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Hypos, How Do You Deal With Them Mentally And Emotionally?

C

col101

Well-Known Member
Messages
358
Type of diabetes
Type 1
Treatment type
Insulin
Morning all,
I'm still new at dealing with being Type 1 and wondered how people deal with the mental and emotional side of hypos. I think I get the physical stuff about glucose tabs/drinks and testing frequently until feel back under more control.
Ever since a big hypo of 1.7 that resulted in paramedics and A&E I find I'm really thrown by any sort of hypo even if I detect it early and deal with it without drama. So for example was 3.4 yesterday evening probably due to experimenting with alcohol for first time since diagnosis! and within an hour was back above 5 and fine. But this morning I feel like taking insulin or eating carbs is like playing russian roulette, a tightrope between hypos and diabetic complications, and I just wondered about others' experiences, do you just shrug it off and carry on as normal, do you get ultra cautious for a while and run a higher target or what?
Really value any thoughts and feelings, thanks.
 
Hi Col101,

I don't know if I have any magic solution to this but wanted to say I think what you're feeling is completely normal... I'm guessing you were diagnosed relatively recently...? I was diagnosed three years ago and sometimes hypos still trip me up and knock my confidence for a little while...

I would say don't be too hard on yourself; insulin is wonderful but it can be scary too... So when these 'blips' happen then I try to tell myself it's okay to feel a bit wobbly afterwards - from experience, trying to tell myself to 'pull myself together' rarely works ;-)

Also if I'm really shaken then I sometimes go a little lower carb for the next meal/day etc - just so I don't need to dose too much - and I feel this gives me a bit of breathing space to build my trust back up that it's all going to be okay...

Lastly I have a cgm - this made a huge difference for me - but I know isn't an option for everyone.

- oh, and I forgot - alcohol always makes me need significantly less insulin too - I've learnt to drop my basal and carb ratios if I drink - but sounds like you kinda worked that one out... :)

Basically I just wanted to say you're not alone in your feelings though - and your confidence will grow - but it's okay to have the wobbly days sometimes too (hug).
 
Dr Richard Bernstein advocates 'The Law of Small Numbers' - it makes perfect sense to me. If you follow a strict low carb diet, your insulin requirement will be much lower and the likelihood of huge swings in blood glucose will be much reduced. He has a 'Diabetes University' You tube series, which is free, a very good and inspirational website and a very detailed and informative book.
However, I am not T1 diabetic, I am no longer even pre-diabetic, so I don't speak from personal experience.

http://www.diabetes-book.com
 
I agree with @-Artemis- what you're feeling is completely natural, I don't think any of us like them, so you're not alone in how you're feeling. Mine vary greatly from feeling a bit hungry at 3.8mmol/l to shaking, sweating and feeling pretty awful at anything less than 3.2mmol/l. However I have to view them as both blips and learning curves, as there is always a reason you go low, so learn from them and it will help you increase your knowledge to know how to manage and avoid them. Using a Libre will help you see if you start going low, so if you're happy to invest in one it will show when you're starting to fall so you can take action, using one will also help your confidence ;)
 
I've had diabetes for more than 20 years so I've got used to hypos a little more. What helped me was getting my pump because my basal insuoin just wasn't working as I needed, leading to random lows, which were stressful because there was no pattern or sense to them.

If you have a bad experience, the it can shake you up for quite a while. I think the important thing to do is go through it in your head - what happened and why - reassure yourself that you hadn't done anything silly and that you actually coped well. It might not have been very nice, but it will have made you stronger and more knowledgable about diabetes. Every little thing we learn is another piece of ammunition in the 'battle against diabetes'.

Wen I drink alcohol, I always have some carbs with it (without bolusing) I find that works well - crisps, savoury biscuits, etc. I don't have a huge amount but I nibble as I drink. I also usually test during the night if I've had more than a glass of wine or similar.

I'm presuming you're counting carbs and can adjust your insulin to match. Perfecting your carb counting is also very helpful. Get a half unit pen if you don't have one already.

When you're doing anything different, test extra. I find testing provides reassurance as well as information.
 
Hi @col101

Experiencing low bg levels like 1.7 would knock the wind out of your sails and shake your confidence, that is understandable and I'm sure we have all been there at some point.

The only way of moving on is look for the possible cause and try and learn from it, but hypo's can happen for no rhyme or reason and no mater how hard we look for the answer we don't always find it, in this instance you should just move on but test more regularly as no doubt you are doing already.
 
All I can suggest is to ensure you have reduced the possibility of hypos by balancing the Basal, getting the Bolus ratio right when carb-counting and having a low-carb diet plus testing often enough. Have you done all of these things so far?
 
Anything involving paramedics is scary and I always found it deeply embarrassing. I felt it was a personal failure to handle my diabetes even though the few hypos that have ended that way with me were for reasons completely out of my control. It takes time to recover from that feeling of being unable to help yourself. I've been type 1 for 33 years now and reading this reminded me of a hypo 15 years ago while staying at my friend's house in the States and they called the paramedics because I went into a coma. It was deeply embarrassing and I remembered bursting into tears on the coach the next day because I couldn't find a seat and feeling like I never wanted to travel by myself again.

You do get over it. You learn from each one, you take your precautions and you work out what things make you feel safer. Your confidence will increase and you will get to a point where a hypo is a minor inconvenience (most of the time). It is a tightrope and a lot of the time falling off it may be due to a factor that you hadn't considered (hot/cold weather, stress, mood or just because). All you can do is keep on going and remember that you're doing a great job.

My usual rule of thumb is treat with 20g of fast acting carbs and when on injections it used to be follow up with 20g slower acting eg cereal bar to stop a rebound. I found the discipline of this helped with stopping me eat everything in sight while giving something to satisfy the cravings. It also most of the time did stop a rebound worse hypo. I don't know what the reason for your 1.7 was but I've always found this worked well for me.
 
Thanks for all your really supportive replies and helpful advice, its's re-assuring to know its not just me that feels this way!
I know the dust will settle and I'll feel less nervous calculating and trusting that each dose of novorapid won't send my BG tumbling. It's early days, diagnosed in February, and I hope it feels a bit less like Sisyphus being punished by the gods as time goes on.
I'm not totally clear why that 1.7 hypo happened, seems like my insulin sensitivity changed by about 50% over about 3 days so my ratios were wrong and I therefore took 1.5 times what was needed. I realise now I should have spotted this happening over the 3 days and ignored a warning shot hypo. Lol, told my DSN it was only a little hypo and got a lecture about there being no such thing as a little hypo.
I do carb count and adjust bolus, feel I should try a basal test once things settle a bit. A snack at bedtime was routine in long hospital stay and without it my BG drops overnight so I'm wondering if even my recently lowered basal is still too high.
I keep reading about CGMs and may talk to my DSN to see if there's any chance to beg or borrow one through the NHS, cant afford to self fund as I've been off work since February.
I feel lucky to have found this group and very grateful for all your help and support.
 
As you get to know your diabetes, you'll be better able to predict hypos @col101 For example, you'll know what's too low for you two hours after a meal and be able to eat a tiny amount of carbs to push you a little higher.

A basal check is an excellent idea : )
 
Hi @col101
with you only being diagnosed this year ( February ) your body could still be sporadically producing a bit of its own insulin -- this is called the honeymoon period , so it is possible this could have been a factor in the 1.7 hypo as well.

I know it is easy to say you will get used to dealing with hypo's and not fear them , but it does take time and learning through experience what works for you.

I have managed 44 years so far of fairly successfully managing hypos ( a few paramedic visits :rolleyes: )
but remember it is you running your life -- not the D running you !
 
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