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Fear Of Hypoglycemia

Charlie 81

Newbie
Hi . Since I came back from Thailand a month ago I started developing severe panic attacks associated with my glucose control . Totally petrified when I see my sugars going low .
I use a Libre which is very detailed on the pace your glucose levels are rising or falling .
I exercise frequently and have always had a relaxed outlook on my T1 diabetes until now.
Very worried that i just cannot get my readings lower than 9 mmol . Frequently keeping them high and obsessively testing .
Does anyone else suffer with this or experienced the same fear ?
 
Hi Charlie. I certainly do. A problem sometimes is that people may not know that it takes over 15 mins for sugar to enter bloodstream after eating. So before ,I'd wait until sugar level went down before eating, not realising that it was going down further as I was eating cos of the 15 mins trip so can be scary. Just to keep it in mind. Good luck from kevin In galway ireland.
 

Yeah Kevin it really is . That horrible trip can so easily be avoided , but with opposite consequences unfortunately. I will keep that in mind and just try to fight the fear and go with it .
Thanks .
 
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Charlie 81 said:
Does anyone else suffer with this or experienced the same fear ?
Click to expand...

Hi, Charlie, I think most of us have had this at one point or another. I've had some appalling night hypos in the past which ended up with me being reluctant to go to sleep in case it happened again.

But we have to move on. It's good that you've got libre. I started using it a couple of years ago, it's made a huge difference in my approach.

There's a couple of good books on kindle which helped me a lot with getting the most out of it:

Sugar Surfing, Stephen Ponder.

Beyond Fingersticks, William Lee Dubois

They've got a lot of tips on how to read cgm/libre output and use it in ways which lets you tighten up ranges without getting into a danger zone.

The other big thing is turning libre into "proper" cgm by putting a bluetooth transmitter on top of it, so that you get hypo and hyper alerts - you can set them at any level you want, say, 5 or whatever if you're being really cautious, so your phone will ring, wake you up long before you hit hypo-land, and you can then decide whether a few biccies are needed.

It's given me a lot of comfort, just knowing that I'm going to get a heads up on a dropping level, so I can go to sleep at 5 or whatever without worrying about it too much.

There's two companies making the transmitters:

www.ambrosiasys.com and www.miaomiao.cool

Ambrosia's blucon transmitter is about 100 quid, miaomiao's is about 150. It's a one off cost - my transmitter from Ambrosia is still running fine a year in.

If you're on android, the go to app for reading the transmitters is xDrip+, if on iPhone it's Spike, links here:

https://jamorham.github.io

https://spike-app.com

These are not officially approved apps - most HCPs and the NHS haven't even heard of them. They are open source apps built by diabetics for diabetics. Many of us use them and trust them.

As you're on libre already, I'd encourage you to have a look into them. They've given me huge peace of mind over the last year or two. I can see hypos starting to develop at about 5 or 6, because the 5 min read from the libre tells me so, and I can take small steps to head it off, sometimes a single dextro tab is enough to close it off long before it gets anywhere near 4.

You'll figure out a way of dealing with this, Charlie. Using cutting edge apps isn't cheating.

To give you an idea of what this stuff looks like, and how it keeps us safe, here's a couple of screenshot of xdrip waking me up at 4am on a wander down from 6 to 4.2, and then me taking 5g to nudge back up to 6.



 
I suffer quite badly from this at times. Think its just panic attacks in my case. I hate going to busy places with lots people eg a shopping centre. I can have a bg of 10+ but can convince myself that I have a low bg. I also tend to do a lot of walking to very remote places where I may not see anyone for hours. Same again I can have a bg of 10+ but have it in my head that I am low.

Thank goodness I now have a libre which can at least give me some comfort and peace of mind

Hope you can mange to conquer your fears
 
Charlie 81 said:
Yeah Kevin it really is . That horrible trip can so easily be avoided , but with opposite consequences unfortunately. I will keep that in mind and just try to fight the fear and go with it .
Thanks .
Click to expand...
Hi charlie. Im trying to find out how much humalog mix 25 is needed to lower B.G. of 12 to 7. I injected when I came back this evening and B.G. was 12. Now its coming down at 10.6 but I'm hoping it doesnt go down too far. Problem is I didnt know how much insulin to inject.but I can eat a sandwich or two to offset drop in levels. I think the worst hypo is when much too much insulin is injected cos what goes in cant be taken out. So a lot of food has to be consumed. Ive got to keep two eyes on that situation in future. Thats why im not injecting a load of insulin in the past few days. Sorry about long post. Cheers kevin.
 
Hi @Charlie 81,
Hypo fear is what used to get me eating extra supper to ward of the possibility of night hypos and at other times too.
For me 7 1/2 years ago at the 45 year mark on insulin I was experiencing night hypos despite 4 to 6 short acting and 2 long-acting doses of insulin per day. That was a frightening time ! Also, because of the difficulty with BSL control, I had lost some of my hypo awareness. The increased vigilance and fear were debilitating.
In the end going on an insulin pump solved the problems fairly well. I still need to be careful but the tailored pump program keeps my BSL in good trim, my hypo awareness is much improved and I have been able to ease back my vigilance.
The hypo fear is gone. Hypos are rare and usually mild and mainly due to my human error.
Exercise is easier to handle on a pump also.
Please consider whether there are ways to work with your health team to see whether an insulin pump or some other regime is a possible way forward for you. And counselling might be another avenue to explore with your health team also.
Best Wishes !!
 
I have a pump, but still do not have a continuous read meter. I am hoping that getting one will relieve me of many of the fears and events that have caused the fears.

I have had so many lows in the middle of the night that it became rare for me to go to bed before 3:30 am.
I became type 1 when I had back surgery due to accident where the facet joint ended up snapped off. This in turn led to chronic pain syndrome (trapped nerve)
This will often elevate my BG. Yet sometimes, the pain will disrupt my digestive system so that my food doesn’t digest.
It is so hard to tell if I am having los or highs or just pain.
I can’t tell that my bg is low until I start getting gold spots in my vision so that I can no longer see. Yet I have been in midst of working and had my bs below 1.9 and not realize it.
So I have been way to high the past year (also had infected root canal and turned out to be allergic to all the anti biotics)
Tomorrow I am seeing a doctor of pharmacology (I live in the US) who is going to try to get my pump regulated and also I hope find an antibiotic that can stop the infections I have. That, in turn, will hopefully make the anxiety lessen....
 
I do worry even though I am T2. We all want perfection but any fasting BG Level less than 10mmol/L should not be a cause for worry.

A diabetic should ideally maintain 5 to 7mmol/L during sleep to avoid hypoglycemia induced coma.
 
Is it the downward arrow on the Freestyle Libre that started the panic attacks? I've seen a few of them, and they are a bit scary looking.

I have had times when hypos were so inconvenient I would run a bit higher than was really sensible. It is very hard to be reasonably physically active, and stay in a reasonable target zone, without having a hypo problem.

After too many zigzags, on the blood sugar roller coaster, at the moment I tend to eat quite a small amount of carbs with meals, on the grounds that the less insulin you take to cover the carbs the less room for mistakes there is, and the less highs and lows.

You could try staying in range and minimising carb intake, so you reduce the swings, rather than running too high. At least for a while, that's reasonably easy to do with Freestyle libre.
 
My bloods have been low especially in the morning. I use my sugr app which encourages you to record. I saw my consultant and he said i shouldn't be checking my bloods so often and only doing morning and before evening meal as many people begin to become obsessed and have anxiety and panic atracks and the app is sponsored by the people who make the strips so they just wanting more use of strips to make money. I didn't fully agree with what he said but then i have been a lot more alert and it taking over my life recently. I think we all need to find a balance

Sent from my SM-A500FU using Diabetes Forum mobile app
 
Hi Charlie81
I have MODY:it's purely from gene (now on insulin 4 to 6 units a day ).I am leading an active lifestyle. It's all about timing it all:I exercises after 1 hour of a meal but always test BG before and after.
Learn your own BG patterns how much your body use it up in the 45 minute of any atrocities. For me if my calves muscles start feeling weak; I would stop to take the blood test. If it's 5 units I Will drink my a glass of orange juice or 2 dates.The wait for 20 minutes to test the BG again.
Keep the diary of your food and what kind of activity burn the cloclose most.
Let me know how you get on. Apologies if my Ennlish it's not crystal clear.
Good luck.
Dowjai001
 
By the my DN said I should remerber: if it's 5 do not drive and if 4 you can be on the floor.
 
Is it the thought of the possibility of hypo or fear of being in that range.....?

For me hypos can come along 2, maybe 3 times a week......but they are down to small inaccuracies in dose or a unexpected increase in physical activity.....so I know that my levels wont continue to go to dangerous levels....and that if it really came down to it, my liver would help me out......

must be tough suddenly going from a laid back attitude to having the fear.......

maybe you just need to make an effort to stay calm when the hypo does come along and try and over expose yourself to them.......I assume you always have the ability to treat a hypo at all times......?
 

Thanks for the advice .
 
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Can you set yourself some little rules?
Like
- aim for 7 rather than 9 mmol/l (you may want to bring your target down over a few months)
- if your BG is under 8 and there's a downward arrow on your Libre, take a finger prick and a dextrose.
- if your BG is over 8, do nothing for 30 minutes
- if your BG is under 6 and there is a slopey down arrow, take a finger prick and a dextrose
- if your BG is over 6 and there is a slopey down arrow, do nothing for 30 minutes

My idea is to train yourself to trust your body.
 
I have this terribly! Last year I went to v fest and my control was amazing then i ate some churros and massively overjabbed. I drank a bottle of lucozade and a bottle of tango full sugar. Then ate a baguette with a sausage. And it eventually came up and settled at 7.. I have a history of panic attacks so after this event if my sugars even started to drop slightly I freaked out and panicked before it was even under 8. I now have Libre which I find is helping me relax a bit as I see the pattern but in the current heat I was working and if I dose one unit of insulin my sugars drop ridiculously. I’m struggling getting mine under 9 too. I’m just hoping the libre helps me maintain it and I can just gradually bring it down and get back to how I was before!
 
achike said:
I do worry even though I am T2. We all want perfection but any fasting BG Level less than 10mmol/L should not be a cause for worry.

A diabetic should ideally maintain 5 to 7mmol/L during sleep to avoid hypoglycemia induced coma.
Click to expand...

Unfortunately not always the case when on insulin. Too many other variables.
 

Hi Charlie, sorry to hear about your fear.

Few things spring to mind... Now your home and back into a settled environment again do you have more time to think about your diabetes and a reality check has re-enforced your fear about hypos ? Have you have a really bad experience ?

Getting confidence back in your management will help build your ability to cope better, I would suggest sticking to the same meal plans for a while, keep a manual diary and write everything down, start to see patterns. Seeing similar bg readings will help your mind process the fear more easily and regain trust. I think all insulin dependent diabetics have this at some point and yes it is rational fear, but it can be overcome.
 
I can remember in the distant past feeling scared going to bed fearing yet another sleeping hypo back when BD strips were all we had to test with, I think the way I see it is to accept a few hypos in the name of keeping my bloods down, and trying to work things so my 'weak' points are during the day when I'm able to correct things, a drop to 3.9 is preferable to waking at 2.9 when you've been low a few hours.

Good luck with getting on top of it.
 
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