpful.
One does not have to be all that low in a dangerous situation ( say, walking a tightrope, to take anextreme example,) for one to be in extreme danger, so the context/ situation also matters.
As all us TIDs do, we dust ourselves off, try to learn from each experience, repeat the good ones and avoid the bad ones.
Best Wishes and always, always carry glucose tablets or similar with you.:):):)
Thanks @kitedoc, as with @Scott-C's reply, I've learnt something. I didn't know about insulin profiles so I'll check that out. Fear is an odd thing so my original question was an honest one
 

SueJB

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Morning @SueJB how are you this morning?

2.2? As @Scott-C says "welcome to the club", thing to do is learn from it. I suspect if you thing back over yesterday evening there may be something that caused the drop, miss calc insulin for evening meal, some IoB from earlier there are many possible things.

How low you have to go before travelling to meet your maker? Well no idea on that one but a 2.2 won't :)
Thanks @Knikki knew I could count on you for a nice bit of humour. Only had lunch yesterday, no evening meal but I reckon I must have overdone the Novorapid. Going to play very safe today, might even have a Jaffa cake
 
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kitedoc

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Hi @SueJB,
I have never met a TID who is not scared of hypos. You are not alone or out of kilter on that at all.
We all continue to learn, including me after 52 years on insulin.
Learning from other's mistakes if you can is the name of the game and sharing your own.
Of course sharing victories is even more legit !!
 

WuTwo

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And to whom the principle of ahimsa is a closed book that they refuse to open because it would make life more difficult for them.
I got my awareness back by deliberately running my levels high for a few months. It is a problem for those who prefer to run bloods at low levels - it doesn't take much of a drop to find yourself hypo and too many hypos = loss of awareness. Thankfully I got it back and in a way I learned my lesson. I run my bloods low but keep an eagle eye on the carbs because (with thanks to Dr Bernstein) small amounts = small mistakes...

I count every gram of carb I munch, and my ratios are individualised for each meal (took a LOT of testing), but it means that if I do muck things up, I don't go as low as I could. Today's huge brekkie was 10.4g of carb, and 2 units of humalog - if I have made a mistake well, how low can 2 units push me after dealing with the breakfast...

Not recommending being a total numbers nerd to everyone; it wouldn't suit most, but it totally suits me and helps me keep my bloods on the fairly straight and narrow.
 

MeiChanski

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Just scared the sh******* out of myself, just felt a bit funny but nothing weird. Quick test 2.2
Frightened now to go to bed
How low can you go before you die?
I hope you're okay
I survived a catastrophe but I've not been the same person since that accident.
I happened to be running low, but at the same time I was feeling tired so you'd think if you're tired, you'd take a nap and thats what I wrongly did. It was also quite sad that the GP at the time didn't prescribe me enough test strips to test. As soon as I climbed in bed, I don't know how long it took the paramedics to get me to come back, but I woke up to see a party in my room. One was looking at the time, one was managing the administration of glucose and one was writing all my details. If I'm correct, I was so slow that my body told me "hey girl we are preserving some energy, you might feel tired" and then during my blackout it was trying to shut down slowly because it didn't have enough glucose to keep all the organs running.

Few years on, lots of therapy, lots of appointments along with dafne I am doing a tad better, I am taking on each day at a time and I have come across a nice group of chums on this forum, because I have lost a few "friends" on the way. My new consultant seems okay, I'm hoping he can provide more help and insight because no T1 diabetic should be going through this. I know we can go low, but it shouldn't be low to the point where you can't assist yourself.
Look after yourself and have some rest :) Our livers need recharging as well.