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Dealing with Hypos - treat first, measure later

tim2000s

Expert
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Type of diabetes
Type 1
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I've noticed a consistent theme amongst forum members with regards to Hypos, and I find it disturbing.

It seems to me that many people feel the onset of a hypo and then rush off to find a meter to test, before doing anything to treat it. I was taught, and believe, that the most important thing to do in the case of feeling a hypo is treat it first, measure it later. It is imperative to get the glucose into your system ahead of worrying about where it actually is.

While there has been a consistent trend of diabetics using the internet to aim for lower blood glucose levels in the "normal" range to reduce the risk of complications (which I don't disagree with, and is something I too strive to achieve), it is still important to let this advice go out of the window when dealing with a hypo.

The basic point is - Always treat the hypo first, before worrying about whether it is a 3.9 or a 2.1. You'll be far better off if you do and you reduce the risk of a more severe hypo by not delaying the treatment.
 
With me.. I don't actually think hypo.. Need sugar. My brain actually tells me I need to test.

This is how I recognise hypo's.. Its not actually I feel low.. Its always been I need to test.

Its recognition because at other times my brain tells me its pre food, pre bed, post food etc. Even during the night if I wake up I know the difference as in I need the loo and sometines just doing a test and waking and thinking I need to test.

As I have never had any urge for the need to eat and literally only eat because I have to this is thenway that my brain tells me I'm hypo.

In 30 years it has never thought I'm hypo. It does however know thatbI need to test rather than being the standard testing times and routines that I follow normally.

Perhaps I'm odd but I classify my hypo recognition as very good. So thats the reason why I reach for my machine first.
 
An extremely interesting topic @tim2000s
Whilst I agree with your main point about eat first , ask questions after I would add that with myself having impaired hypo awareness (which is how I have approval to go on a pump )
I sometimes test and find out I am hypo without the realisation I was. ( if that makes sense)
 
@himtoo You are in a different category (and I'd hope have CGM as well, to assist with Hypo awareness). The point I was making is that a lot of people have stated that they feel hypo symptoms and then test rather than treating, which to my mind, is the wrong way around!

@donnellysdogs I sometimes get that feeling as well, but it's not a consistent one.
 

I find this interesting.. So does your brain tell you at other times "i'm hypo I need to eat"
 
Yes Tim I do completely agree with your point on eating first.
It is something that appears to be overlooked but should not be.
Priority # 1 should always be treat the low first.

@donnellysdogs
sometimes I do get "classic"symptoms such as a bead of sweat on my brow or that internal shaky feeling.
Sometimes I can be merrily pottering about the house and then test in what seems randomly to discover I am
hypo at 2.4. ( and I normally test 8-10 times per day )
I ALWAYS test religiously before driving and pulling over to test during journeys.
I also am very lucky to have a partner that notices before I do sometimes.
 
I test too religiusly pre driving, and same as you before meals, after, bedtime etc.. In my mind they are steadfast times. And averrage at 8-10 a day like you too.

But what I'm actually asking is do you ever actually ever think "i'm hypo, got to eat" when you get those symptoms or are they all down to "need to test"

If its always "need to test" and its random then there is a recognition although at the lower levels you mention then it is indeed impaired.

I can honestly say like last night I tested randomly when I wouldn't otherwise and it was 3.9. Just because my brain doesn't scream "hypo" it does scream to test.
 
Yes -sometimes I feel the need to eat because my brain alerts me with the symptomatic warning signs.
 
Yes,tim2000s,I agree,treat first,test later.I no longer recognise hypo's and therefore test much more to avoid the dreaded hypo.I have been diabetic for 52 years today and have never been hospitalised for a hypo.
 
Usually I don't have the ability to test, I don't have a steady enough hand to get the strip into the machine. So I just treat it now. I'm usually very hypo aware but the other morning I woke up at 2.1 and didn't feel a thing, just thought I was tired from waking up lol.
 
And it took you a bit longer to get going ?
 
For me,my hypo symptom severity doesn't necessarily reflect the number which is why I test first ( I always have my glucose meter on me so I never have to waste too much time on it)
Sometimes I feel a severe shake, sweating etc and then I test and it's Maybe 4.1,4 or 3.9..... And then other times I don't necessarily feel those symptoms first, just a clouding of my brain which prompts me to test and then it might be in the 2's or 1's sometimes
 

I don't think there is anything wrong with doing a test first assuming you are (a) not having a severe hypo and unable to do so (b) a diabetic with good hypo awareness. I have found that stress and hunger can give me hypo symptoms but upon testing there's no issue.

Needless to say, everyone is different, but for how long a test takes? I'd rather that than take on unnecessary sugar.
 
So why wouldn't you take 10g of carbs first in all these cases and then test, regardless of what the symptoms felt like? In every case you are on the verge or way into a hypo, so stopping to test is daft!
 
From day one I was told to treat the hypo first without delay and worry about it later if you were mistaken, but this was in the early days and when I was using animal insulin the hypo's were more profound and seem to come on more rapidly as they do noiw with human and analogue insulin, so providing I'm not shaking like a leaf I do often test so that I know how much glucose to take, but as a rule I catch most hypo's early on.

Interesting discussion mind................
 
I have to test before treating and my treatment is different because of the consequences.

T1s have to treat with sugars or glucose. That is common practice.

T2s and other conditions, need a different approach. Some do need glucose, but others would be seriously affected by that treatment.

I personally have been given lucozade by a sister in hospital and I had to remain there for another 4 hours, till I recovered, a simple plain biscuit and a cuppa,(no milk or sugar) will do just as well to gradually raise levels slowly but surely.

I have read posts on here by T1s proposing that the 'only treatment' for a hypo is glucose or the like, we all have to be careful of different conditions.

The other reason for testing first is if a new diabetic or diabetic, needs advice about hypo, they might be going through carb flu or are having withdrawal symptoms from low carbing.They do get hunger pangs and a need to eat carbs. Giving somebody high carbs is likely to derail their new lifestyle.
That's not saying that if it was an emergency then glucose first then test!
 
"nosher8355 said:
T1s have to treat with sugars or glucose. That is common practice..


I have read posts on here by T1s proposing that the 'only treatment' for a hypo is glucose or the like, we all have to be careful of different conditions.
Click to expand...
hI nosher
i have read back through the entire topic and find no mention of T1's proposing glucose or the like. 10 grams of carb is mentioned which could indeed be a small biscuit like a digestive ( 12 cho ) .
also many T2's are on insulin as well as oral med and do need to be mindful of the need to treat first test after.

Also -the topic is in the type 1 section of the forum
 
@nosher8355 I posted this in the T1 forum because I was looking at T1s talking about reaching for the meter rather than the glucose. The point still stands though, and anyone on insulin can have the same set of issues, T1, T1.5 or T2...
 
tim2000s said:
So why wouldn't you take 10g of carbs first in all these cases and then test, regardless of what the symptoms felt like? In every case you are on the verge or way into a hypo, so stopping to test is daft!
Click to expand...
Because stopping to test takes about ten seconds max, and I've been luck enough never to be in the situation of having a severer severe hypo where the minimal time taken to test costs me y consciousness.... Obviously everyone is different so this may not apply to everyone, and also may not always apply to me but it works fine for the moment.
Besides, I also find that since starting into lchf, any hypos I have are much less severe and profound
 
Personally I tend to test first as I sometimes get self inflicted false hypos - I convince myself I'm running low, start to feel all panicky, think I must be about 2.5, get the meter out and.... 6.4. Symptoms disappear instantly.

In the event I didn't have my meter or was unable to use it, I would just start on the carbs anyway to play safe. But if the meter is there and I'm still in control, I'd rather check first.
 
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