It's the medication that's dangerous

I do know of people who were not diabetic, not type 1 or 2 or disillusional and they have had a hypo. The thing is most do not know its a hypo.

How many times have you heard people say I don't feel well I will get something to eat. Hypo symptoms

How many people do you know who have had a shed full the night before and woke up shaking and sweating and feeling lousy, had something to eat and they are OK. Hypo symptoms

Non diabetics or people who are not aware of diabetes do not recognise the signs. Well they do but they don't know what it means.

The other major difference is people who are not diabetic have the functioning bits to correct a hypo before it goes to far. Or actually gets to a hypo awareness stage.

But I know people who I have worked with doing manual labour and not eaten all day and have passed out. That is a hypo. They had the signs but chose to ignore them. Body shuts down, again the difference is because its naturally induced and not medication the body quickly rectifys the problem and they tend to come round very quick.

Hypo awareness is the bodys way of saying feed me. :lol:

Lack of hypo awareness in any type diabetic goes without saying is dangerous.

Low hypo awareness is also dangerous, I would rather get the warning signs at 4 - 5 and give myself time to react than get them at 2 - 3.

It panics me enough at the thought of a hypo, you know the days when you suddenly feel hypo yet know there is know way you can be.

Fuji. Spot on as usual.

Hana.
There are many more forums on the net where somebody has made the same or similar assertion as you. I know of none where the majority that answered have backed that assertion. The one's that did are usually fairly new to Diabetes and frankly, hadn't done a lot of research in the right areas. Didn't know a great deal about the subject matter. The general consensus was as one poster put it ........' a *** theory.' His words not mine. You can assert what you wish, it does NOT make it right, as you so frequently state.

I frequently assert that the World rotates atop 4 Elephants on the shell of a Giant Turtle, The Great A'tuin, drifting through space, that if we went too far we would fall off the edge........you have to be a Terry Pratchett fan to know what I'm talking about. Mind you some people think I am barking ?
I mean that's fantasy, isn't it, everybody knows that can't possibly be ??? :wink:

As for this thread, I think I will retire disgracefully, I know when I am beaten. It's Sunday before Christmas and I have much better things to do..........

(This is all banter by the way) :lol:

hanadr said:

............It's perfectly possible to have quite severe hypo symptoms at a normal BG, such as 5 or even a high such as 7............

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Hana,

As suggested by Ken, I've just been reading up on hypos and I suspect that there are three quite different things that we are talking about here - i.e.:

a) what level is hypo'

b) what causes a hypo'

b) when are hypo' symptoms experienced.

The first thing I read was - and I quote exactly:

"Hypoglycaemia is defined as a blood glucose level of less than 2.2 mmol/l."

That is a long way away from the 4 that we seem to have been talking about here - certainly, seems a very long way below my lowest ever readings of 3.4.

Secondly, and again it is a quote: "fasting hypoglycemia is diagnosed from a blood sample that shows a blood glucose level below 50 mg/dL (2.78mmol/l) after an overnight fast, between meals, or after physical activity".

Again, we seem to be a long way from the 4 being discussed in this thread.

Thirdly, I have come to learn from reading through Ken's stuff that hypo' incidents can be caused by other non-diabetes related conditions: "Causes of fasting hypoglycemia include certain medications, alcoholic beverages, critical illnesses, hormonal deficiencies, some kinds of tumors, and certain conditions occurring in infancy and childhood".

i.e. Hypo' incidents can be caused by something totally unrelated to diabetes.

Also, and as you say, it does seem that people can be a very long way away from being hypo' and still experience hypo' symptoms from rapidly changing blood glucose levels.

Thanks to Ken, I now think that I understand better why I have never experienced hypo' symptoms and, as a non-insulin dependent Type 2, I'm still totally unconcerned about the situation that I find myself in - i.e. never gone below either 2.87 or 2.2 mmol/l and never experienced hypo' symptoms.

By the way, I've nothing whatsoever against people using "four as the floor" as a general method of advice in dealing with the situation. However, I see no point whatsoever in trying to convince people such as me that I have something massive to worry about. Personally, I don't think that I have!

Best wishes - John

Oh Yes. I forgot, there was something else I needed to do..........


I really am going for a lie down....... :?

Fujifilm said:

..........It panics me enough at the thought of a hypo, you know the days when you suddenly feel hypo yet know there is know way you can be....

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Hi Fujifilm,

I can fully understand your situation as a Type 1 - it is very different for you. It is very different to my situation and I have sympathy for you.

However, the situation is very different for most Type 2s on metformin only. Basically, as I see it we are really no different to non-diabetics from anything that I've read so far anyway. Certainly, from what little I know about the subject, I'd be very surprised to hear health authorities thinking that they needed to start some campaign to teach non-diabetics about hypo' awareness even when they are driving or doing something similar and even more potentially dangerous.

Best wishes - John

Certainly, from what little I know about the subject,

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John, this says it all. Please do more research on well reputed sites before posting potentially false information. You may ' cherry pick' 'facts' to suit your own philosophy but on here we try and stick to the established facts to educate and advise new members.
You are entitled to state opinions as YOUR opinions but please do not try and state them as FACT

John. Nice try ! Not right though.......

The numbers you are quoting refer to a Clinical Diagnosis of Hypoglycaemia in a Patient in Hospital. It is NOT the definition of Hypoglycaemia. Confusing isn't it ?? This is the level which has to be reached along with two other criteria. this is called Whipples Triad, a diagnostic approach named after the American surgeon Allen Whipple. Whipple's triad includes the following factors:

1. Signs and symptoms of hypoglycemia. You may not exhibit signs and symptoms of hypoglycemia during your initial visit with your doctor. In this case, your doctor may have you fast overnight. This will allow hypoglycemic symptoms to occur so that he or she can make a diagnosis. It's also possible that you'll need to undergo an extended fast in a hospital setting. Or, if your symptoms occur after a meal, your doctor will want to test your glucose levels after a meal.

2. Documentation of low blood glucose when the signs and symptoms occur. Your doctor will draw a sample of your blood to be analyzed in the laboratory.

3. Disappearance of the signs and symptoms. The third part of the diagnostic triad involves whether your signs and symptoms go away when blood glucose levels are raised.

That is where the 2.2 mmol/l figure comes from, NOT from a definition of Hypoglycaemia.

Then consider this:
The brain with its absolute dependency on a continuous supply of glucose is central to discussions on hypoglycemia and on how hypoglycemia is defined. Glucose crosses the blood-brain barrier by facilitated diffusion via endothelial GLUT 1 receptors and this is the major rate-limiting step. At normal blood glucose concentrations, the rate of supply is approximately twice that of neuronal glucose utilization. As the arterial plasma glucose concentration falls below approximately 3.6 mmol/l, this transfer becomes rate limiting to neuronal glucose metabolism. Clearly what matters, therefore, in determining hypoglycemia is cerebral capillary glucose concentration. However, in ordinary clinical practice the only available measure is venous serum glucose concentration and there has been long discussion as to what this value should be in order to define hypoglycemia. A commonly used value is 2.2 mmol/l but this value can only be used to diagnose hypoglycemia when two other criteria have also been established viz. the symptoms experienced should be compatible with hypoglycemia and they should be improved when the hypoglycemia is corrected.

As arterial blood glucose falls below about 4.5 mmol/l, serum insulin concentrations fall. With a continued lowering of blood glucose to below about 3.8 mmol/l there is secretion of the counter-regulatory hormones, glucagon, catecholamines, cortisol and somatotrophin (of which the most important in the acute situtuation are glucagon and epinephrine). With further reductions of blood glucose (at about 3.0 mmol/l) there is symptomatic awareness and at around 2.6 mmol/l cognitive dysfunction is apparent. However, it is clear that recent episodes of hypoglycemia can alter (increase) these thresholds so that greater reductions in serum glucose concentrations are required before hormonal responses and symptoms are manifest. This is true both for normal volunteers and diabetics. The reverse occurs (decreased thresholds) in diabetics who have had a period of high serum glucose concentrations. Thus, depending on preceding blood glucose concentrations, a diabetic may be symptomatically hypoglycemic at a ‘normal’ serum glucose concentration or asymptomatic with a serum glucose of, say, 2.5 mmol/l.

The immediate treatment of a hypoglycemic emergency is to restore circulating glucose concentrations which in a Hospital would obviously be an IV infusion. Different to the way we treat our own hypo's.....at least those of us that recognise them.

sugarless sue said:

Certainly, from what little I know about the subject,

Click to expand...

John, this says it all. Please do more research on well reputed sites before posting potentially false information. You may ' cherry pick' 'facts' to suit your own philosophy but on here we try and stick to the established facts to educate and advise new members.
You are entitled to state opinions as YOUR opinions but please do not try and state them as FACT

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Hi again Sue,

Certainly, I know very little about the wider subject of diabetes. Also, as I have said before on very many occasions, I can only talk from very limited knowledge and having a detailed knowledge of knowing about what has affected my own non-insulin dependent Type 2 condition.

As I remember things, the sites I have been looking at were the ones that Ken directed me to.

Certainly, I do not have a "philosophy" or may I say either a strong "opinion" on the subject being discussed. I was hoping to learn something new on this topic. However, I certainly haven't read anything so far that leads me to believe that I need to be worried about my particular situation.

Best wishes - John

However, I certainly haven't read anything so far that leads me to believe that I need to be worried about my particular situation.

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Well that is good John. Please remember however that there are more members who read this than yourself, so the information is aimed at all members who wish to read it.

Whatever you say Ken! Whatever you say! I'm sure that you'll be right!

Best wishes as always - John

wallycorker said:

I'd be very surprised to hear health authorities thinking that they needed to start some campaign to teach non-diabetics about hypo' awareness even when they are driving or doing something similar and even more potentially dangerous.

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There would be no need for that because non diabetics do not need to know about hypo awareness they have the working bits that regulates the BG, they have no need to know what their BG is.

"IF" a non diabetic had a hypo, its more than probable that they ignored all the warning signs.

Much the same as if a diabetic person ignored the warning signs.

The danger I feel is, a new person visits such a forum as this and they are a type 2 or diet dependant (I will leave out type 1s as we are fully paid up diabetics :lol: ) and confuses the advice being suggested.

Say I have been to the doc and he tells me you are a type 2, take metamorfin and away you go, keep an eye on your diet, and if you check your BG "4 is the floor" So off I go take the meds eat better and occasionally check my BGs and they are 5 or 6. I am happy as a sand boy and chug along on and on occasion I may feel a bit odd but have a biscuit and I am OK again.

Then I come onto "a" forum and read that people are achieving BGs in the 3s and thats more of a "normal range" so now I am confused, I want to be healthy and look after myself so I set about trying to achieve BG of 3. The consequence of this may be put me in a position that I should not be in had I listened to the correct advice from the people qualified to give it. I would love to give a non diabetic a meter and tell them to keep a BG of 3, its my guess they would be feeling pretty unwell quite quick.

The way I see it is, before being diagnosed I had no idea what my body BG was, everyone is different some run higher BG than others, personally I try and keep mine at below 9 and aim for 7 thats what I am comfortable with and can easily control it gives me hypo awareness at around 4 - 3.5

Sometimes a little knowledge is dangerous and the advice given here (in my opinion) should be that which is generally accepted and given by health professionals.

its the medication thats dangerous. :!:

Not if its taken, following the correct advice and information.

A car is not dangerous until you put a nut behind the steering wheel.
.

when first diagnosed type 2 and diet controlled the heat and stress of running a very busy kitchen would quite often give me a mild hypo. on the flipside the neuropathy that I'm currently battling my hypo awareness is out the window last night I had a piece of beer battered cod, chips and mushy peas took a 10 shot of novo and 2.5 hours later dropped to my knees rattling and 2.4 was my number usually 4.5 and I know whats instore.
well done if you can hit normal bg's but it may not work for all and the advice should come with a but and an if

I freely admit I am a newbie trying to understand T2. I did think that the original line was that unmedicated T2 were not likely to 'Hypo'. I really thought that a 'hypo' was passing out, convulsions etc and not the symptoms that warned of low blood glucose levels, so apologies to Culigula for not getting that.

My reservations about professionals and hypo advice goes back 25 years. Seven year old daughter on six occasions, when overdue to eat, felt 'sick', became unconcious, convulsed and stayed out to it for up to 40 mins. Had raft of tests including epilepsy, nothing abnormal noted, was put on glucose drip at begining of fast for a general aneasthetic and right throughout op ending up with a BGL of only 2. something 24 hours later while still on drip. Sent to endocrinologist who when I asked if she was having hypoglycemic episodes said that she didn't and that true hypoglycemia was very rare and was a bit of a 'fad disease'.

I asked what was causing the blackouts and he told me to take her to a pschyc...... We did and she could find no cause either. So in the absense of any helpful advice I continued to trust my gut feeling and feed her as if she had hypoglycemia, small meals often with plenty of complex carbs. Today at aged 32 she works physically hard as a Park Ranger and is a firefighter in her time off! She is not coeliac but wheat plays merry hell with her as does fruit, yeast, sugar and so on. Candida Albicans seem to fit the pic but one medical professional tell her it is a 'fad disease' and go see a pschyc while another gets a positive test result!

A low carb diet is working wonders and I know we are only interested in diabetes here but the cross overs are many and perhaps this might explain my lack of understanding of what a hypo really is.

Clearviews, I have a lot of your daughter's symptoms. Like her, I've learned how to avoid them. Look into LADA diabetes, and look into Graves thyroid disease.

Coeliac disease, gluten intolerance and gluten sensitivity are thought to spring from candidiasis. Gluten and candida albicans have identical attachment proteins. In attacking (deamidating) the attachment proteins, the digestive immune system slices it into proteins which other immune mediators recognize as microorganisms.

The gut releases the protein zonulin, and makes the gut wall permeable. It creates this permeability in the presence of both candida and gluten. Candida grows on ingested sugar. We ingest gluten with grassy cereal grains. All are "carbs".

In the bloodstream undigested gluten can mimic several body proteins. Perhaps most harmfully, gluten A5 mimics endorphin. The pancreas monitors blood endorphin in order to regulate catabolism .......muscle devouring muscle. When the pancreas detects A5 it floods the blood with insulin. The added insulin can cause hypoglycemia.

A couple weeks ago I added iodine to my treatment regime. It's helping tremendously, but I don't yet know what the level of restoration will be. The thyroid axis requires iodine to function. The thyroid axis includes the thyroid, the pituitary and hypothalamus. Among other things, the hypothalamus regulates immune function.

Iodine .......worth a try.
..

clearviews said:

I freely admit I am a newbie trying to understand T2. I did think that the original line was that unmedicated T2 were not likely to 'Hypo'. I really thought that a 'hypo' was passing out, convulsions etc and not the symptoms that warned of low blood glucose levels, so apologies to Culigula for not getting that.

A low carb diet is working wonders and I know we are only interested in diabetes here but the cross overs are many and perhaps this might explain my lack of understanding of what a hypo really is.

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Hi Clearviews.
There is no need for any apology. (apart from getting my name wrong ? ) :wink:

We Moderators here are just glad that this forum has helped you in some small way. We deal in the facts, not theory and supposition. We give it to you straight and then you have to make your own mind up. You are not the only one who has misunderstood something....that's why we positively encourage members to ask questions, to clear things up, to make sure things are understood clearly.
Doesn't always work - but we do our best.

I can understand your reticence regarding HCP's. I too have great reservations about some. However I am fortunate that my Endo/DSN are two of the best in the Country as far as I am concerned. Not everybody get's to have such a great team to support them. What your daughter had to endure is scandalous I just hope that things are now getting better ?

I would just like to wish you a very Merry Christmas and a Happy New Year down in Sunny Australia - I suppose Christmas dinner might be on the beach ? You lucky people !
cugila.

Ken

What Catherine has said is correct. The Law requires ALL drivers of Motor Vehicles on a road to be in proper control of their vehicles at ALL times, that includes ALL types of Diabetic's. A simple Road Safety measure.

After nearly 50 years of accident free driving I AM well aware of that.

There is no exemption because you didn't know you were hypoglycaemic, however there are certain specific defences to the offence committed which all depends on the circumstances. As a driver you should be able to test prior to a journey and also during that journey if required.

I do not suffer from Hypoglycaemia so no problems there then.

How you do that is entirely your responsibility. Nobody elses. If your GP doesn't give you test strips then you will have to buy your own. You can't blame your GP or the PCT for not giving you a meter and test strips.

I have no intention of wasting test strips for in my case a non existent condition, If and when I go on medications only then will I consider testing before driving.

As for not driving, well, if you think you are not fit to drive then you should not drive, in the same way as drink impairs ability, so does a hypo. Have an accident whilst in that condition and you could find some very searching questions being asked, and your Insurance cover may be invalidated as you would have broken the terms of your agreement, however some companies are sympathetic to things like this. The Police, I can assure you are not !

After nearly 50 years of accident free driving I AM well aware of that too.
.
If you ever have a hypo then you SHOULD feel the symptoms, (back to unawareness again). If as you say, you drive a lot it is incumbent on YOU to make the decision as to whether you drive or not.....it is solely YOUR responsibility. If you get it wrong, then the consequences can be severe. I suffer from hypo's sometimes, and test before a journey, during the journey and frequently have to stop at Services to either top up BG levels with some food or just rest while hyper levels subside. That is my choice and my responsibility. I am the driver. I am in control of the vehicle.

I have NEVER had a hypo so I haven't had the symptoms, the medications you are on would certainly increase your chances of a Hypo, don't forget it's YOUR responsibility to inform the DVLA if;

you suffer more than one episode of disabling hypoglycaemia (low blood sugar) within 12 months, or if you or your carer feels that you are at high risk of developing disabling hypoglycaemia
you develop impaired awareness of hypoglycaemia

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http://www.direct.gov.uk/en/Motoring/Dr ... G_10030957

Hope that helps.

Perhaps this is why I don't suffer from Hypoglycaemia

Interpretation
Glucose thresholds for counter-regulatory hormone secretion are altered in well controlled type-2 diabetic patients, so that both symptoms and counter-regulatory hormone release can take place at normal glucose values. This effect might protect type-2 diabetic patients against episodes of profound hypoglycaemia and make the achievement of normoglycaemia more challenging in clinical practice.

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http://www.thelancet.com/journals/lance ... 40-6736(00)03322-5/fulltext

Graham

50 years of accident free driving but seen loads in my rear view mirror :lol: :lol:

I AM ONLY JOKING

Graham.

I am so glad you are such a safe driver. It is refreshing to hear. I think I can safely add you to the hypo unbelievers list then ? Then again, as far as I am aware you aren't on any medication are you ?

you suffer more than one episode of disabling hypoglycaemia (low blood sugar) within 12 months, or if you or your carer feels that you are at high risk of developing disabling hypoglycaemia
you develop impaired awareness of hypoglycaemia

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That is SO helpful to our members Graham, you see after 28yrs, mostly as a Traffic Cop I think I do know the law regarding this.....apart from which I have NEVER suffered a disabling hypo and neither do I have a carer....I can look after myself very well thank you...... My awareness is perfect at the moment, I aim to keep it that way.

This was my response to clearviews who also WAS an unbeliever......because he didn't properly understand what a hypo was. He does now thankfully and is happy to admit his mistake.

clearviews wrote:
I am not going to hypo if I am not taking meds and never have had a hypo in my 57+ years.

Really.....I doubt very much that you would have known anything about it. Mild Hypoglycaemia can be worked through very easily. Have you NEVER found yourself sweating, felt faint, gone pale, had a headache, had tingling lips, felt your heart pounding, been anxious, had blurred vision, felt hungry, been irritable or confused, found your concentration lacking, felt like your personality has changed (shouting at the kids, ranting at the telly, newspapers, life in general,) found it difficult to get up in the morning, or shaking..... Just some of the symptoms that you might get, not all of course. One I could add to the list is a blocked nose....very annoying, all rectified with two or three Glucotabs and a snack.

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As for the rest of your post, your point is ? :?

Fujifilm said:

50 years of accident free driving but seen loads in my rear view mirror :lol: :lol:

I AM ONLY JOKING

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Now how many times have I heard that one before.......... :lol: