How to treat a hypo

annabell1 · Sep 17, 2019

Hi now that I'm doing LCHF/PALEO Keto I'm wondering what you do if you have a hypo. I was always told to take sugar then have a meal but wondering what to do following this WOE. I just got home from going out for lunch and I ate about 4to 5 hours ago got home and checked my BSL and it was 2.8mmol/L I have just taken two glucose tablets and trying to find something to make for dinner now as didn't take anything out of the freezer. I'm T2D on diamicron 30mr and junivia 100mg once daily.

Muneeb · Sep 17, 2019

annabell1 said:
Hi now that I'm doing LCHF/PALEO Keto I'm wondering what you do if you have a hypo. I was always told to take sugar then have a meal but wondering what to do following this WOE. I just got home from going out for lunch and I ate about 4to 5 hours ago got home and checked my BSL and it was 2.8mmol/L I have just taken two glucose tablets and trying to find something to make for dinner now as didn't take anything out of the freezer. I'm T2D on diamicron 30mr and junivia 100mg once daily.

Maybe you need to monitor you glucose levels closely with LCHF/KETO and it might be the case that you no longer require medication or need less? This would near enough eradicate hypo issues.

HSSS · Sep 17, 2019

If you’ve gone low carb since being prescribed your meds you need to go get them reviewed. A much lower baseline of glucose may mean that your meds are now too strong for your needs and causing the hypos.

Please don’t listen to a dr telling you to eat more carbs to match your medication. It is supposed to be the other way around. All med leaflets tell you to use it in conjunction with diet and exercise (lifestyle) and that’s what you’re doing. .

Edit for spelling as usual

annabell1 · Sep 17, 2019

HSSS said:
If you’ve gone low carb since being prescribed your meds you need to go get them reviewed. A much lower baseline of glucose may mean that your meds are now too strong for your needs and causing the hypos.

Please don’t listen to a dr telling you to eat more carbs to match your medication. It is supposed to be the other way around. All med leaflets tell you to use it in conjunction with diet and exercise (lifestyle) and arts what you’re doing. .

Yes um starting to thing that I'm just hesitant to contact as My last visit to my Endocrinologist I mentioned that I like to try get of meds he told me it was like taking tic tacs so I'm a bit hesitant to contact the clinic

DCUKMod · Sep 17, 2019

annabell1 said:
Hi now that I'm doing LCHF/PALEO Keto I'm wondering what you do if you have a hypo. I was always told to take sugar then have a meal but wondering what to do following this WOE. I just got home from going out for lunch and I ate about 4to 5 hours ago got home and checked my BSL and it was 2.8mmol/L I have just taken two glucose tablets and trying to find something to make for dinner now as didn't take anything out of the freezer. I'm T2D on diamicron 30mr and junivia 100mg once daily.

Annabell - the meds you describe there encourage you body to work harder to reduce your blood sugars, so you do have to be mindful of hypos. I'm not disputing it happened, but did you double check your 2.8 at the time? How did you feel at that level?

In terms of how you treat a hypo, I would say that depends how low you find yourself and where your next meal is on the agenda.

It sounds like you did the right thing to take a couple of glucose tablets, to tide you over. Did you test yourself again after 15-30 minutes to check the glucose tablets were bringing the numbers back up again? If your next meal is some time away, then you may need to back up the glucose tablets with something else, just to keep those numbers in check.

If you find this happening regularly, then it would be wise to see your Doc for a meds review, as it could be possible to reduce your meds a bit. In the meantime, please keep an eye on things and ensure you always have hypo treatments with you.

If you drive, please ensure you are testing before you drive, and every 2 hours of a longer journey.

annabell1 · Sep 17, 2019

DCUKMod said:
Annabell - the meds you describe there encourage you body to work harder to reduce your blood sugars, so you do have to be mindful of hypos. I'm not disputing it happened, but did you double check your 2.8 at the time? How did you feel at that level?

In terms of how you treat a hypo, I would say that depends how low you find yourself and where your next meal is on the agenda.

It sounds like you did the right thing to take a couple of glucose tablets, to tide you over. Did you test yourself again after 15-30 minutes to check the glucose tablets were bringing the numbers back up again? If your next meal is some time away, then you may need to back up the glucose tablets with something else, just to keep those numbers in check.

If you find this happening regularly, then it would be wise to see your Doc for a meds review, as it could be possible to reduce your meds a bit. In the meantime, please keep an eye on things and ensure you always have hypo treatments with you.

If you drive, please ensure you are testing before you drive, and every 2 hours of a longer journey.

All good I'm learning more here than I have since being diagnosed...

But I checked again straight after the reading it was 3.2mmol/L then took the two glucose tablets 10 minutes later tested it was 4.3. I hadn't eaten about 5 hours ago so just having something now chicken breast with cabbage salad. But thank you for explaining what to do I've never really been told by a diabetic educator what to do. Just to eat lollies sugar and have a meal.

HSSS · Sep 17, 2019

annabell1 said:
Yes um starting to thing that I'm just hesitant to contact as My last visit to my Endocrinologist I mentioned that I like to try get of meds he told me it was like taking tic tacs so I'm a bit hesitant to contact the clinic

Perhaps he’d feel differently if it were him or his family taking the tictacs (especially as those sweets are sugar lol). I understand your reluctance but if you are going hypo due to too much medication for your (new/current/ongoing) way of eating then it needs review. If you don’t want an argument just explain you’ve changed the way you eat, you like it and your numbers are better. So much so you now wish to reduce the medication to avoid the hypos and perhaps check it all again in a few months to make sure it’s all still ok. Hard to argue with that. No matter what his views all he can do is advise. You get to make the decision.

DCUKMod · Sep 17, 2019

annabell1 said:
All good I'm learning more here than I have since being diagnosed...

But I checked again straight after the reading it was 3.2mmol/L then took the two glucose tablets 10 minutes later tested it was 4.3. I hadn't eaten about 5 hours ago so just having something now chicken breast with cabbage salad. But thank you for explaining what to do I've never really been told by a diabetic educator what to do. Just to eat lollies sugar and have a meal.

Do always up the testing when you have a hypo, as they can sometimes come in clusters - especially if exercise is involved

annabell1 · Sep 17, 2019

No exercise just a normal day so do you mean even after I've eaten dinner to check again I'm guessing 4 hours?.

Brunneria · Sep 17, 2019

annabell1 said:
No exercise just a normal day so do you mean even after I've eaten dinner to check again I'm guessing 4 hours?.

Sometimes having a hypo causes my blood glucose to be a bit jangly for a while.
By that, I mean that my bg is prone to slightly more extreme highs and lows than usual as my body recovers and tries to return to equilibrium.
But I need to make clear that I am not on diabetic medication, so I'm not speaking from experience of your meds.

I suggest that you check your bloods before and after eating, and whenever you feel like you did with that hypo, and stick to a regular eating plan.

You may not experience any of the jangliness that I do!

I would agree with everyone above - if you are experiencing hypos for the first time, following introducing low carb to your regime, then adjusting your medication downwards is a good idea. If your meds really were like popping tic tacs, then you wouldn't be hypoing, would you? (excuse me while I bang my head against the desk in frustration that any healthcare professional would ever say such a thing!)

EllieM · Sep 17, 2019

One problem with hypos is that your liver will attempt to get you out of them by producing glycogen (stored glucose). This is one reason why T1s (sorry all my experience is T1) can go low at night and wake up fine in the morning. (And another reason why alcohol should be treated with caution, as it interferes with the liver's release of glycogen).

But if you are going very low carb and have multiple hypos, your liver may run low on glycogen, and your safety net is gone/reduced.

I'm googling and failing to find a scientific reference, but I thought I read somewhere that on a ketogenic diet it was normal to have a much lower blood sugar.
Interesting video here, but as the author stresses, he's only one person and is going against all the standard medical advice
TLDR, he felt fine with a blood sugar less than 3 and high ketones....
Would be interested in comments from keto T1s....

Daibell · Sep 17, 2019

Hi. Diamicron (Gliclazide in the UK) makes the pancreas produce more insulin so you may need to reduce the dose and/or make sure you don't do without carbs for too long between meals. When I go hypo I just take two glucose tablets and usually leave it at that but do have some low-GI carbs as well if worried.

Resurgam · Sep 17, 2019

Eating a low carb diet is a very powerful tool in lowering blood glucose - it is not just a fad diet for reducing weight, you really need a re evaluation of your medication and it is not at all sensible to go on taking it if you are dropping low - there are those who have no need of tablets or even insulin after going low carb, it is that good a way to treat the problem.
Although it seems wrong, if you continue to that medication - be sure you are eating enough carbohydrate to counteract the effects of it - you can go back to lower carb once you have seen your doctor or nurse to sort things out. If they go all glazed eyed and smilingly tell you to go on eating the carbs then you might just have a problem.....

KK123 · Sep 17, 2019

Resurgam said:
Eating a low carb diet is a very powerful tool in lowering blood glucose - it is not just a fad diet for reducing weight, you really need a re evaluation of your medication and it is not at all sensible to go on taking it if you are dropping low - there are those who have no need of tablets or even insulin after going low carb, it is that good a way to treat the problem.
Although it seems wrong, if you continue to that medication - be sure you are eating enough carbohydrate to counteract the effects of it - you can go back to lower carb once you have seen your doctor or nurse to sort things out. If they go all glazed eyed and smilingly tell you to go on eating the carbs then you might just have a problem.....

That is such a good way of looking at it Resurgam, food is a very powerful tool and should be considered as a 'medicine' in and of itself instead of just fuel. If you are reducing your 'food medicine' then other medication has to be taken into account. As for your last paragraph, would they tell a person with a nut allergy, 'Here's your EpiPen, go on eating nuts and use this'??

Resurgam · Sep 17, 2019

Taking Metformin due to going hypo - as it restrict the liver releasing glucose - that seems rather a mistake.
When I was taking Metformin I had to sleep wrapped in two towels and change the bed every morning - it was turning me inside out - I still have a few residual problems, I think from the internal pressure, but I should not have tried to take it for so long when I felt so ill.

annabell1 · Sep 18, 2019

Daibell said:
Hi. Diamicron (Gliclazide in the UK) makes the pancreas produce more insulin so you may need to reduce the dose and/or make sure you don't do without carbs for too long between meals. When I go hypo I just take two glucose tablets and usually leave it at that but do have some low-GI carbs as well if worried.

thank you I have only discovered the glucose tablets about 2 months ago as I always used to eat lollies or sugar but they spiked my BSL to high and hated having one extreme to another I don't get many low hypos like I had yesterday normally I would feel shaky if it dropped to 4.3 mmol/L and yesterday I felt tired and a bit shaky but not like I was having a hypo.

annabell1 · Sep 18, 2019

HSSS said:
Perhaps he’d feel differently if it were him or his family taking the tictacs (especially as those sweets are sugar lol). I understand your reluctance but if you are going hypo due to too much medication for your (new/current/ongoing) way of eating then it needs review. If you don’t want an argument just explain you’ve changed the way you eat, you like it and your numbers are better. So much so you now wish to reduce the medication to avoid the hypos and perhaps check it all again in a few months to make sure it’s all still ok. Hard to argue with that. No matter what his views all he can do is advise. You get to make the decision.

yes I thing I better contact the clinic for advise

annabell1 · Sep 18, 2019

Resurgam said:
Taking Metformin due to going hypo - as it restrict the liver releasing glucose - that seems rather a mistake.
When I was taking Metformin I had to sleep wrapped in two towels and change the bed every morning - it was turning me inside out - I still have a few residual problems, I think from the internal pressure, but I should not have tried to take it for so long when I felt so ill.

sometimes I think we need to listen to our bodies and doctors need to listen to us especially when suffering side effects or reaction. I was put on metformin when first diagnosed I was in hospital to treat sever Pan Ulcerative colitis and was put on high dose of hydocortisone infusions and prednisone and ended up with diabetes so they put me on metformin which made my colitis worse. thank goodness I finally was put under the care of a specialist to treat my ulcerative colits and automatically took me of the metformin and was then put on insulin as my BSL was very high from the steroids then.

annabell1 · Sep 18, 2019

KK123 said:
That is such a good way of looking at it Resurgam, food is a very powerful tool and should be considered as a 'medicine' in and of itself instead of just fuel. If you are reducing your 'food medicine' then other medication has to be taken into account. As for your last paragraph, would they tell a person with a nut allergy, 'Here's your EpiPen, go on eating nuts and use this'??

EllieM said:
One problem with hypos is that your liver will attempt to get you out of them by producing glycogen (stored glucose). This is one reason why T1s (sorry all my experience is T1) can go low at night and wake up fine in the morning. (And another reason why alcohol should be treated with caution, as it interferes with the liver's release of glycogen).

But if you are going very low carb and have multiple hypos, your liver may run low on glycogen, and your safety net is gone/reduced.

I'm googling and failing to find a scientific reference, but I thought I read somewhere that on a ketogenic diet it was normal to have a much lower blood sugar.
Interesting video here, but as the author stresses, he's only one person and is going against all the standard medical advice
TLDR, he felt fine with a blood sugar less than 3 and high ketones....
Would be interested in comments from keto T1s....

thank you for the link to video and explanation on how our bodies react as all have suggested I think I need to contact my diabetic clinic to discuss what to do.

I don't have many hypos even before eating this way my BSL would go down to 4.3 sometimes 3.9 but never had it as low as I had yesterday but I am know wondering if it was a real hypo after reading some replies because as soon as I got that reading I panicked but retested my BSL it was then 3.8 I think. it is confusing how do you know if it is a correct BSL reading.

I think I need to discuss with my doctors and specialist as I was always told don't let it drop down below 4 and treat it like a hypo if it does regardless and see if I can reduce or come of the medication.

annabell1 · Sep 18, 2019

Brunneria said:
Sometimes having a hypo causes my blood glucose to be a bit jangly for a while.
By that, I mean that my bg is prone to slightly more extreme highs and lows than usual as my body recovers and tries to return to equilibrium.
But I need to make clear that I am not on diabetic medication, so I'm not speaking from experience of your meds.

I suggest that you check your bloods before and after eating, and whenever you feel like you did with that hypo, and stick to a regular eating plan.

You may not experience any of the jangliness that I do!

I would agree with everyone above - if you are experiencing hypos for the first time, following introducing low carb to your regime, then adjusting your medication downwards is a good idea. If your meds really were like popping tic tacs, then you wouldn't be hypoing, would you? (excuse me while I bang my head against the desk in frustration that any healthcare professional would ever say such a thing!)

I do get shaky before this woe but my BSL could be 5 and I felt like I was having a hypo but I think my BSL would spike high then from all the carbs I ate so may body wasn't use to normal BSL.

I suggest that you check your bloods before and after eating, and whenever you feel like you did with that hypo, and stick to a regular eating plan.

agree I thing that is what I need to do check my BSL more frequently more so especially as I am eating this way

I have had hypos before but it is very rare maybe a few times a year and I treated it before doing this WOE with sugar lollies or banana as that Is what was my understanding what I had to do. I recently discovered the glucose tablets as I read somewhere that it was better to take those then to what I used to do and I do found them so much better than what I did before.

I am so grateful for all the advise I am getting on here I joined this forum years ago but never really used it but wish I did as I have learned more in the couple of weeks. i

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