Can you get your HYPO awareness back

Tracey167

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Hi

I lost all my hypo awareness about 4-5 years ago and my husband had to become my full-time carer, i have spoke to Doctors, diabetic nurses and diabetic consultants about it and have tried everything to try get some awareness back, but nothing, my consultant told me ages ago that as i have had type 1 for so long it is normal to lose awareness. But on Tuesday i went to the hospital to see a Diabetic nurse a different one again (i never see the same one twice) and she told me to run my sugar levels higher , i replied i have done that before and it did'nt work and she insisted that I CAN get my awareness back by doing this. At the time i did'nt say nothing but when i left the hospital and thought about it i thought what a cheek she has'nt listened to what i told her just insisted she knew more than what i did. I also told herabout my hypos and on one of the days i had a hypo after lunch and she insisted it was because of my breakfast injection (humalog) but when i tested before i had lunch my BG was 6.3 . I think she one of these job worths who thinks they know more than anyone else. She has told me to do the DAFNE course of which i agreed but i told her i can't do it in term time as my hubby has to come with me cos of my hypos as its 2 buses from where i live to the hospital and the course is 9am to 4pm she says get my hubby to pick kids up from school then come to the hospital and meet me after, i don't think so having to pay 1 adult 2 kids bus fares for 4 bus journeys there and back for 5 days. There is NO WAY my hubby will agree to that. I hope i don't see he next time.


tracey167
 

mo1905

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I heard the same thing, run your levels higher than normal for a while and your hypo awareness returns. I know you've already tried it but can't hurt to give it another crack ? Even if it's just to shut the know it all nurse up lol ! Good luck ;-)
 

Switch2501

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Yes you can get your awareness back by running your bloods higher.

Everyone is different mind, so one persons "higher" might not be enough for you.

I started to lose my hypo-awareness but I did manage to get it back through running them higher. Still got it too :) just now it's at a lower (normal, I.e. not getting warnings at 5.5 any more) level.


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noblehead

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Your diabetes nurse is right Tracey, running higher than normal bg for a period of several weeks is usually enough to restore hypo awareness symptoms....although I appreciate you've tried this before.

The following article from Diabetes UK says much the same but also suggests that a CGM may be beneficial too, take a read and perhaps discuss this with your diabetes team:

http://www.diabetes.org.uk/Guide-to-dia ... awareness/
 

Tracey167

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hi all

thank you for all your replies, i will give it another try and run my sugar levels higher for several weeks, the horrid thing is where i suffer from a lot of low sugars (hypos) when my sugar levels are high it makes me feel tired, nauseas and sometimes thirsty depending how high my levels go, i find it hard to take control of keeping them higher than normal but not to high so there threw the roof if you know what i mean. But i will try my best thanks again

tracey167
 

donnellysdogs

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The thing is Tracey... Running your levels higher will also be good in other ways.
From the sounds of it your hypo's have taken over your life if you have to have your husband as your carer incase of a hypo... You shouldnt be in this dituation to be honest...
It is possible to get your hypo awareness back. It really should not be necessary to be reliant upon your husband to be carer for hypo's....
You will need to run your levels higher for a longer period thana few weeks.. Probably a couple months to be honest if you've been like it for years.
 

Cody

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I know exactly what u are talking about!! I found out I had lost my hypo awareness when at the clinic speaking to my dietician and it was horrible. Her drilling in the consequences of me not being able to drive again as this would be recorded with the dvla. She was not even telling the truth it never came to light about me being hypo. YOU really can get ur awareness back tho I was told to keep my readings between 8-12 for 3 months before I was fitted with my insulin pump and hey presto I have awareness back and even better awareness of hypo is at 4-5 not 3.9
 

iHs

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Tracey167 said:
hi all

thank you for all your replies, i will give it another try and run my sugar levels higher for several weeks, the horrid thing is where i suffer from a lot of low sugars (hypos) when my sugar levels are high it makes me feel tired, nauseas and sometimes thirsty depending how high my levels go, i find it hard to take control of keeping them higher than normal but not to high so there threw the roof if you know what i mean. But i will try my best thanks again

tracey167

Tracey

Although you meet the NICE TA151 criteria for funding for an insulin pump, you will not get one until youve got a handle on working out your insulin to carb ratios correctly and also your correction factor.

You should definately not be relying on your husband like you do to be your rescue when you go hypo. You can, with more frequent bg monitoring, work out the correct amounts of bolus insulin to cover the carb that you eat in your meal so that 2-3hrs after you eat food your bg levels are not going dreadfully low or high. Also try not to use 'guess work' in calculating your correction insulin. Look at the 100 rule to get guidance.

What I would do in your shoes is adjust my overnight basal so that when I get up in the morning, instead of having a bg level of 4-7mmol, I would make 7mmol my target and adjust my bolus insulin downwards to allow for any drop below my target of 7mmol. Obviously if you are finding yourself waking up with a bg level way below 4mmol, then treat that with 2 tsp of sugar in a cuppa, wait 20mins for your bg level to rise up and then eat breakfast and bolus afterwards because your bg levels are below the target of 7mmol.

Next, adjust your bolus insulin (trial and error I'm afraid) for the carb that you eat and allow for your bg levels to rise to 10mmol 2-3hrs afterwards. On a bg level of 10mmol you will not find yourself going hypo in the following 2hrs and you will not need to eat a snack. Instead, your bg levels should fall back to 6 or 7mmol again, so then you can calculate the bolus for your next meal and again allow for your bg levels to be 10mmol again 2-3hrs later. If, when using trial and error, you find yourself going below 10mmol 2-3hrs after the bolus, then eat a small amount of carb as a snack and dont bolus for it. As a very rough guide, it is thought that 10g carb will raise bg levels up by 2mmol but this is not set in stone and is only a guide. If your mid morning or mid afternoon bg levels are only on 4 or 5mmol, then by eating a 10g carb snack (biscuit) your bg levels should rise up to 6 or 7mmol again.

I admit very much that bolus basal carb ratios and correction factors is somewhat mentally taxing but with determination with adjusting insulin, writing the carb eaten down on paper, testing bg levels every 2-3hrs and using targets to base calculations on, most diabetics can find their way. To make things a bit more easier, you can keep to eating 30g carb for each of your main meals and then you will be able to discover that you will need more bolus insulin to cover breakfast, a bit less bolus to cover lunch and then most likely, more bolus to cover your eve meal. Once youve been able to work out the correct insulin to carb ratio to cover each of your meal times, you can then adjust the carb that you eat and use your carb ratios to work out the bolus insulin needed and using the 100 rule, youll be able to work out how much bolus insulin you need to use to lower your bg levels back to the target of 7mmol.

Is this all 'gobble gook' to you. If you dont understand anything, then please just say as I am only trying to give you a bit of help
 

Luckystar96

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I agree with most of what the previous person said BUT not about treating a hypo in the morning with sugars in a cuppa! This will take far too long to treat a hypo(under 4 is definitely a hypo) . The quicker you bring your sugars up the better as the longer they are low the more likely you are to lose warning symptoms. The best thing is lucozade, it's the quickest. I have lost symptoms in the past(night time) and managed to get them back by running a bit higher for a while, but it does take a lot of effort. Worth it though as its the difference between being independent and being totally reliant on others. Good luck with everything.
 

donnellysdogs

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**** good info iHs. Tracey, re-iterating that you CAN get hypo awareness back, especiallywith the info iHs has taken the time to type out...
You should not be reliant upon others when hypo awareness is achievable.

Your brain may not kick in and think.. I'm hypo, but if you do good testing and raise your levels... It would kick on and give your brain a jolt to say do a blood test. My brain doesnt kick in and say 'you're hypo'... But it always kicks in snd tells me to do a bloodtest.. And that in itself is because your brain says..i've dropped.. Need to test. Now when my brain says .. Need to test... I now from that thought know... Need for dollies... But it doesnt actually say 'hypo' to me....but the fact it is telling me to do a bloodtest is actually the hypo warning.

It is down to you to really want to get your hypo awareness back, and to give your other half a break from being your carer....

I have felt really sorry for my hubby on the few times in nigh on 30 years of my hypo's when he has helped me.. I do my **** utter best not to put him in that position...its not nice being the person trying to assist a diabetic out of a hypo, not nice at all... And you can stop that situation if you really want to. Its down to you... And it doesnt have to mean that your levels have to go incredibly high either.
 

Tracey167

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309
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Hi

I started doing more blood glucose testing instead of 4 times a day i am also doing 2 hours after meals as well so in total i'm doing around 8 tests a day. BUT when i told the diabetic nurse this the other day she told me NOT to do tests after meals only before but i think this is NOT good advise from her, the reason i started doing more tests was to try and take more control of my HYPOS and hopefully stop them before they take hold. As for relying on my husband i do not rely on him, the reason for him becoming my carer was because when i lost my awareness a few years back he used to call me reguarly from work to check if i was ok, but on a few occassions he would have to leave work urgently as i was unwell, and unfortunatly he lost his job,so from then he felt uncomfortable leaving me alone with young children and not knowing what he would come home to and was advised to become a carer. Like i said i have run high levels before for around 7 - 8 weeks but this did not bring my awareness back, i am willing to try again because i know life would be so much easier for me and my husband if i had my awareness back, he could return to work and i could maybe do a part time job or even a part time college course.

tracey167
 

iHs

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Hi

The only way by my thinking in preventing hypos is to test more frequently as that will allow you to catch the hypo before it has had a chance to get very bad and eat some carb if necessary. Not everyone can get really good control with only eating 3 meals per day and have perfect bg levels mid morning and mid afternoon. Some can and some cant. I think testing your bg levels freqently even though the cost of teststrips is costing the NHS a fortune in money, will enable you to get better control even if you do need to eat a small snack. You need to remind your dsn that the cost to the NHS through you not testing, is going to be far greater than the cost of not prescribing sufficient teststrips. A trip to A&E for a hypo is very costly and the fact that your husband has had his employment terminated because of the hypos you have is very costly.

I can appreciate from reading yr msg about your husband as employers will use any excuse they can in terminating employment.
 

donnellysdogs

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Good to read your posting Tracey.

Me personally, I dont think that anybody with hypo unawareness should be told not to test after meals etc.... You need to be able to test regularly... New pump people have to test every 2 hours because of the need to get their insulin right.. Throughout the night too!! So why should you be told 4 times a day just before meals and probably before bed too.

Good for you... It will give you so much more good self esteem back... Not saying its low... But, ia few more tests to get levels higher, get hypo risks less and get realisation back will enable you both to live with more freedom... Not less because of testing.

I dont care how many times I test to keep myself healthy. Had a cgm which was helpful on occasions before it blew itself up... Now I'm back to blood tests again. I regularly test overnight...

If you really need to at your most vulnerable times.. Test hourly for a day at those times...It enables you to see just when your drops are happening... The biggest drop in bloods could be at a time before the actual hypo...

Great to read that you are positive and doing more tests..
 

Trina

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Well all I can say is that since being put on the insulin pump I am starting to get symptoms of hypos back which I personally think is super wonderful. For years I was having problems, to the extent that I was frightened to go out let alone drive. So all I can say all is not lost, it is possible to get the symptoms back, but that's only me


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