Hypo

PeteN11

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Why not? It happens to all of us every night. After carbohydrate from the last meal has been used up, blood glucose falls and blood glucose falls. The liver releases glucose to keep the body ticking over while we sleep and until breakfast. You ever heard a non-diabetic not waking up because of low blood glucose?

The important point is that if, for whatever reason, a hypo is not treated you will survive. The average liver can supply 130 grams of glucose, enough to deal with a severe hypo. In the absence of a complicating co-morbidity, this always happens.
Some of the stuff you are saying is highly misleading and in part quite wrong.

What you state above happens to people who are non diabetic.

For most of us with T1 outside of the honeymoon period the Liver very rarely kicks in to keep glucose levels up during a Hypo. This is because the alpha cells in pancreas get confused when they detect Insulin in the body. If insulin is detected the body thinks BG must need reducing therefore no need for Glucagon to ask the liver to to raise that BG any more. T1's have too much injected insulin in their bodies for Glucogon to act the same as a non diabetic.

Hypo's at any time of day are serious. Those happening during sleep can be fatal and should be referred to their consultants. To say otherwise is incorrect.
 

DCUKMod

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....Yes, we should take precautions, be responsible, be vigilant and act promptly when blood glucose goes out of the target range. I have been working at this for 43 years. Sometimes life gets in the way, though, so don't be too concerned if for whatever reason a hypo isn't treated.


MarkMunday - With respect, were this the case, there would ever be a blue light call for a low hypo. Now, we know that just isn't the case.

Whilst you appear to choose to ignore hypos, if they happen at an inconvenient time, it is certainly not a strategy to suggest to anyone else.
 

urbanracer

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Neuroglycopenia (glucose starvation of the brain) occurs when blood glucose is 1.1 mmol/l. You ever seen such low blood glucose?

Yes, it happened to me on a plane on the way back from the US, and I managed to see 1mmol on my meter shortly before I passed out. I had not taken insulin for over 5hrs and had been feeling relatively fine up to that point. I came round with my wife and three stewardesses trying to force OJ down my throat. Not a great experience and fortunately nothing like it has happened since as I normally have hypo awareness if I get below 5mmol.
 
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MarkMunday

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Some of the stuff you are saying is highly misleading and in part quite wrong.

What you state above happens to people who are non diabetic.

For most of us with T1 outside of the honeymoon period the Liver very rarely kicks in to keep glucose levels up during a Hypo. This is because the alpha cells in pancreas get confused when they detect Insulin in the body. If insulin is detected the body thinks BG must need reducing therefore no need for Glucagon to ask the liver to to raise that BG any more. T1's have too much injected insulin in their bodies for Glucogon to act the same as a non diabetic.

Hypo's at any time of day are serious. Those happening during sleep can be fatal and should be referred to their consultants. To say otherwise is incorrect.
Not sure what you are getting at. Yes, the pancreas is not able to quickly detect insulin injected under the skin. The result of this is that glycogenolysis (conversion of liver glycogen to glucose) is not inhibited after injecting insulin. Blood glucose goes too high because of excess liver glucose, not too low. Glycogenolysis is stimulated by epinephrine and glucagon. Glucagon is is stimulated by low blood glucose, not insulin. Epinephrine is produced in the adrenals. Injecting insulin does not affect the mechanism whereby low blood glucose is rectified.
 

MarkMunday

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... you appear to choose to ignore hypos, ....
Reread my posts. I never said ignore hypos. I said don't be afraid of them and I explained why. The misinformed alarmist narrative doesn't do any favours. Especially to parents and young people with T1. It causes anxiety, depression and corresponding mental health issues. Instilling unwarranted fear in affected people makes dealing with T1 more difficult than it needs to be.
 

kev-w

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.

Low blood glucose by itself is not that dangerous.

I'd have to say that's nonsense, a low blood sugar prevents the brain getting sufficient oxygen hence the symptoms we get, a sleeping hypo, depending on the causal insulins lifespan can be very dangerous as the liver can't release enough sugars to compensate, that's why folk drop into a 'coma' from lows.
 

SueJB

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Hey everyone! This is the longest hypo I think I have ever had! Has anyone else had a hypo for this long without waking up? Slightly worring if I am honest!View attachment 42527
I've never had a hypo that long @No1DeadlyPoison, in fact because I have very little hypo awareness I worry. Not about having one because I know how to treat it but the lack of feeling anything until I'm 2 something
 

DCUKMod

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Reread my posts. I never said ignore hypos. I said don't be afraid of them and I explained why. The misinformed alarmist narrative doesn't do any favours. Especially to parents and young people with T1. It causes anxiety, depression and corresponding mental health issues. Instilling unwarranted fear in affected people makes dealing with T1 more difficult than it needs to be.

Mark, my local Diabetes UK group became nearly £2k better off a couple of years ago, as a result of the funereal donations and a quiz organised by a local pub (The pub regularly raises for DUK), following the sudden death of a young man - 21/22 - in a hypo state.

Allegedly, there had been alcohol in play and more than a "straightforward" hypo, but having a few drinks could easily fall into the "life gets in the way" category.

I'm afraid neither I, not this organisation, would ever condone a laissez faire attitude to clinical hypos. Whether or not you mean it, that is, in my opinion, exactly how several of your posts read.

As a T2, in longer term remission, and never having taken any meds for it, my personal experience of medically concerning hypos is the sum total of zero. That doesn't mean I have not read about them, and their potential path from just fine to fatal. That reading tells me that hypos don't fall into the "see how it goes in a few hours, when I feel a bit more like it" category.

A reasonable exception could be immediately prior to carby food being on the table, in front of the individual.
 
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PeteN11

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Not sure what you are getting at.
That is probably because you did not read or understand what I wrote.

The Liver will not release glucose whilst there is insulin in the body. It doesn't do it for non diabetics and it does not do it for T1's.
Non diabetic insulin/Liver glucose release is produced on a minute by minute basis whereas T1's normally inject a dose of insulin to last all day and then even more after meals. So even when a Hypo occurs the Liver does not intervene because the pancreas hasn't asked it to.

With no insulin in our bodies the liver can go on to produce glucose but the levels are inconsistent due to the fact that pancreas isn't functioning as it should be.

You only have to look at the read out from the original post. If the Liver was allowed to save us from Hypo's why did it not intervene at around 5am when the BG was starting to get too low?

If it took 4-5 hours for the Liver to step in then Non diabetics would be suffering from Hypo's as well.
 
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PeteN11

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Injecting insulin does not affect the mechanism whereby low blood glucose is rectified.
Of course it does. How do you explain T1's ever having a Hypo if all is well and good in the "low blood glucose rectification mechanism"?
 
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porl69

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Low blood glucose by itself is not that dangerous, even if a lot of insulin is driving it down.

All I can say is WOW! Have you ever had a severe hypo where 999 had to be called by a partner/friend?
 

Fairygodmother

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@MarkMunday, deep nighttime hypos are, in my opinion, best to be avoided. I’m not going to get into the liver secretion argument, that’s just a form of ping pong.
However, the tiredness the day after a nighttime hypo impinges on living well. Moreover, the physical effects of a nighttime hypo can be distressing, if not damaging. How many of us have had a hypo severe enough to affect movement and have risked, or had falls; how many people have been unable to reach out for a hypo treatment; how many of us have luckily known that we can’t safely negotiate a flight of stairs; how many people have come to to find themselves in a soggy sweat soaked bed with a couple of paramedics saying “I think s/he’s aware again”?
Luckily these episodes are pretty rare, I have no intention of scaring anyone, but they’re a good reason why we need help with getting insulin doses and food right, especially when we’re new to this game.
 

Jaylee

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Ladies & gentleman,

Can we please stay on topic regarding addressing the OP's issue..
Further going off the beaten track will result in deletions & thread bans.

Thanks for your compliance.
 
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Sadjers

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Hey everyone! This is the longest hypo I think I have ever had! Has anyone else had a hypo for this long without waking up? Slightly worring if I am honest!View attachment 42527
Was alcohol involved? My sugars rise rapidly after a few beers and crash back down after about 12hours. Apparently, your liver is working at digesting the alcohol and does not supply sugar to your blood.
I agree with most people's comments and you should try to stop the overnight hypos. Your liver will sometimes react to a hypo and increase your blood sugar. BUT, the liver will always take that sugar back. This can start a vicious up and down cycle.
 

Fairygodmother

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Sorry @No1DeadlyPoison, we’ve strayed from your own experience of the dastardly hypo fiend.
How are you now? Have you sought help from the people who advise on your diabetes, your DSN and doctor(s)? Hypos, as some of us have said, come with the territory, but it might be worth looking at the profile of the basal you use and discussing it with the professionals.
 

Rylando88

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Would it be possible for you to set a couple of alarms through the night to check your glucose levels match the readings given?
Another idea could be to try to go to bed with slighter higher readings than normal (around the 8-12mmol range nothing too crazy) just to see if it prevents you dropping too low in your sleep?

Do you have any alarms set on your device? I wear a Dexcom G6 at the moment and if my sugars go below 4.2mmol (I chose this number myself, you can set it to whatever you like) it sets an alarm off on my mobile and also alarms my mum and dad via their mobiles too which can be really useful if I am asleep etc. You also get a weekly report showing you trends and all kinds of graphs with your readings and times and activities included which can be great for getting an overview of how your sugar levels and body respond to certain foods/activities/other.

Also maybe speak to your team at the hospital about split dosing and timings of long acting insulin. I used to take my long acting at bed time then changed to mid day and now I find taking it when I wake up works best for me. I have also changed types of long acting a few times - Lantus/Levemir/Tresiba to name a few!

Definitely have a look into a few options if you can, I am currently recovering from brain damage and memory loss after having a hypo in my sleep before Christmas last year and I can confirm that the body definitely DOES NOT bring you out of the hypo by itself as someone further up in this post suggested, I did not wake up, I was in a coma for over a week and in hospital for a month and now have swelling and damage to my brain (which is healing with time but it is a very slow and challenging process and there is no certainty that I will ever fully recover).
Sorry if that is a bit of an overload of info but I felt like I needed to address the post suggesting that the hypo would "sort itself out" because that is so untrue!
 
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Hopeful34

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What an awful time you've had, and are still having, I'm so sorry. Sending you hugs and best wishes for a full recovery.

Thank you for posting what you're going through. I've had a few overnight hypo's recently where I haven't woken up, and have slept through my low alert alarm on my phone, so time to change the alarm tone, I think, as apparently your brain can get so used to a certain noise, it just ignores it. Your post is, for me at least, a timely reminder.
 
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