Newbie - Hypo confused

[Prince4]

I am a newbie, so go easy on me please

I have had my first few Night Hypos which I found to be terrifying. I do not monitor my blood but recognised the symptoms ( high HR, Numb lips etc) so quickly ate some sweets and plums and banana and calmed myself down within 10 minutes but really considered phoning 999....

Some background ,I am Type 2 and HBA1C is 71 which is high but down from 94 - 12 weeks previously. I am confident next reading will be in the 50's. I have radically overhauled diet and lost around 30 pounds since start of the year . I'm around 17 stone so still too heavy but losing weight fast. I am running around 25 miles a week and have eliminated all added sugars from diet. My diet is pretty much steel cut oats and blueberries + fish and green veg. ...2 meals a day. I am also now starting to take Metformin twice a day as opposed to just 500mg ) was scared of side effects).

My question is, how can I avoid night hypos in future. I want to restrict carbs as much as possible but now I understand that it is the lack of carbs in the evening that is causing Glucose to crash? Is it wise to eat more porridge in evening to avoid crash?

I have an Acqu-check for blood sugar but not sure when I should be measuring?

 

[Zhnyaka]

if you only take metformin, then you can't have hypo. Hypoglycemia is a consequence of hypoglycemic drugs (such as insulin or gliclazide), and not drugs that reduce insulin resistance (such as Metformin)

 

[Prince4]

Really? You cannot hypo unless you are on Insulin? I didn't know this....

 

[Zhnyaka]

Really? You cannot hypo unless you are on Insulin? I didn't know this....

not necessarily insulin. For example, ozempic or gliclazide can cause hypoglycemia because they affect insulin production, but Metformin cannot, because it only affects insulin sensitivity, but not its production. Your body is smart enough to know when you have enough insulin. If you read the side effects of metformin on its instructions for use, you will not see hypoglycemia among them (instructions for insulin even says what to do in case of hypo)

 

[dancer]

Perhaps it was a false hypo, as your blood sugar is now lower than it has been for a long time. If so, your body will get used to your new blood sugar levels.

 

[Antje77]

My question is, how can I avoid night hypos in future. I want to restrict carbs as much as possible but now I understand that it is the lack of carbs in the evening that is causing Glucose to crash? Is it wise to eat more porridge in evening to avoid crash?

If your body is used to high blood glucose, lowering it can definitely feel like being hypo, it's called a false hypo.
Your body will get used to normal levels again.

Every scary thing you read about hypos is aimed at T1's or T2's on much stronger medication or insulin, going hypo is not normally a risk in T2 because hypos are caused by medicatin, not by diabetes itself.

I have an Acqu-check for blood sugar but not sure when I should be measuring?

When you feel hypo to see what's going on!

And also before a meal and some 2 hours later to see how that meal affected you.
If you find you are more than about 2 mmol/l higher than before the meal you might want to consider having less carbs for that meal next time.

You might like to have a read of this: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

 

[Sax]

Its maybe worth saying a hypo is below 3.8 - 4 mmol/l, an HbA1C of 71 means your average daily is 11 mmol/l, down from around 14 mmol/l previously.

 

[CatsFive]

I am running around 25 miles a week

At 17 stone, that could be quite bad for your joints. Walking is better - walk up hills if you want more of a work-out. Of course if you walk up you have to walk down as well, which has the benefit of being eccentric exercise - you are lengthening the muscles under load and applying a braking force. This is in contrast to uphill walking, which is concentric exercise, shortening the muscles during contraction. However it also jolts the joints, so if you can, aim to walk up the steep way and down the less steep way.

Also cycling, rowing, swimming & weights are all forms of exercise that are much easier on the joints.

 

[Jaylee]

I am a newbie, so go easy on me please

I have had my first few Night Hypos which I found to be terrifying. I do not monitor my blood but recognised the symptoms ( high HR, Numb lips etc) so quickly ate some sweets and plums and banana and calmed myself down within 10 minutes but really considered phoning 999....

Some background ,I am Type 2 and HBA1C is 71 which is high but down from 94 - 12 weeks previously. I am confident next reading will be in the 50's. I have radically overhauled diet and lost around 30 pounds since start of the year . I'm around 17 stone so still too heavy but losing weight fast. I am running around 25 miles a week and have eliminated all added sugars from diet. My diet is pretty much steel cut oats and blueberries + fish and green veg. ...2 meals a day. I am also now starting to take Metformin twice a day as opposed to just 500mg ) was scared of side effects).

My question is, how can I avoid night hypos in future. I want to restrict carbs as much as possible but now I understand that it is the lack of carbs in the evening that is causing Glucose to crash? Is it wise to eat more porridge in evening to avoid crash?

I have an Acqu-check for blood sugar but not sure when I should be measuring?

Hi

Welcome to the forum. Sounds like you’re making good headway with your diabetes.

I see you have access to a meter which is great. Are you able to test your blood when you have these symptoms?

 

[Prince4]

Its maybe worth saying a hypo is below 3.8 - 4 mmol/l, an HbA1C of 71 means your average daily is 11 mmol/l, down from around 14 mmol/l previously.

Thanks felt like my heart was racing when I woke up. Recorded by sugar at local hospital nurse and was 13nmol but this was because I had extra toast, plums , sweets and Oats as I panicked about the low sugar. Thanks , next time I will check sugar levels when I feel like I am hypo'ing. Just checked my levels before I have dinner and they are 5.6NMOL

 

[Prince4]

Hi

Welcome to the forum. Sounds like you’re making good headway with your diabetes.

I see you have access to a meter which is great. Are you able to test your blood when you have these symptoms?

Thanks - yes just loaded up on the drums, have just checked pre meal and they are 5.6nmol....I'll check again 2 hours after dinner and then at bed time.

 

[Prince4]

If your body is used to high blood glucose, lowering it can definitely feel like being hypo, it's called a false hypo.
Your body will get used to normal levels again.

Every scary thing you read about hypos is aimed at T1's or T2's on much stronger medication or insulin, going hypo is not normally a risk in T2 because hypos are caused by medicatin, not by diabetes itself.

When you feel hypo to see what's going on!

And also before a meal and some 2 hours later to see how that meal affected you.
If you find you are more than about 2 mmol/l higher than before the meal you might want to consider having less carbs for that meal next time.

You might like to have a read of this: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Got it. So its a bit like an Alcoholic going cold turkey? The body will make someone feel sick as it craves the substance it so readily used to get....If someone checks there levels and it is a fake hypo and levels are normal then I assume you just have to ride it out??

 

[Jaylee]

Thanks - yes just loaded up on the drums, have just checked pre meal and they are 5.6nmol....I'll check again 2 hours after dinner and then at bed time.

“Drums” you use the Accu chek mobile? Don’t be afraid to use it when you have the symptoms.

Even if you have anxiety when this happens, if it is possible, check first. I use the mobile too.. takes 8 seconds for a result.

Best wishes.

 

[Prince4]

I have the decoupled Accu Check Instant. The mobile version looks good though. No need for test strips. What are your thoughts on Flash/CGM?

 

[Deleted member 527103]

I know I am being pedantic but I think we need to be careful saying "you cannot hypo unless you are on BG reducing drugs such as insulin of glyclazide".
I used to say and wrote this until my non diabetic partner bonked half way through a tough cycle ride. I tested his BG 20 minutes AFTER he stopped to recover. He was feeling "much much better". His BG at that time (after some recovery) was 2.9.
Yes, I know this is not the case for someone waking in the night. But it changed my way of thinking. And made him realise the importance of correct fueling.
So, I now try sto say "It is unusual to hypo unless you are in BG reducing drugs ..."

(I did start this comment with "I know am being pedantic...)

 

[Jaylee]

I have the decoupled Accu Check Instant. The mobile version looks good though. No need for test strips. What are your thoughts on Flash/CGM?

Been using a flash sensor Libre 1 & 2 for a number of years coupled with a non official “3rd party” app, it works great for me on my phone..
They work by interpreting a measurement in the interstitial fluid layer under the skin.
On the whole I find them close to the meter. (0.6mmol difference & im happy.) the app can be calibrated too.

I did self fund for the first 2 years with the libre. Before getting them on script. They last 14 days & cost somewhere in the region of £48?
If your buget allows? You could try one for a fortnight & spot some trends for a fortnight.

I see the meter like a speed camera where the flash or CGM set up is more like a “dash cam”

The mobile has a cassette with a tape. After the test, it just simply rolls on. It will tell you how many tests are left & even when the cartridge/cassette is due to expire.

 

[Zhnyaka]

His BG at that time (after some recovery) was 2.9.

Isn't 2.9 a normal value for a healthy and hungry person? Look, this is not a particularly rare phenomenon https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296129/

 

[Deleted member 527103]

Isn't 2.9 a normal value for a healthy and hungry person? Look, this is not a particularly rare phenomenon https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296129/

2.9 after some recovery, is not normal.

 

[Antje77]

If someone checks there levels and it is a fake hypo and levels are normal then I assume you just have to ride it out??

Depends, and it's a matter of personal choice too.

I wouldn't like someone who's driving and experiencing all the hypo symptoms with a false hypo to keep on driving and just ride it out for instance!

I think I would go for a compromise: If my meter showed me I wasn't in hypo territory but much lower than I'm used to, and if I was feeling very rubbish with the false hypo, I think I'd have a small bite of fruit or such to see if that does the job. Just nudge the BG up a little to feel better and be able to funtion again.
I wouldn't go all out T1 style hypo treatment, throwing dextro, toast, plums , sweets and oats and whatnot at a false hypo.

Some T2's prefer riding it out but I sure hope they don't if they happen to be operating machines or cars when it happens.

 

[KennyA]

I have a feeling there are T2 issues not fully understood yet.

I get night sweats, nightmares etc which correlate with sudden steep drops to "hypo" levels in my BG (as shown from using a CGM for a time). I don't think these are sensor pressure issues, because of the correlation with the physical symptoms. No symptoms, no drop.

I don't consider them real hypos, as they don't need to be treated. They last (from the CGM graph) about 10-20 minutes tops, I wake up and that's it. I don't do anything about them because my liver is already busy dumping glucose.

It looks as if it's the start point for the dawn phenomenon rise: I don't know why it's preceded (for me anyway) by a fall in BG. I could do without the sweats and the nightmares but the low BG levels for a few minutes aren't a concern in themselves.