low carb diet and hypo unawareness

[banjo brunette]

Since Bufferz has just mentioned this topic on another post here, I thought I would ask for people's experience of decreasing hypo awareness as blood sugar levels fall on a low carb diet.

When my HBA1c was in the 8s and bg levels were anywhere between 7 and the high teens I was prescribed pioglitizone and glimepiride (sp?) and I got hypos at around mid 5s - my lovely diabetologist kindly suggested that these were "only hypos to me" - not real as they weren't at four but my body reacting to a relative low. OK.

Now I'm low carbing (have been for about 4 months now but not due a HBA1c until before my next clinic visit in February) my daily range is 4.2 to around mid 5s and anything in a 6 is a high. HOWEVER, I don't seem to feel hypo warnings anymore in the low 4s. My only properly sweaty, nervy "normal"-feeling hypo recently tested out at a very low 2.9. A little voice in my head told me to test last night (no physical signs) and I found I was at 3.7 and did something about it.

I can understand how this might happen but is it dangerous for type 2s??

Cor!! What a long post - sorry. And forgive me if I've got HBA1c wrong - I usually describe it as the HB-thingy as I can never remember the letters in the right order :roll:

Cheers, BB

 

[hanadr]

BB
Those low numbers need not be dangerous in a T2. It rather depends on what medication you use. If it's insulin or a sulphonylurea, you could have a problem. If it's Metformin, it probably isn't. The reason is that on Metformin alone, the Bg level isn't likely to be changing very fast, so you have time to realise what's happening and correct it. The Hypo causing mediations can overtake you, although, when I did use Gliclazide a few years ago, It never went too fast for me and I always got a correction in time.
Is there a pattern in the time of day, or activity, which cause the drops? If so just being aware and doing a check could be the answer.
You obviously do have a subconscious awareness, because it did alert you.
Hana
PS the conventional reply would be to say to run BG a bit higher for a while, but I'm guessing you don't want to give up your good numbers.

 

[banjo brunette]

Hi Hana
I take metformin as well but don't think that causes hypos. I suspect it could be the Glimepiride - even though I'm down to only 1mg a day. As to what causes the hypos? Sheer naughtiness and not getting round to eating at a routine time - it seems to be a bit of a Saturday special with me since somehow my good weekday eating routines seem to go pear-shaped at the weekends...

I'll stick to what I'm doing on the low carb front until I go to the clinic in a few weeks' time. It would be quite wrenching to see those levels go up now!
Cheers, BB

 

[Doczoc]

I'm a type 2 and think I have good hypo awareness.

I function very well at 3.8+ but can tell instantly when I am 3.6 (never seem to fall below this). When you are used to stable, low BG numbers it becomes far easier.

The worst ever was a 2.3, that was after a VERY heavy night out on the beer, wasn't nice at all. That was the only hypo I've ever experienced.

 

[banjo brunette]

Hi Doczoc

Ouch, hypo AND hungover?

I seem to have reached a point now where a little voice kicks in at about 3.9ish and says "fancy doing a quick test?", which as Hana points out is still a sort of hypo awareness, and very low 3s or high (???) 2s where I still get full-on physical hypo signs. Since the last one I had at this low scared me quite a bit, I've tried not to get into this position again (though I did come over all peculiar at the checkout in Asda on Friday...)

Will just have to remember to carry my meter and listen to the little voice.

Cheers, BB