Unexplained Hypo - advice/ideas/encouragement please...

[-Artemis-]

Hi All,

I'm not totally sure what I'm looking for exactly - but I need a little help on getting past something that happened last Thursday...

I was out shopping: that morning I'd done 45mins strenuous (Vinyasa - as opposed to the more chilled Hatha style) yoga, then an hours stomp with the dogs - then into town to do some jobs and do a bit of shopping.... so an active day - but not unheard of (I often do the yoga, then the walk).

Anyway - at around 4.30pm I felt a bit hungry - talking on board that I was a bit more active than usual, I tested (4.9 - so not low) and got a green juice from a juice bar, and carried on shopping. I should mention that apart from my background - which usually is spot on - I didn't have any active insulin on board as I can usually get away without injecting any bolus at lunch time, so long as I keep my lunch below 20g carbs and go for a good walk with the dogs afterwards: both of which I'd done that day.

At 5.50pm I went into the ladies of the shop I was in - definitely washed my hands as I remember the paper towels - then tested. 7.8 - kinda what i expected after the juice. I had already gotten my dinner - and I tend to eat really early; like 6.30/7pm latest - so I decided to inject in the loos, finish what I was doing in that shop, and go eat. The second thing I should mention is that I'm on porcine neutral for my bolus insulin; which *always* has an onset of at least 45mins - most usually an hour. So I always inject 30mins before I eat as a minimum. Even when it becomes active, its very slow - which is why I like it - but I've never seen it bring me down more than a couple of points even after an hour of injecting prior. Meaning I was expecting to inject, spend 30 mins or so in the shop, wander out and find a seat and eat... and in normal circumstances I would have been a low 6 by the time I did that.

After I came out of the loos, having just injected, I wandered over to a sale rail and basically spent twenty minutes just flicking through it and holding tops up etc - my point being is that I actually barely walked anywhere/did anything as I got distracted by this one rail. Having finished faffing around with the rail I was kinda aware it was now close to 6, so I'd go find somewhere to eat. I felt completely normal at this point: I just thought it would be a good idea to go find somewhere. As I'm walking out of the shop I suddenly see white spots and am aware my knees are buckling - everything from this point blurs a bit - but basically I grabbed my meter, tested, and was 2.1. Even whilst I was semi-passing out I couldn't believe my numbers would have dropped that much, that quickly - so whilst shoving a couple of glucose tablet in me, retested and it still said 2.1. To cut a really long waffle a bit shorter - the store staff came rushing over, panicked at the state of me (by this point the sweats and shakes had kicked in big-time), and called an ambulance. Suffice to say all was eventually fine.

What I'm struggling with / why I'm posting is cos I'm not doing a great job of "getting over it". I live alone and the whole thing has really shaken me up; and I'm sorta embarrassed to say i've fallen into a bit of a pity party around feeling like:
a) I could have died
b) I had noone to go to, to "look after" me, for the days afterwards (I mean, just give me a hug/make me a cup of tea/be around whilst I have to get over the association of injecting etc - rather than needing actual care - it was emotional support I needed, rather than physical),
c) not knowing why it happened - so not knowing how to prevent it again. In the past I've had hypos, but I've always been able to relate them to stuff - so can put things in place to try and reduce the changes of it happening again. This time, apart from being a tiny bit more active perhaps, I can't relate it to anything. And I'm not convinced by the activity thing as I'm sure I've been that active in a day before without such a crazy drop in such a short time. I'm also totally freaked out that I didn't feel it - at all.
and d) feeling like no-one really gets how scary it was. All this happened on Thursday - and on Saturday I saw my boyfriend (who lives a 4.5 hr drive away for work - so we only see each other weekends). We're in a committed relationship and hopefully long term relationship - despite our distance in the week - so I was desperate for some support by the time I got to see him. When I did see him it was apparent he didn't really want to talk about it and eventually said he didn't see the point in dwelling on it. Which I kinda get - but it's also kinda hard when I'd just spent two days with no-one to process it over with/give me a hug and say "jeez, what a sh*t day".

So - as I said at the start - I'm not sure what I'm looking to hear: but I'm now back at home (alone again) and left feeling extremely anxious, and not very supported.... I'm worried about how to stop the anxiety really manifest itself (I've had problems with anxiety many years ago - really don't want to go back there), plus I'm aware this could be damaging to my relationship if I start to allow the niggle of not feeling all that supported turn into resentment too....

Sorry for the ridiculously long post - but any tips on how to "let it go" - without turning into a Disney film - would be massively appreciated....

 

[noblehead]

Sorry to read about your awful experience Artemis.

It does seem unusual given the slow onset of the insulin you inject, a possible explanation is if you injected in your leg and were walking around this can speed up the absorption of the insulin, but if this wasn't the case then I'm lost.

Not wanting to sound like a broken record here, but to put your mind at rest and to get some sort of reassurance and support I'd have a word with your diabetes team, fully understand that your anxious now due to living alone, hopefully its just a one-of.

 

[-Artemis-]

Sorry to read about your awful experience Artemis.

It does seem unusual given the slow onset of the insulin you inject, a possible explanation is if you injected in your leg and were walking around this can speed up the absorption of the insulin, but if this wasn't the case then I'm lost.

Not wanting to sound like a broken record here, but to put your mind at rest and to get some sort of reassurance and support I'd have a word with your diabetes team, fully understand that your anxious now due to living alone, hopefully its just a one-of.

Thanks for the understanding @noblehead - that by it itself really helps.

I had injected into my tum, and I did see my doctor the next day; she's brilliant - but basically said it was just one of those freaky things. Her husband is type 1 and she says she's seen various times where there's been no rhyme or reason to his hypo.... which is the bit that I'm most struggling with: the idea that this could "just happen" again - and what if I'm not in the middle of a shop next time? What if I'm alone, in my house...? I know - all being well - I'd hopefully just deal with it - but I'm just super-struggling with the lack of any reason around it, therefore the possibility of it happening without warning whatsoever again, in combination with the alone thing.... don't want to get too caught up with thinking that way, but don't know how to stop it....

 

[noblehead]

Your Dr is right, it happened to me one evening last year when sitting down to my evening meal, not had to drink full sugar coke before but needed to that night as I was dropping extremely fast, sometimes these things do happen without rhyme or reason.

 

[livitridge]

Hello, I'm really sorry to hear what you went through! I can tell you that I know exactly what it feels like.
I've been in this vicious circle for a few weeks now, it ruined Christmas Day which was very sad for me. Beginning of December I had a whole week of unexplained hypos, even when not taking any insulin at all. My basal settings have always been the same and have always worked for me, so I'm wondering why are they not now? What have I done wrong? I think in your case, maybe it was because you had been doing activity that day. It can have an effect for 2-3 days after. Some times the after effect can just 'kick in'
In my case, I'm not sure. I remember having a hypo at 11pm, and it took 1 hour to come back up despite drinking a whole bottle of lucozade. Then the next day, my BS was 7.mml before dinner, I took half the amount of insulin I should have (because I was scared) and I was 3.1mml 1 hour later .. Which obviously scared the hell out of me! Ever since I have been running my blood sugars high on purpose, I feel like I'm trapped and the longer I continue being terrified, the less likely I will ever get back to normal. Just when I plucked up the courage to do my insulin as normal again, I've noticed some strange things. For example, last night my Bs was 17 before dinner (whoops) but anyway, I ate my dinner, and forgot to bolas and correct (double whoops) but woke up thismorning at 8mml. So what if my blood sugars were normal before bed? I would of had a horrible morning/middle of the night hypo I reckon. I'm fed up of thinking to myself 'wow that was a close call, lucky I had my sugars high!' No body wants that!!! I don't deal with hypos well, without fail I will always have a panic attack, especially when my BS doesn't come up within 30 minutes.
I don't see myself getting over this and letting it go, I hope you don't let yourself fall into the same position as me because I can't enjoy life right now. I've also let it effect my relationship because I'm so depressed all the time. Good luck to you I'm sure you are better with this stuff than I am!

 

[-Artemis-]

@livitridge - you too huh
How long have you been on insulin...?

- it's sooooo annoying - cos I was just getting to a place where I was feeling confident in what I'm doing.... There must be a way to feel better / get it better though...?

@noblehead yea - I guess....{sigh} ....on a completely separate note - a) you've become a moderator since I was last on here - congrats! and b) did I glimpse something about you and pumps too....?

 

[noblehead]

@artemis, yes on a pump now and so far so good, been tweaking the doses here and there and had to do a few basal fasting checks (after starting on a flat rate) but it's all coming together, feeling a bit off today with cold so all testing is on hold, don't miss the injections btw

 

[-Artemis-]

@artemis, yes on a pump now and so far so good, been tweaking the doses here and there and had to do a few basal fasting checks (after starting on a flat rate) but it's all coming together, feeling a bit off today with cold so all testing is on hold, don't miss the injections btw

Ooo.... interesting.... I am going for an assessment next week - would you say your numbers are more even post pump - or is it too early to say....?

 

[azure]

It's horrible when a hypo comes on so quickly like that. I find it quite terrifying.

Apart from being 'just one of those things', maybe you just injected in slightly the wrong place? Once, when on regular human insulin years ago, I did my normal injection 20mins before I was due to eat. Right dose, no mistake with carb-counting, and I didn't do anything except stand by the cooker. Suddenly I felt a really weird feeling wash over me about 5 minutes or so after I'd done my injection, and I then start having awful, violent jerking in my arms and legs. Obviously, the insulin had got absorbed too quickly. It was so frightening. I've had lesser versions of that too.

I hope you're ok now. Remember that you did nothing wrong. You thought and planned and acted sensibly. It was just one of those stupid diabetes surprises. I'm often home alone too, and if I'm feeling nervous I keep a bottle of Lucozade near me as it works quicker than glucose tabs. If I feel at all funny after bolusing for a meal, I always test my blood sugar again.

Don't let it get you down. It's unlikely to happen again for a while, and you can have a plan to avoid it or treat it. When I'm shopping, I usually sit down well before eating as I find shopping uses a surprising amount of blood glucose. Little things like that can help.

 

[-Artemis-]

It's horrible when a hypo comes on so quickly like that. I find it quite terrifying.

Apart from being 'just one of those things', maybe you just injected in slightly the wrong place? Once, when on regular human insulin years ago, I did my normal injection 20mins before I was due to eat. Right dose, no mistake with carb-counting, and I didn't do anything except stand by the cooker. Suddenly I felt a really weird feeling wash over me about 5 minutes or so after I'd done my injection, and I then start having awful, violent jerking in my arms and legs. Obviously, the insulin had got absorbed too quickly. It was so frightening. I've had lesser versions of that too.

I hope you're ok now. Remember that you did nothing wrong. You thought and planned and acted sensibly. It was just one of those stupid diabetes surprises. I'm often home alone too, and if I'm feeling nervous I keep a bottle of Lucozade near me as it works quicker than glucose tabs. If I feel at all funny after bolusing for a meal, I always test my blood sugar again.

Don't let it get you down. It's unlikely to happen again for a while, and you can have a plan to avoid it or treat it. When I'm shopping, I usually sit down well before eating as I find shopping uses a surprising amount of blood glucose. Little things like that can help.

Ah, thank you so much @azure... There's some good bits of advice there, as well as it just being good to hear someone gets it... I think maybe more than anything, I just needed to experience some empathy/kind words... It's really freaking scary stuff we sometimes go through: whilst I don't want to dwell/wallow in it, a little acknowledgement of that goes a really long way. I don't know why? But I do know your post helped, so thank you x

 

[noblehead]

Ooo.... interesting.... I am going for an assessment next week - would you say your numbers are more even post pump - or is it too early to say....?

Getting their Artemis thanks, still need to tweak a few things and incorporate more exercise into the mix but its early days, good luck with your assessment and hope all goes well

 

[-Artemis-]

Getting their Artemis thanks, still need to tweak a few things and incorporate more exercise into the mix but its early days, good luck with your assessment and hope all goes well

Good to hear... And thank you

 

[Jaylee]

Hi, all I can say is I feel your pain.. Been there too. Though I am more relaxed with hypos as long as I carry a treatment..
The "white spots" are common by all accounts. Especially on a deep low.. Though I tend to see em at night. By day it's more like green/blue maps of France..

Remember there is a little delay in a BS reading. You may have already been on a drop after the juice. the "7.8" being the peak a good 20 minutes earlier...??

 

[Heathenlass]

Sorry to hear that you had such a horrible experience (((((((hugs )))))))
The reasons for the hypo that I would have answered to have already been covered, but this is my take on the emotional side :

Having an unexpected hypo especially in a public place can knock your confidence, and yes, you need emotional support following it. I think as far as your partner goes, it's a bloke thing . I don't mean to be derogatory to the men, but their response to a crisis is mostly to " fix" what's wrong. If they can do that, be actively in the process, then they are ok with It and it's no biggie. Once it's fixed , it's over, move onwards .Also if they are concerned, but the event has passed, then they don't like to dwell on it. Possibly there is an element of unfounded guilt in there too, he knows he wasn't there to support you , and wishes he could have been. On top of all this, ultimately he is not diabetic, and therefore hasn't really had that experience to empathise with. I do think the two sexes deal with issues that are emotional differently . ( Male readers, please put the pitchforks and flaming torches down! ).

If you need support or just want to vent, post it up ! If there's a party going on somewhere, even if it's a pity party, I wanna know, I'm not proud or fussy It's not the same as someone actually being there and making a cuppa and giving a proper hug, but us lot do know what the hell it feels like, and the emotional implications of it all . Virtual tea and sympathy can make all the difference

Signy

 

[-Artemis-]

Hi, all I can say is I feel your pain.. Been there too. Though I am more relaxed with hypos as long as I carry a treatment..
The "white spots" are common by all accounts. Especially on a deep low.. Though I tend to see em at night. By day it's more like green/blue maps of France..

Remember there is a little delay in a BS reading. You may have already been on a drop after the juice. the "7.8" being the peak a good 20 minutes earlier...??

Hey Jaylee, thanks for getting it... And interesting re the white spots - I've never had anything like it before; but then I've never fainted, plus I've not had a reading that low before either. I hope I don't get to see the maps ;-)

Re the 20 minute lag - is that the case even with finger/meter testing? I know cgm & libre's are behind, but didn't know meters could be...

 

[-Artemis-]

Sorry to hear that you had such a horrible experience (((((((hugs )))))))
The reasons for the hypo that I would have answered to have already been covered, but this is my take on the emotional side :

Having an unexpected hypo especially in a public place can knock your confidence, and yes, you need emotional support following it. I think as far as your partner goes, it's a bloke thing . I don't mean to be derogatory to the men, but their response to a crisis is mostly to " fix" what's wrong. If they can do that, be actively in the process, then they are ok with It and it's no biggie. Once it's fixed , it's over, move onwards .Also if they are concerned, but the event has passed, then they don't like to dwell on it. Possibly there is an element of unfounded guilt in there too, he knows he wasn't there to support you , and wishes he could have been. On top of all this, ultimately he is not diabetic, and therefore hasn't really had that experience to empathise with. I do think the two sexes deal with issues that are emotional differently . ( Male readers, please put the pitchforks and flaming torches down! ).

If you need support or just want to vent, post it up ! If there's a party going on somewhere, even if it's a pity party, I wanna know, I'm not proud or fussy It's not the same as someone actually being there and making a cuppa and giving a proper hug, but us lot do know what the hell it feels like, and the emotional implications of it all . Virtual tea and sympathy can make all the difference

Signy

Ah Signy you wise woman you! I think that's *exactly* what happened with the bf - he's super 'male' so I do think he felt like, unless we can figure out a way to fix it, then why talk about it... Which I do kinda get is his way of dealing with it. It's just I really, really needed to 'shake it off' through talking about it - and prolly needed a good blub about it too.

As it was, none of that happened - so now I feel a bit stuck... I guess that's why I came on here: as another way to try and shake it off.

Thanks for saying to post about my 'party' ;-) here too... I guess I thought that peeps here might think 'yea, so what, you had a low: I have them all the time'... I guess I feel a bit of a wimp that I'm still feeling stressed out and a bit sorry for myself about it all... Still, the cat is being very cuddly tonight... Every cuddle helps...

 

[Heathenlass]

Never underestimate the power of a cat cuddle ! That's why I have five ... Oops, forgot, they have me as their devoted slave and deign to form a cat heap on me when I'm feeling a fit of the blahs in case I ****** off with the tin opener

There's no shame or wimpiness in the way you have been feeling, it's more common than you think . And yeah, it can take a while to regain your equilibrium , so be gentle with yourself having said that, a good blub, rant rave and roar can be very therapeutic , if somewhat puzzling for the felines

A diabetic friend once said to me that she felt that being a diabetic was the loneliest feeling in the world, because her experiences felt like uniquely hers, and no words could ever express how it felt to her, or impacted on her life , to her non diabetic family and friends . I believe this to be true to an extent so a comfort zone , even if it's here, online, can be invaluable

So, let's paaaarty !

Signy
Ps . Your cat is fab !

 

[-Artemis-]

You're funny!! Thanks - needed a giggle

... And yea, pretty much feeling like your friend described... I think it's not helped that I don't have any other 'real life' peeps with D, plus I was always the supportive one with friends: since the D diagnosis I don't know what to talk about anymore cos everything revolves around that - and I don't have the energy to take on what I used to, so I've kinda just stopped calling / hanging out with friends so much... All in all leaving me feel a bit like an angsty teen who bemoans 'no one gets me...' - and I don't want to be an angsty teen! :-S

... Do you really have 5 cats?!

 

[Jaylee]

Hey Jaylee, thanks for getting it... And interesting re the white spots - I've never had anything like it before; but then I've never fainted, plus I've not had a reading that low before either. I hope I don't get to see the maps ;-)

Re the 20 minute lag - is that the case even with finger/meter testing? I know cgm & libre's are behind, but didn't know meters could be...

I totally get it.. Been getting it for the past 38.5 years.. Lol I have never passed out. But came close when I was about 10?

The "lag" by all acounts in my opinion yes.. I say 20 minutes.. It's kind of my rounded up rule of thumb regarding human blood circulation..?
I'm no medical expert. But when you think about how long it normally takes for the average pain killer to kick in too..
Some people test every 5 minutes when low, then panic when the levels don't rise fast enough even when pouring a shed load of sugar down.
As long as you are conscious & treating the hypo. The blood will rise..

 

[Heathenlass]

Yup! I'm a Crazy Cat Lady In Training !

Signy