How do you deal with hypo’s at work and communicate them?

Hi everyone,

I am curious how you all deal with hypo’s or hypers at the working place and in particular how you communicate them to your colleagues (while you’re in a hypo/low blood sugar)?

Below I will first provide a small list of the symptoms I experience in case of a hypo/low blood sugar.
Then I will put forward some situations in which I have difficulties to act properly or to communicate them effectively to colleagues. In this post I first focus on hypo’s. In the next on hypers.
What I need to say in advance is that since I have impaired hypo-unawareness I do notice my hypo’s relatively late, resp. mostly by neurological malfunctioning.

Hypo symptoms:
- Experience difficulties executing appropriate goal-directed actions (having an impaired sense of which actions are needed to generate certain outcomes).
- Unable to follow a storyline because for instance when the eight word starts, you have already forgotten the first.
- Impaired access to memory: don’t know what I intended to say (forgetting the thing that came up a few seconds ago).
- Difficulties integrating all the sensory input into a coherent whole.
- Sensory stimuli (sounds, light, colors, smell, etc.) are experienced as overwhelming because the ‘normal filter’ doesn’t function anymore.
- My lips are less controllable, which makes it difficult to pronounce the words I am intending to say; and if my lips move, they move clumsy and in slow motion.
- Loss of my facial expressions: failure of laughing, gentle nodding, looking interested, etc.
- Loss of a great part of my personality: logical/analytical thinking, humor, skills, habits, etc.
- No power in my muscles (unable to greet colleagues in the hall/corridor by putting my hand up).

Situations
- In a meeting with colleagues
- In a 1-on-1 interaction with your new supervisor
- When giving a lecture (with a powerpoint)
- In a phone call with someone who is higher in rank

How do you deal with these situations?
- Do you have a card with a text on it describing the hypo-situation you are in and written down what the other might expect (“unfortunately no presentation/meeting possible in the upcoming 15 minutes”).
- Do you have a separate room in your office where you can go to in order to raise your blood glucose level as fast as possible, meaning: a stimulus-free environment?
- Have you made some arrangements with your boss that once your sensor is alarming in a meeting, you give a small signal to your boss and leave the room?
- Are you still able to produce a few simple words making clear that your brain and muscles don’t function appropriately anymore?

In other words: what do yoú do?
Can one of you give me some tips and tricks on how to deal with such situations professionally?

Since I like to start with a new job in a while, I would like to prepare myself by anticipating on hypo-situations and how to deal with them properly….

Thanks in advance!

Kind regards,
Welmoed

Hi Antje, Indeed, I am a Dutchie as well . Thanks for your warm welcome!

I actually already have a CGM sensor and even the Minimed 640 G with a basal-stop when my blood sugar drops, but unfortunately I still have low blood glucose levels that go along with neurological malfunctioning. ...

Regards, Welmoed

Thanks all for giving feedback!

Hi Loopercat and Jollymoon,
I guess I might have more heavy symptoms of a hypo than you have, because a normal hypos takes about 30 minutes with a spike downwards in the middle before I recover and can function normally (in the sense of continuing on executing the thing I did in a proper way). It is maybe only possible to recover unnoticed if you are behind a computer on a desk (but if you are in front of a group pupils or having a feedback conversation with your supervisor it’s more difficult for me…). In cases when you have to give feedback to a group by speaking, or to give a reply that makes sense (that shows a more or less accurate thinking process), I can’t give proper feedback due to these symptoms. You don’t have problems as such then?

Antje, I believe we might have different work contexts indeed..? I have been working as a teacher, a museum educator and recently on the university (behind a desk: making your own planning, but having to give talks as well). The latter is especially a moment in which hypo's can suddenly surprise me. Maybe you are self-deployed (wild guess)?
I have at least long time thought that being self-employed may combine well with diabetes (make your own planning and reschedule them when having a hypo/hyper), but I was always scared for what my diabetes-future would bring (what if you become suddenly ill and the diabetes might cause a delay in recovering period, etc)…

Maybe it is because I have diabetes for 42 years now, that it becomes more difficult to feel these hypo's come into being... It seems likely/possible that you - the more recently diagnosed - still have some active bèta-cells that prevent you from longer/neuroglycopenic hypo's ..

Hi Nicole, actually: yes, I have at least 2 low blood sugars a day (I have been diagnosed to have Brittle diabetes) and that definitely has an influence on my work and my colleagues. The endocrinologist, diabetic nurse/educator and I have done many things to make these hypo's disappear, but they unfortunately still pop up.
Your suggestion could be a wise thing to do ..to concentrate even more on a low carb diet. I already eat low carb bread and eat very healthy, but the bread is still 'bread' ..so maybe I can gain some profit there in order to reach more steady and high blood sugars...Thanks for your advice!

By the way - a little straightforward question maybe -: is your dog a hypo-dog...who smells your hypo's? He/she looks actually exactly like the hypo-dog of a friend of mine . She likes having this dog so much!

Hi Antje,

Beautiful previous work place (I see you are a true Dutchie indeed )!!

Your former work place would indeed actually have been a very difficult one for me, I guess , (although it looks nice.. out in the open air!). On the other hand, I am also someone who doesn’t give up easily and have a strong will to bé there and act as good as I can. This temperament kept me going ..and made me go on working with diabetes for a very long time. I still do, but at a different pace and with more respect for my diabetic delays (because they are of course there independent on how strong your will is to keep on going).

When it comes to your advice of changing the reference number on my pump (resp. the number you use to stop your basal insulin delivery): unfortunately, I have the minimed 640G and on this pump the number to stop your basal delivery is the SAME as the number for restarting the basal delivery again (leading the blood sugars to rise sky high after a basal stop). Especially when I raise this reference number, it takes too long before my pump starts pumping insulin again.

I am waiting for the Tandem X2 pump. I heard this pump had the option of choosing different reference numbers for up and down: that would be great! Fingers crossed.

Hi Antje,

Since my sensor-alarm 'for low' is inside my pump (I do not have another tool to read glucose curves or set an alarm), I can only change the alarm to a higher level by also adjusting the reference number on which the hypo/basal-stop is activated. Unfortunately, I can't make the alarm go off at a higher level without (after a while) also have a stop of insulin delivery and afterwards having a high blood glucose again (see the problem I referred to in my previous reaction).

Maybe there is someone who knows a way to put the output of the guardian 3 sensor also on your mobile phone ? (Maybe I could then add a separate alarm based on the data on my phone...).

Thanks for your reflections on this subject!

Loopercat, I am still reflecting on your input . I will therefore react later!