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Hypo but I Don't Feel it!

Beachbag

Well-Known Member
Messages
688
Location
Nr Swansea, S Wales
Type of diabetes
Treatment type
Insulin
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Filling in forms! ;)
Tonight I had my usual pre dinner humalog mix 25 but couldn't finish my dinner. About half an hour ago I returned from walking the dog and did a routine BG test only to find I was 3.9. I re checked and it was 3.6 but I have no symptoms of a hypo. What do I do now?
 
Have a small sugary drink, this will bring your sugar up very quickly. would suggest then a 10~15 carb snack to avoid same thing happening through the night, stay safe

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brett said:
Have a small sugary drink, this will bring your sugar up very quickly. would suggest then a 10~15 carb snack to avoid same thing happening through the night, stay safe

Sent from the Diabetes Forum App
Click to expand...
Thanks Brett. This hasn't happened to me before. Hypos yes, but not without symptoms. It's weird.
 
Not uncommon as meters can be slightly out by 10% and are a safety net for us diabetics to check. I used to find hypos harder to feel after any form of exercise as they dropped quicker (even a gentle walk) before my brain would catch up lol. Also, if your usual sugars are 5~6 less of a safety net than if usually 6~7, and can (not always) make lows harder to feel.

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Ok, thanks again. BTW....It wasn't a gentle walk. It was a brisk one, almost three miles with just a couple of wee stops...for the dog, not me! Rosie goes like a train, lol.
 
If this was a one off incident I wouldn't worry too much. As Brett pointed out, the BG monitors have a fair bit of tolerance. If this did start happening on a regular basis and still no hypo symptoms, you'd need to run your BG levels artificially high for a few weeks to regain awareness. Hopefully though, this won't be the case.
Mo
 
Hi Beachbag!

It was probably the walk in the fresh air that masked the symptoms. If you'd have been indoors you'd probably have noticed.

Don't worry too much. 3.9 and 3.6 are very mild hypos - in fact they are normal BG levels for non diabetics. You'll come to no harm at those levels. You only need to correct it quickly to make sure it isn't still dropping.

Smidge
 
It wasn't so much the hypo, it was not recognising it which bothered me. I'm usually aware once it drops below 5. I'm wondering if low carbing has anything to do with it......not that I will give it up! Since starting low carb 30g per day, I simply don't ever feel hungry.
 
Mo, as I said to Smidge, it's not recognising the hypo which bothers me... I drive and always test before I drive but also rely on my own ability to recognise a potential hypo. I'm concerned that last nights hidden hypo wasn't just a one off and if that's the case what's gone wrong.
 
I don't take meds but it has happened to me a couple of times. My lows are usually around 4.0, 4.1 but just on a couple of occasions I have been in the mid 3s. It's just one of those things and is probably a combination of meter inaccuracy and quality of sample. Capilliary blood samples by finger prick can contain other fluids which have been 'squeezed' out into the blood sample.
 
As you know your mixed insulin is a combo of quick and slow acting, designed to deal with both basal requirements and to deal with carbs consumed. As you are low carbing, over time, this will deplete your livers ability to release glucose when needed as there will be no stores. You would probably burn all the carbs consumed with.minimal effort. This might of resulted on a very quick drop due to the fact the quick acting element had few carbs to work with, combined with no stores, which I have found to impair hypo awareness. Nothing wrong wit that but you need to discuss with your team either reduced dosage or just a basal. But, on that regime when you do fancy a "treat" you would then get a quick spike. Not sure if a mixed insulin can be matched to carbs, as of it is then your left with a very high basal element of the mixture.
I do understand that a 3. Something is a mild hypo that non diabetics get. But, with any insulin a level like that would usually suggest it would drop further all be it slower to do so in some people. I might of wrote a load of **** I'm sure someone will correct me.

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Hopefully it is a one-off Beachbag. The usual advice to restore hypo awareness symptoms is to run bg levels higher for several weeks, as a driver you do by law have to inform the DVLA if you lose your hypo-awareness altogether but I wouldn't do that just yet after one episode, see how things progress and just make sure to test more often especially if your driving.
 
Hi Beachbag,

The lower you keep your BG, the lower your body is used to having them, so it won't respond until a lower level. Have you heard of a false hypo? This is when your body is so used to high BG it thinks it's in hypo at 5s and 6s - which it clearly isn't.

As you bring your BG down, your body will learn a new 'Normal'. That's probably all that's happening. I get hypo symptoms at the high 3s generally. 4 is only an arbitrary level - it doesn't mean anything biologically. I've noticed that as a low-carber I don't get the sudden drops that I get when I eat refined carbs, so I'm often happy to leave mine in the 3s depending on how much active insulin I have on board, what I'm doing, when my last meal was, when the next one is etc. For you, I wouldn't recommend that because of your mixed insulin. As you bring your BG down through your diet, you will need to talk to your team about reducing your mixed dose so that the hypos don't become more frequent. Or, maybe consider a move onto basal/bolus so that you can tune your bolus to your needs.

Smidge
 
Hi Beachbag

As you are now achieving better control of your bg levels with the pre mixed insulins, the bg level of 3.6mmol is not exactly the true hypo feeling so don't worry that you didn't get the classic hypo feeling. You will probably get it when your bg falls to below 3.5mmol. The time to get a bit concerned is when bg levels fall down to 3mmol or below that even as that usually signifies not enough carb being eaten or the other way of too much insulin or even control of bg levels being 'too tight'

For the time being remember to eat carb in the correct amounts like I said before - 'little and often' and test your bg levels frequently until you are able to know what amounts of carb you need to eat at different times of the day to keep the action of the pre mixed insulin ok.

ALWAYS ALWAYS carry some glucose tabs or sweets on you when you go out especially when doing any form of exercise and also keep something like a bag of hula hoops on you just in case you need a bit more than just glucose tabs. Also, remember to take your bg meter out with you so that you can test to find out how low or high your bg is and take prevention steps. Its easier through bg testing to prevent hypos than it is to treat them....
 
Thank you everyone for sharing information. A couple of points....

( Not **** Brett. All useful knowledge! ) I'm gradually understanding more about the science behind LC, it's fascinating and makes even more sense to me.

Smidge, my Diabetic Nurse mentioned the possibility of swapping to basal/bolus. I have to call her tomorrow so will raise it with her again because I really think LC is the way for me

Noblehead. The driving thing is my biggest concern. Having been off the road already due to a GP error, I am extremely careful about testing pre driving etc. Living where I do, with my lifestyle, and alone, driving is essential. Fingers crossed it was a one off!


iHs. I normally get true hypo feelings below 4.2.....under normal circumstances 3.6 has me reaching for glucose pretty fast. Last night I thought I'd be ok. Usual amount for dinner etc except I couldn't finish it and thereby, I think, lay the basic problem. I always carry emergency glucose supply especially as I lead an active life in some fairly isolated places, and had I picked up on the usual hypo warnings I wouldn't have got as low (for me) as I did.
I'm enjoying this "voyage of discovery" and really appreciate the help and time you all so readily give. Thank you
 
If the same happens again Beachbag just have a small glass of orange juice or a biscuit to make up the carbs. Good luck on your voyage of discovery......... we never stop learning that's for sure
 
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