Hypo experience

[Dalekkiller]

I've volunteered my services to talk about hypos to a bunch of doctors in the new year (eek!). I've written a short paper about my experiences and what I think would help (adequate test strips and education). Any extra thoughts would be gratefully received. Thanks in advance

 

[Daibell]

A few random thoughts based on many posts I've seen. Best to avoid hypos in the first place:

- Try to minimise insulin by advising to keep carbs at a sensibly controlled level. This will minimise blood sugar swings and hence avoid swinging into a hypo
- Go for Basal/Bolus rather than a mixed insulin where the patient is happy to manage two insulins etc. This gives better control as long as the patient has the right education.
- Advise to wear a wrist band if at risk e.g. in the gym which I do.
- Advise to tell family and close friends what to do in the event of a hypo

I've only ever come close to a hypo so not the best person to talk from experience

 

[noblehead]

Definitely a good opportunity to say that you believe that all diabetics should have test strips on prescription regardless of treatment or type. Just explain to them what happens when you go hypo, for example the symptoms that you experience and how frightening they can be if levels drop too low, also explain your treatment methods and how you might also follow this up with a carby snack if it's within a few hours of injecting.

You could also go into the after-effects of hypo's explaining how they can often leave you drained with headaches (again if bg drops too low) and how they can effect you psychologically......especially if someone lives on their own. Emphasise the importance of carb counting courses such as DAFNE and how they can reduce the incidences of hypo's by careful carb management and adjusting insulin doses to suit, if you've had experiences of a hypo and have had to be treated by a paramedic or A & E you might want to mention the treatment that you received and how you rated it.

Above all else don't be nervous and enjoy the experience and use it as an opportunity to get some good valid points across, I've done two talks to junior doctors in the past and although initially nervous I quite enjoyed the experience

 

[smidge]

Good on you for volunteering! Hypos are one of the aspects of diabetes that get me up there on my soapbox - there is so much nonsense and misinformation about them. For me, the things I'd like to get through to medics are:

1. Diabetes is about high BG not low BG. It is our medication that can cause low BG not diabetes itself.

2. Diabetics who are not on BG-lowering medication will NOT have serious hypos and do NOT need to treat them.

3. Slightly low BG is NOT a hypo - it is normal and usually does not need treating (unless you happen to have a lot of insulin on-board).

4. 4 is NOT the floor!!! It isn't even low BG. There is a large margin of error built into that figure and as long as your BG is not falling rapidly you'll be fine.

5. Your body will almost always correct a hypo before it gets dangerous. Don't take the chance but just know it and don't be scared.

6. Only correct a hypo until your BG stabilises. The smaller you are, the less blood you have and the less you will need to correct a hypo, so 10g rapid acting glucose and 15g slow acting carb is a guideline - it is NOT the law!

7. The more insulin you take the bigger your mistakes and subsequent hypos will be. The lower the carbs you eat the less insulin you will need.

8. More people die or suffer serious complications from the effects of high BG than from hypos. Don't let a fear of hypos make you keep your BG too high.

Ok, you won't all agree, but that's what I'd teach people!

Smidge

 

[mikegresty]

I agree with you completely test strips and testing should be increased for all as such should complete education of how to prevent and deal with diabetes, hypo and hyperglycaemia and diet. I have myself suffered greatly resulting in permanent disability at the hands of doctors failing to inform, admit or help with anyone but the most perfectly controlled diabetic and have been told the hypo types I actually suffer from dont exist despite a two week hospital stay after almost biting my tongue off and suffering memory loss at the end of which the head doctor himself sent me home after being unable to bring my levels under any form of control. I find doctors only want to see what's written clearly and in my case especially they prefer to deny any other variations.

 

[Daibell]

Perhaps worth adding that diabetics should be told that excess alcohol will stop the liver dumping glycogen in the event of a hypo, so avoid too much or any if the risk of a hypo is high

 

[catherinecherub]

I've volunteered my services to talk about hypos to a bunch of doctors in the new year (eek!). I've written a short paper about my experiences and what I think would help (adequate test strips and education). Any extra thoughts would be gratefully received. Thanks in advance

I would be interested to know if hypos are a common occurrence for you.
Your profile does not list any hypo inducing meds. Are they the result of not eating on time or exercise?

 

[VinnyJames]

I've had a fair bit of experience bringing new info to Doctors (12 years).

They know you are a lobbyist for diabetes and they know you will ask that diabetes should have extra funding. I.E testing strips, meters etc.

I was told I was 'in the diabetic range' and sent home with metformin 1000mg SR bd.

What I would have liked my GP to tell me is that diet and exercise (where possible) is the most effective along with self management. The GPs and nurses dismiss our self testing as a 'snapshot reading.' Tell them it's not to necessarily measure our blood sugar but to identify our personal food spikes.
You will not get them to Prescribe testing kits even if they accept your point (some will) as they are under a lot of pressure from PCT Prescribing Advisers. However, the impact of self testing cannot be overstated in the management of diabetes, as you know.
New patients should be aware of this.

Stress the importance of this website forum. They should tell their patients this forum saves lives and reduces complications. Sell it as a support network as GP's tend not to be fans of the internet (lots of worried well take up GP time as a result of surfing the net).

Don't be intimidated as I guarantee your knowledge will be far superior to theirs.

Good luck!


Sent from my iPhone using Tapatalk

 

[collectingrocks]

Although I did not know I was prediabetic at the time...I went into a coma-like state after drinking too much having not eaten enough. I'm sure this was due to being hypo so as Daibell mentions above, do not drink to excess, or at least without proper food in your stomach

 

[smidge]

Perhaps worth adding that diabetics should be told that excess alcohol will stop the liver dumping glycogen in the event of a hypo, so avoid too much or any if the risk of a hypo is high

Yes, absolutely. Alcohol also masks the hypo symptoms so you can go lower than usual before you realise. This is an issue for those on any BG lowering medication, not just insulin.

Smidge

 

[2131tom]

I've had a fair bit of experience bringing new info to Doctors (12 years).

I was told I was 'in the diabetic range' and sent home with metformin 1000mg SR bd.

What I would have liked my GP to tell me is that diet and exercise (where possible) is the most effective along with self management. The GPs and nurses dismiss our self testing as a 'snapshot reading.'

A very good point.

I have (IMHO) a good GP, who's given me some time to discuss my condition. But even he has only done so because I've asked him questions during several appointments for peripheral issues, subsequent to my diagnosis in September this year. I'd like to have seen an immediate offer - that should be made to ALL who are newly-diagnosed - of an urgent (say) 20 min consultation with the GP, to explain the issues involved, the symptoms I can expect to have, medication(s) that might be tried and those I might need now, and ways I might better manage my new, chronic, life-threatening, illness, followed by a rigorous case-management regime.

As it was, I too was given 1000mg Metformin and sent on my way. Nothing about what happens next, prognosis, or anything. The DN I made my own appointment for, 3 weeks later, really wasn't helpful. She wondered aloud if '1000mg was really enough' but didn't want to follow that up ('Oh well, doctor must know best' was her next remark), and seemed more concerned about what I'd done in the previous year to 'cause the problem' (weight gain, she surmised) than what I should be doing in the future.

The current treatment regime is too hit-and-miss: It seems to depend on how clued-up (or vocal) you are, or decide you want to be, whether you're well enough to push your case, and whether you have a GP/DN who can make the grade. That's an appalling approach to such a serious problem that's widespread and growing. I can't see why a transparent and progressive programme of treatment and assistance cannot be devised which must then be applied to all diabetics, with GPs etc. being monitored for overall compliance.

In terms of efficiencies, it doesn't take a genius to work out if ALL diabetics who want it (and that's the vast majority, I think) can be given help to help themselves, the NHS is in a win-win situation. If it doesn't, it's storing up a time-bomb of cost, let alone in human misery and premature demise, in the next few decades to come.

 

[Thommothebear]

Only one point from me, type 2 diabetics on metformin only CAN have exercise induced hypos, they are short lived and do not need treatment as far as my own experience is concerned as BG's will normalise again after a short while, but they can be dangerous for other reasons, such as when driving or in my case cycling or kayaking. Testing is important to ensure these can be avoided.