Hypo without symptoms?

Hi Diane . . .

This issue of what exactly is a "Hypo" is quite a sensitive one.

Some give a technical definition to Hypoglycemia, saying that a blood-sugar level below x.x is a Hypo. Others say that Hypoglycemia is defined by the loss of brain function that often (but not always) accompanies low blood-sugar levels.

I can tolerate low blood-sugar levels without any loss of brain function because I use a Ketogenic diet and spend most of my time in nutritional Ketosis. This issue was briefly discussed on a recent thread:

http://www.diabetes.co.uk/forum/threads/lchf-hypo-danger.56717/page-2#post-527324

If you are in Ketosis (due to fasting, or being on a LCHF diet) then this would be my first guess why you are fine even with a very low level. When in Ketosis, the brain is being powered mostly by Ketones, not by Glucose. Therefore a low blood-sugar level is not such a threat to the brain's well-being. In that case, warning signs will not be triggered because the brain considers them unnecessary.

If you are not in Ketosis then I can't offer any explanation, but am interested to hear any others!

Regards,
Antony

(I have learned on this forum always to express clearly that I do not advocate low levels. I don't recommend low levels or say that they are nothing to worry about. I only say that being in Ketosis significantly changes the situation regarding Hypoglycemia).

If hypo awareness is lost the usual advice is to run levels slightly higher than normal for a couple of weeks and it should return. Hypo awareness can be lost or reduced if your normal BG levels are generally low.

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Hi Diane,

Have you been diabetic for a long time and have you changed the type of insulin you use recently? The longer you have had diabetes the more likely you are to start some losing some hypo awareness and also switching to a different insulin can sometimes mask hypo awareness.

The usual advice is to run your levels slightly higher for a few weeks so your brain doesn't become used to running at low levels. Sometimes this works, sometimes not. When I started to lose my hypo warnings I was told to look out for any tiny signals that may indicate low blood sugar. Not the ordinary shaking, sweating, feeling dizzy signs but really subtle signs such as the twitch you noticed. It does make looking out for signs a whole lot harder, you have to become the Sherlock Holmes of hypo signals.

If you continue to get hypos without warnings discuss it with your diabetes team as they may be able to lend you a continuous glucose monitor to see when and why your levels are dropping so low. Good luck with it.

A close call Diane. As Mo and Flowerpot say the usual advice is to run bg slightly higher for several weeks which usually resets the hypo awareness symptoms, if it doesn't return then I would speak with your diabetes team.

Alter yr morning carb ratio so that less bolus is given and then bg test the effects.....might then be ok or might need to be altered again

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...are you on tablets for blood pressure, as some of them can mask the symptoms of a hypo...

dianehogben said:

happened again this morning. 6.2 before breakfast, now its 2.1. Lucozade is becoming my best friend!
I have been diabetic for 32 yeaqrs, and have always had symptoms, so this is a bit alien to me!!

Click to expand...

Quite a drop. I would look to reducing your insulin as it's obvious that your taking too much for the amount of carbs you eat, before you do make sure your basal insulin is set at the right dose by doing some basal fasting checks, once you know that is right you can look at your insulin ratio's.

As said earlier try running higher for a while and see if your hypo awareness returns, in the mean-time I would test your bg more frequent so that you can take preventative action before the hypo's begin.

Here's me, been wondering the same thing and just posted a message about it. You have jogged my memory though and I now remember that I once had a hypo like that. I didn't even feel 'odd'...just decided to test and guess what...I was 1.3!!!!! Should have been out cold but wasn't. Phew! Twenty odd years later and I'm still here.

Yeah I was fasting to get somethink done at hospital and they decide to take a test after about 4 hours ! I thought would b sweet but 1.1 ! All he'll broke lose but I felt fine siting down. !


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