Dn visit

If your still thinking there nothing wrong with your brain. you haven't had enough hypos jet. next years black the new grey and there's 50 shades of that. you just cant win

Don't believe everything a DN says to you...

Here is a review of evidence for recurrent hypos and brain function;

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860007/

The conclusions says;

"In contrast to the concerns of many diabetic patients, there is little or no evidence for a long-term deleterious impact of recurrent moderate hypoglycemia on brain function. Indeed, the literature suggests that if anything, the brain responds to RH by increasing support for cognitive functions, and in particular by enhancing fuel supply, resulting in improved cognitive performance which may extend across large portions of the lifespan."

I think the way to deal with these things is to say; "Can you point me to the literature on that? I'd like to read up on it." Which is a politer way of saying; "prove it."

Best

Dillinger

Hi Jackie006
@Dillinger has it spot on.
The only downside to a lot of lows is that over time you can get used to them and not feel the hypo as early.

My HBa1c has been 5.7% - 5.9% for the last 2 years and never above 6.5% for the last 15 years and been diabetic for 43 years -- brain is as good as ever

Hiya, my DSN put the same fear into me with hypos saying I should avoid at all costs... Mmm not that easy when your a type 1... Must be some NHS bulletin drifting about the country !

I've been told a couple of hypos a week won't do any harm and that it's a sign of good control. Doesn't feel it at the time!

There is this weird fear of hypos with the NHS; obviously we don't want to have hypos if at all possible but mild ones that we can manage ourselves are no problem really. The only tricky things are rapid onset hypos or hypoing where you can't get to glucose.

I think the real reason that our DNs get so excited about this is that it is a tangible thing that you can see and easily correct. High blood sugars are not so easy to detect but the damage that they do far exceeds the momentary lapse of reason that a hypo brings.

Also, if you think about it as the non-diabetic population can have HbA1c's in the range from 20-41 mmol/mol
(4-5.9%). An HbA1c of 20 means an average (aggregate) blood sugar of about 3.8 mmol/l - which if you follow the "4's the floor" means that some or our non-diabetic friends are permanently hypoing...

If you are on insulin I have no problem for correcting a blood sugar if you get to 4.0 (i.e. taking some glucose to lift you up a bit) but as a comparison it's interesting to think about that.

As an aside if I wake up in the high 3's I won't take additional glucose as I know I have no fast acting insulin in my system and I also know I have a marked dawn phenomenon so my blood sugars are going to be going up without the help of dextro tablets.

The worst advice I ever got was proudly showing up with my HbA1c of 5.8% and being told I had to get that up as it was 'far too low'. I was less informed than I am now and did what they said...

Best

Dillinger

Dillinger said:

The worst advice I ever got was proudly showing up with my HbA1c of 5.8% and being told I had to get that up as it was 'far too low'. I was less informed than I am now and did what they said...
Best
Dillinger

Click to expand...

well done to you for providing the great link on memory issues earlier in the thread

I am very proud of the fact I repeatedly have A1c's below 6.0%

my last 4 checks ( 2 years ) have been 5.9 , 5.8 , 5.7 , 5.9

common sense should be telling us to try and get as close to normal as possible -- at least that is what i think

I would be brain dead by now if that were true. Even though I am a Type 2 I have always had problems with hypos. Be rest assured you most probably already have it right and its your DN that has issues. As @himtoo stated though you do get used to them though which can be a bit if a problem

Dillinger said:

If you are on insulin I have no problem for correcting a blood sugar if you get to 4.0 (i.e. taking some glucose to lift you up a bit) but as a comparison it's interesting to think about that.

Click to expand...

Totally, Dillinger. I agree with every word, for what it's worth. And also, 1 or 2 dextrosols is probably enough for a slow 4.0.

I've been Type1 for well over 52 years,by what's been said I would have no brain left but I can assure you I have,my last two A1c's were 4.8%and 4.6%.I will carry on as usual!

yingtong said:

my last two A1c's were 4.8%and 4.6%

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Wow, what regime do you follow to get those numbers? Dr B?

Hi zed,I'm now on a pump for the last 5 weeks due to loosing my 'hypo' awareness but I maintained those figures for the past 12 years with a 120gms of carbohydrates per day with regular gentle exercise on a MDI which averaged 5 injections per day.

yingtong said:

Hi zed,I'm now on a pump for the last 5 weeks due to loosing my 'hypo' awareness but I maintained those figures for the past 12 years with a 120gms of carbohydrates per day with regular gentle exercise on a MDI which averaged 5 injections per day.

Click to expand...

And here in lies the problem - you may achieve a HbA1C in the high 4's and not be brain dead but it comes at the cost of your hypo awareness which, in a whole variety of situations will keep you from being "body dead"!

The odd hypo may not be a big deal and I started my diabetic life determined to keep my HbA1C in the 5's and prove I could be "normal". However, I've come to accept that normal doesn't exist anymore. I'm not worried about the odd hypo causing me brain damage in later life, I'd rather keep good awareness and early warning signs now so that I can live a later life!

This is an ever recurring discussion and as a T1 you can't even begin to compare your BG levels to that of someone with a perfectly functioning pancreas. Yes, their BG levels run low but they have the ability to correct it naturally and without any action from themselves. It's all taken care of for them. If car engines had been designed to replenish the oil level when it got low then us T1's would still be using the dipstick and having to top it up or let some out the sump.

Scar doc,thanks for your comments,I'm 67 years old and only have minor background retinopathy and I have never been hospitalised for hypoglycaemia or ketones,I have a PhD in civil engineering and have never lost a days work through my diabetes,I have worked all over the world and played semi- professional football and most field sports to county level.My Consultant has said I could not of prevented what has happened and that it is that I have been using artificial insulin for a long time.I will still try and keep my HbA1C as near normal as I can and take my chances.

Also scardoc,you will never see me give people advice on Diabetes on this forum because I am not Medical Expert on Diabetes but I do understand my own particular diabetes and the reason I gave my blood results was in a answer to a question from sued.