Is hypo a serious issue for T1?

[Rabdos]

Hello

Is hypo still a serious issue for Type 1?

Because I see huge focus on preventing hypos when my impression is that the main morbidity/mortality comes from hyperglycemia complications.

Thanks!

 

[Deleted member 527103]

Yes, definitely. Hypos are very serious.

The way I see it is high levels build up problems for the future whereas hypos cause problems now.
You can become unconscious from a hypo much quicker than from a hyper and this is why there is focus on minimising them.
Imagine driving a car back from the gym, blood sugars suddenly fall due to exercise, you pass out and crash the car.

That said many severe hypos can cause long term issues

Is there a reason for your question @Rabdos ?

 

[lessci]

Hello

Is hypo still a serious issue for Type 1?

Because I see huge focus on preventing hypos when my impression is that the main morbidity/mortality comes from hyperglycemia complications.

Thanks!

Worse case scenario - Untreated Hypo = diabetic coma = death

 

[Juicyj]

Yes hypos are incredibly dangerous for insulin controlled diabetics, aside from death, hypoglycemia can cause fuel deprivation in the brain which is the first organ to suffer when levels become dangerously low.

 

[EllieM]

The whole dead in bed syndrome for youngish T1s is incredibly scary and may be associated with heart failure due to night time hypos.
https://www.diabetes.co.uk/diabetes-complications/dead-in-bed-syndrome.html

Supposedly it's not as dangerous as a DKA but personally I have had ambulance inducing hypos (worse for my husband than me because he thought I was dead./dying) and no DKAs.

As a T1, I can inject extra insulin when my bg goes high. When my bg goes low I can treat with glucose, but if it goes too low I am no longer mentally able to manage the condition.

Cgms make it less dangerous (if you have access to one) but it's still a long term risk/fear.

To put it brutally, long term high bgs give you diabetic complications. Short term, hypos can kill you.

 

[Fenn]

Personally I hate them but not because of the danger, they are just horrible horrible horrible

 

[Ushthetaff]

Both high and low blood sugars aren’t good but hypos untreated will result in no complicatIons ever ,as you’ll not be about to have them .

 

[Deleted member 543160]

As a T2 my understanding is that both hypos and hypers can be life threating events for T1s, but hypos possibly more so because they happen faster.

 

[NicoleC1971]

Hello

Is hypo still a serious issue for Type 1?

Because I see huge focus on preventing hypos when my impression is that the main morbidity/mortality comes from hyperglycemia complications.

Thanks!

Get your point but yes they are serious because if you have them frequently you lose warning signals and this can result in death or injury.
Yes - fear of hypo results in over treating hypos or playing it safe by running high. It is a tightrope for type 1s.
Your question isn't unreasonable but from an emotional pov, low blood sugars are very scary whereas the high is horrible but its harms are deferred to the 20 year horizon...Yet of course high sugars (plus high insulin for type 2s) causes more disease.

 

[EllieM]

There's a fascinating thread here about hypos versus DKAs and hospitalisation
Which results in more hospitalisations: severe hypos or severe hypers (DKA)? | Page 2 | Diabetes Forum • The Global Diabetes Community

It's pretty old, and I'd hope that the advent of cgms (libre and dexcom) have improved the figures.

Yet of course high sugars (plus high insulin for type 2s) causes more disease.

Though I sort of agree, I think you probably need evidence for statements like that, and if feels a bit like comparing apples to oranges to me. eg which is worse, kidney dialysis plus leg amputation after 50 years of T1 or a car crash after two years of T1 which kills/injures you and your passengers. (Yes, both are extreme exaggerations.)

Though hypos are short term dangerous, most of us survive them fine (maybe with a bit of help from our friends) and if you're living to old age with T1 you start to notice the long term effects from high bgs.

I was probably too negative about hypos in my previous post though , since as long as you have hypo awareness you generally wake if you have one at night, and my issues with them have come when my hypo awareness has been compromised by having too many.

I love my cgm. . It's both restored my hypo awareness and acts as back up so that I don't get too many.