I can only imagine how horrible it must be to have a very serious low.Sorry to hear about her experiences, it's safe to say that it's common amongst us, I can only describe my worst hypos as near death experiences so it's absolutely understandable how her fear has manifested itself.
How does she manage her t1d, insulin delivery and what sensor ? How are her injection/set sites ? Does she have lumps in these areas ? Has her team given her any guidance in regards to managing her insulin ?
As they go hand in hand with t1d, they are unavoidable unfortunately - however with that being said, I now manage my t1d using the Tandem Slim and Dexcom G7, the system is a hybrid closed loop and it has helped me avoid low hypos as the pump will stop insulin delivery if it detects I am falling, this means that in the last 3.5 years of using this system that i've not had a frightening low low. I will get a low from exercise but am also fairly intuitive to detecting when levels are falling quickly and can prevent a hypo if I act fast with glucotabs or jelly babies (both quick acting and always on me). I also use Hilltop Honey now which has been brilliant for bringing me up quickly during exercise. Does she have good hypo awareness ? Be good to learn more about how she manages and see if tweaks or changes could improve her circumstances and build her confidence back up.
I know this won't be what you want to hear, but unfortunately it can happen even if you dose correctly because there are 42 different things that affect blood sugar, not just food. @Antje77 do you still have the list that you previously posted?I have tried to reassure her that we know the reason for that bad experience and that it can’t happen if we dose correctly
I do, but I'm away for the weekend and illegally sleeping in my car at a very pretty place, and I can't muster the courage to try to share that picture on my phone.there are 42 different things that affect blood sugar, not just food. @Antje77 do you still have the list that you previously posted?
I've posted it above @EllieM as my phone wouldn't let me open your suggestion.This one maybe
When low, I ignore the CGM and go by feel - both the lag and potential offsets make quite a large difference when there's such a large effect over the space of only ~1mmol/l. They are quite useful to see that you're rising though, as otherwise the desire to keep eating is hard to overcome (though I also get short rises that then drop again, especially when exercising.)I second @SimonP78 's suggestion of multiple hypo treatment options for confidence. Also, when I have a bad low (below 3) I find that my dexcom lags significantly so using a glucometer can give you confidence that yes, your levels are going up (or at least not going down), when your cgm is still showing a scary downwards trend. My dexcom also tends to read slightly low during a severe hypo so having my glucometer to hand is really reassuring for me.
It can be hard to explain, and we all feel different things, and these things can also change over time.When she has a ‘normal’ low she feels it but we treat it and she’s fine. A ‘bad’ low is when she’s had a couple of times dropping fast, she’s felt it but can’t explain how she feels and she has then panicked which has made the situation more stressful. She’s only had a couple of these but feel they’ve made her now more worried if she goes even slightly low.
Does she like them? It's much easier to eat something you like, you don't put if off for as long, or indeed spend time faffing thinking what else you could eat that you'd prefer. It's useful for it to become "muscle memory" - I'm falling at a slow rate, I'll eat this (immediately) to begin with, I'm falling fast I'll eat that (also immediately.)But thinking what you have all mentioned is having more hypo treatments. We have these at home, they’re everywhere! But I’ll put together a hypo kit for when she’s out of the house. At the moment we just put in lift shots loose in her bag. But maybe having something dedicated for hypos will make her feel safer.
As I mentioned above I use XDrip+ (alongside Juggluco, which reads the sensors and provides the data to XDrip+) - as well as level alarms and rate of change, it gives you an approximation of IoB and CoB and a projection of likely BG. Not at all perfect but a reasonable guide and trying to do the calculations in your head is not viable imo.We don’t do much regarding IoB. We’ve been looking at it if she’s going to exercise but wondering how do you all monitor that?
I can only imagine how horrible it must be to have a very serious low.
She’s using MDI and Dexcom g6. She’s in range 89% over the past 90 days and has excellent control. But the two extreme lows have really affected her confidence.
We have got her on the list for a Medtronic closed loop system as heard they help and shut off insulin when it detects levels are trending down.
It’s really reassuring to hear you haven’t had a bad low for some time in a similar system. So think that sounds like the way to go.
We use lift shots if going low which seem to work fast, and she can feel the lows. But she’s started to really panic. She never used to and want to reassure her.
Thanks for the advice. I have been trying to get her to talk to other type 1s. She’s not up for it at the moment but I’ll keep encouraging her as know it will helpCheck injection sites as insulin can pool under the skin and this in itself can cause issues along with insulin stacking, yes as others have said the G6 is a great system but cannot detect lows when more active as the system has a lag so always carry a BG meter as back up, also use intuition, we forget with tech to tune into our senses, so using this to be aware of physiological changes when we start falling like blurry eyes, feeling spaced, not being able to string words together properly etc etc is vital.
Yes to a glucagon injection pen too - if you haven't got one already, keep one in the fridge.
Ask her to come talk to us on here too, maybe she will gain comfort from talking to others to help rebuild confidence ? Perhaps make some t1d friends, I love meeting other t1d's, we have an instant bond, also useful to just work things through mentally and cross check, it does really help.
The HCL system is a game changer and after a few months once it's settled in with ratios etc it will be an invaluable system so this should help boost confidence levels.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?