Hypo's

Hi,

i also sometimes have hypo's i dnt feel until its around 2.2, then sometimes i get shakey and sweaty etc at 3.9, it's odd how it changes.

i'm sure it's normal for some people to not have any awareness of hypo's which is very unfortunate.

If your worried about it speak to your diabetes specialist about it

and i would continue regular testing especially after any vigorous exercise

you donnt say which Type you are but if you inject, testing an hour or two after meals regularly would be a good idea too.

all the best x

jude2008 said:

I have had quite a few hypo's lately, and worryingly, I have only been aware of them because I picked them up due to routine testing. I have not had any symptoms at all. Usually, I get sweaty, shake,etc., but not recently. I worry because I live alone now and am scared that it will happen when I am asleep. I was only diagnosed 6 months ago, so I am still finding my way around all of this. Is it normal to have hypos with no symptoms?

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Hi Jude2008.
As far as I am concerned, No, it's not normal to have no hypo awareness. As you are a Type 1 this can lead to a dangerous situation developing. You must try and get your hypo awareness back. It is not good that you do not get the symptoms at low levels.

It is not unknown for long term Type 1's to have little or no hypo awareness, approximately 20 percent of long term insulin-dependent diabetics exhibit hypoglycemia unawareness, however that is an individual thing. It is something that can be reversed using some simple techniques. However you are fairly recently diagnosed (6 mths) which would seem to indicate your bg levels have been running low for some time ?

What type of Insulin do you use ? It is possible that you may be having problems with the Insulin so I would suggest talking to your Nurse in respect to changing it over to something else. Synthetic and analogues are known to cause hypo unawareness.

The most usual method for Reducing Hypoglycemia Unawareness is this:
1. Raise blood sugar targets for two to three weeks in order to avoid low blood sugar.

2. Test blood sugar more often, providing more data to make more rapid adjustments.

3. Increase protein intake and reduce carbohydrate intake, reducing insulin requirements.

4. Use the data from additional blood sugar tests to note the different symptoms experienced at specific blood sugar levels.

There is another method which involves frequent testing and recording of the results. Patients test their blood sugar more often; some test as often as 12-15 times per day, thus, providing themselves more data to make more rapid adjustments. You can also increase protein intake and reduce carbohydrate intake, thereby reducing insulin requirements, which reduces the overall risk for low blood sugar'

Whichever method chosen, it is important to restore awareness of low blood sugar in order to prevent major incidences of hypoglycemia. A major incidence is defined as one that requires assistance. For example when someone loses consciousness or has a seizure. Although seizures are rare they are quite dangerous and can result in short-term or permanent cognitive damage as well as the loss of driving privileges in the UK.

You are probably best discussing this with your DSN or GP to find the best way to restore the awareness.

ebony

When you say hypo and not being aware of it, what sort of figures are you getting?

Sometimes the symptoms of a pending hypo can be very subtle so you need to really think are having symptons and just not realising what your body is trying to tell you?

Concerning night-time hypos, you would be wise to carry out some BG testing over night, to build ap picture to what is happen with your BG, you don't have to set your alarm cloclk for every hour on one night, (can if you want do thouggh) but starting with 2am (this is the should be near enough to be your bodies lowest ebb for hormone production, so in theory the lowest your BG should get over night) the on different nights, set your alarm a hour different, I normally start at 2am, then work towards the moring, depending how quick I want the data, I will do either every night or every other night... you then build a picture, so can if necessary change your back ground insulin to better suit..

There are subtle symptons that suggest if you've had a night time hypo, You waking BG is a lot higher than your bedtime, You can also feel awful, suffer some vision problems all can point to night-time hypo's... You feel like you've been on a drinking binge but you haven't touched a drop of alcohol!!! most likely to slept through your hypo..



Ken has given some good advice, but I am concerned with number 3, as to start to reduce carb and increase protien, you do need to understand carb counting, how to determin if you back ground insulin is correct, understand the effects of any exercise you do.. And know your carb to insulin ratio's for meals, adjustments etc.. If you haven't been a diabetic for very long, and don't follow a carb counting regime, then this really shouldn't be undertaken without the advice from your diabetic medical team....


Hypo unawareness can be caused by running tight control near to the lower ranges of blood glucose, also having a rollar coaster type control where you bound from high to low and back again can cause this alongside long term diabetes..

In your case has you've only been diabetic for a short period of time, I suspect you aren't picking up the subtle warnings from your body, so I would suggest that you take regular (and some extra tests) so that you build your data for your food intake, etc testing when exercising or doing something slightly different, if you food your self low, have a very good think to how you are actually feeling as you might just realise that there is something there telling you!

hi jude,
i did read your first post about your other problems, depending on what you take for them , i know quite a few can cause low blood sugar, so i would check this with your health care provider

jude2008, it sounds to me that this is a temporary situation that may be resolved by running your blood sugar a little higher than normal for a few weeks. It's certainly worth trying, you could ask your diabetic healthcare team for more info on this. Persistent low blood sugar levels can reduce your awareness of symptoms, that can normally be restored by doing this, especially in someone so recently diagnosed (your profile says 1 year?).

cugila said:

It is not unknown for long term Type 1's to have little or no hypo awareness, approximately 20 percent of long term insulin-dependent diabetics exhibit hypoglycemia unawareness, however that is an individual thing. It is something that can be reversed using some simple techniques. However you are fairly recently diagnosed (6 mths) which would seem to indicate your bg levels have been running low for some time ?

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Sorry to disagree with you Ken, but the situation you describe points at autonomic neuropathy as a cause, which cannot be reversed so easily (if at all). Doesn't appear to be relevant to jude2008's situation either, being diagnosed only a year?

Hi Keg.
No problem. You are welcome to disagree, we all have our own opinions and experiences.

The question asked was this,

Is it normal to have hypos with no symptoms?

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I did suggest that she should discuss it all with the Nurse as it does seem a trifle strange as being only 6 months diagnosed. Could be down to the Insulin, we don't really know. Your suggestion could also be right. However, I would not go anywhere near offering what may be considered a diagnosis of a particular condition. That is not allowed on the Forum. There are many things it could be and we always try not to scare the member by concentrating in one particular area, hence the advice to discuss with HCP. As I also have NO experience of autonomic neuropathy I have no idea if it is a possible cause and I certainly wouldn't presume to give out advice on the subject unless I knew what I was talking about.

As there is a whole host of symptoms besides feeling hypo which the OP has not mentioned, I would have to disagree with your view too. See this link about symptoms of autonomic neuropathy:
http://www.mayoclinic.com/health/autono ... N=symptoms


Best to leave it to the real experts I would say.

Ken

My symptoms have changed since moving from mixed to b/b

They are still there, but unless its a fast drop or a bad hypo then I dont always get the previously obvious symptoms. My bg is a bit higher actually on b/b mainly( :? ) but the symptoms less

I think its about reinterpreting - ie feeling quite sick or hot, as opposed to floaty or shaky

Jude,

As a T1 diagnosed 6 months ago you may be having a 'honeymoon'. That is, a time soon after diagnosis when you need much less insulin (maybe even none) for a period of weeks to months. It's temporary, you'll need to keep testing frequently and keep in touch with your care team to identify when the honeymoon ends, because your insulin requirements will go back up again.

You need to contact your doctor or DSN for advice.