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Change in hypo awareness

lely

Well-Known Member
Messages
208
Just had a hypo. Did not feel it till it was 3.8. Normally I would at 5-6.
But been slowly getting BG's under control lately, my accu chek now says my average bg is 10.4. It was over 13 in November and.
This is my fear. The better your control the less hypo awareness you have.
So I'm not gonna over react as usual and swig a bottle of luco coz I wanna keep levels low I've eaten 5 jelly babies and I'll retest in 15.
As my weetabix will still be in my system anyway that usually takes me up again by lunch.
Anyway just wanted to put this out there. Reassurance I suppose so many of you mention lower BG's than 3.8 all the time.
 
I have found over the years that as my control has improved and my BG swings reduced to smaller range I too have less warning. Only now get warnings for rapid and large drops. My BG can go pretty low around 3 or more before I see it. Luckily I could afford a CGM which turned my life around.
 
Personally, I think you're absolutely right not to go overboard with correcting. 10g carb and see what that does? That's just me, though.
 
When you've been running high bg levels for a while its quite common to feel hypo symptoms at a higher level, hence why you were experiencing them at 5-6mmol. They are called False Hypo's (Google for a full explanation).

Getting the symptoms now at 3.8mmol is fine and its good that you felt the hypo coming on, over-treating a hypo is something we have all done at some point, only by testing your bg afterwards can you determine how much glucose you need, I find if its within 2 hours postprandial (with active insulin on board) I need glucose and a small carby snack, if its 3-4 hours after injecting then 2-3 JB's is enough.
 
3.8-4.2 is about the perfect point for hypo awareness to kick in
 
Something that I'v always wondered about hypo sensing at 3 / 4; doesn't the DVLA say you're not supposed to drive below 5? They don't really seem compatible.. ( I know you have to check regularly when driving but you can't check continuously....)
 
staffsmatt said:
Something that I'v always wondered about hypo sensing at 3 / 4; doesn't the DVLA say you're not supposed to drive below 5? They don't really seem compatible.. ( I know you have to check regularly when driving but you can't check continuously....)
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Yes, not to drive below five.. However our meters are not 100% accurate so a 5 could actually be 4... And that wouldn't be allowing for any differences in the 2hr slot time they state between tests.
 
himtoo said:
3.8-4.2 is about the perfect point for hypo awareness to kick in
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I agree with this. You shouldn't have any impairment until maybe the mid or low 2s ( I had a 2.8, a numerous 3.1s and only had a slight headache, and hunger)

It would be very annoying to have awareness in the 4s or 5s lol So the only other place is in the 3's.

As long as you are AWARE, and you recognize when this may happen.. say 5 hours after last meal, or 2 hours after that bolus that you weren't to sure about. Lows shouldn't just pop up, if they do its due to to much basal, poor carb counting, or neglect (not trying to be rude, i just think this is the best term for situations when people forget about, or ignore their diabetes for any number of reasons)
 
These types of posts mildly concern me about my own BG control. When I was first diagnosed last year, my HbA1c was 13%. I had absolutely no symptoms, felt fine. It wasn't even as though DKA had become the "new normal" for me - I didn't experience any "lifting of the fog" once my BG had begun to normalise. My very first hypo I didn't notice until 2.2. Even now, I am not aware of hypos until about 3.0. I am not aware of being hyper at all.
Do I just have a weird tolerance for BG extremes?!
I test like a mad woman just to make sure I am on target!
 
 
Tighter control usually results in a lower bg level being felt before the hypo awareness feeling kicks in so that is why the NICE guidance of 6.5% is not good and why many D consultants dont recommend it as they know that due to the way injected insulin lowers bg, many diabetics with tight control (5mmol to 8mmol) will only get to experience the hypo feeling when bg falls down to about 3mmol or below that. Of course, eating a low carb diet helps keep bg controlled with less swings but doesnt do much to keep the hypo feeling at 3.5mmol.
 
Eating a low carb diet also helps the body and brain adapt to using lipids for fuel, and as a result, the brain still functions effectively at lower blood sugars, which isn't the case for higher carb diets.
 
Hmm I'm often tempted to try low carb. Can't see how I wouldn't be hungry all the time / lose weight though (I'm actually trying to put some on!) that's probably a topic for another thread though!
 
staffsmatt said:
Hmm I'm often tempted to try low carb. Can't see how I wouldn't be hungry all the time / lose weight though (I'm actually trying to put some on!) that's probably a topic for another thread though!
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You'd be less hungry than eating carbs. To put weight on you just eat loads of calories worth.
 
staffsmatt said:
Hmm I'm often tempted to try low carb. Can't see how I wouldn't be hungry all the time / lose weight though (I'm actually trying to put some on!) that's probably a topic for another thread though!
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It's the HF high fat part. It sounds disgusting, but that's just our conditioning. You just eat lots of olive oil / butter / cream / nice meat / coconut oil, and butter coffee. And berries and cream.

Without the fat, I was hungry all the time. That was mizzy. Also lost and lost weight.

I got over the disgusting idea, and it's a good way to eat.
 
I'll have to have another look at it after the DAFNE course.. Cheers all
 
I have been instructed by my D.N. to aim to run at 7.5 for this reason I rarely notice I am low until in the 1.5 - 2.0 range. Obviously this is rather dangerous, hence keeping a higher average blood sugar level. Hope this helps you to realise how well you are doing with your `hypo- awareness. Keep up the good work, and keep asking the questions, someone will always be at hand to help out.
 
Be careful Dave. Myself, I wouldn't agree to run at 7.5. It's too high. It's your decision - your complications - not hers. How about asking to borrow a CGM for two weeks so you can learn exactly when to inject for what foods? Which will reduce the spikes that she's implying you are getting after eating. From 3.9 to 7 is a very big margin.

Just my two pennorth.
 
Personally I'm not a big fan of blanket you are diabetic you should run at x targets. Ever since I was diagnosed I've felt well at around 7, too much either side and I start to feel unwell. My advice (and it is just my opinion) is to decide at what level you feel well and try to run around that.

To offer a bit of reassurance I've been diabetic for 32 years now and so far no complications, Everyone is different though and as LucySW said at the end of the day it's your body / life and your decision.
 
My DSN told me to not exercise unless I was above 8.5! I initially followed her advice but have now found I can safely do my workouts at 6, so long as I have a small snack and some GlucoTabs with me. Luckily I can feel hypo symptoms kick-in at about 3.5 to 4, so know to pop a GlucoTab if I start feeling a bit low.
 
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