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What is a hypo?

H

hanadr

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Hypoglycaemia
>>Hypoglycaemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycaemia can vary from person to person, as can the severity. Classically, hypoglycaemia is diagnosed by a low blood sugar with symptoms that resolve when the sugar level returns to the normal range.<<
I looked up several definitions of hypoglycaemia (hypo) One notable thing is that mostly they describe symptoms and causes, but don’t give numbers.
Hypoglycaemia is a syndrome, not a number It’s Low blood glucose, causing light-headedness, confusion and other symptoms, but low Glucose without symptoms isn’t hypo. The problem of hypo unawareness is the patients whose BG is dropping and who are impaired, but don’t realise it. If this is caused by medication, it’s a potential danger, but may not yet be an actual one.
One problem with defining normal blood sugar is that very few studies have been done on blood glucose in non-diabetics, whose BG is, by definition, not normal
Bernstein comments in his book that he tests all the sales reps who call at his office, promising to predict their blood sugar, and the usual BG reading is 85mg/dl (Translates as 4.7mmol/l)
I have found a range of Normal BG from 3.5mmol/l to 5.5mmol/l quoted. Non-diabetics rarely go above 6 and then it’s likely to be short lived
For reasons of convenience. The medics in this country have settled on 4.0mmol/l as the boundary.
In fact most people can function down to about 2.5mmol/l perfectly well and newly diagnosed diabetics often get hypo symptoms at well above 4.0mmol/l
I even know someone, who was told by a consultant endocrinologist, that she doesn’t have reactive hypoglycaemia, because her lowest BG registered 2.9mmol/l and it needs a reading of 2.5mmol/l to diagnose it.
There is an alternative theory that hypo symptoms are caused by the sensation of blood glucose dropping fast, rather than any particular level.
In any case the important thing about hypoglycaemia is that it’s impairment in function caused by low BG, NOT just a BG reading
So if you test and find you are at 3.8 and feel fine, don’t panic. If you have recently taken medication, you have time to eat something. If you haven’t medicated, and/or are not diabetic, don’t panic full stop.
 
I've tested and found a reading of 3.4 without having any symptoms whatosever.

I can't tell any difference betwee 3.4 and 10+ without testing. I get absolutely no symptoms whatsoever that I can recognise.
 
I get classic Hypo symptoms around 4.5 mmol/l. Allows me to do something about it.

Have dropped to 3.2 and felt absolutely awful. Allways can tell when I go hyper as well, a test just confirms what I feel. I think I have good Hypo awareness still. Two of my medications can cause Hypo's - so am very careful, especially if I am about to drive anywhere.

Ken.
 
Wally and Ken
you have made my point for me
It's all down to how you feel.
I do get hypo symptoms, if i take something that will drop my BG, but I rarely do that, other than Metformin, which technically doesn't do it.
I don't feel 10+, becausI haven't been above 8 for years and that was only once in the last 2 years.
 
Even afternearly nine years as a Type 2, my body tells me absolutely nothing about the fact that I am a diabetic. I wouldn't know that I had the disease without a meter.

I seem to be very different to most people.
 
Hi Hana
Agree with all your points made - have experienced this myself . Some longer diagnosed need to get to lower before they get symptoms whereas a 3.6 or so is enough to give me a blinding headaches

I suppose the medics need some number to work from hence 'four is the floor' because of the risk to insulin users in particular and the rate which it can drop to dangerous levels quickly - esp on the fast acting insulins.
When first diagnosed it does put the fear of god into you until you learn what your limits are. Eg I rarely treat 3.8 or so now but when first getting under four you were religiously shoving 15g fast acting down your throat come what may. After a while you are safe in the knowledge that just eating something should be ok. For me at least
Theres nothing worse than overtreating or bouncing about as a result of the overtreating.

This is ok cause of my relatively easily readable regimen at present but when I move to MDI I will likely treat all hypos under 4 until I learn again how quick the drop is. I hear some talking about hypoing for 'an hour' which is not my experience so far.

Also because hypo unawareness as they see it is an indicator of autonomic neuropathies at times its probably good to have some cut of or other. I do know that before dx I did have hypos (long days at work, not eating, too much coffeee) and was able to recognise my diabetic hypo symptoms based on that!
Like most things diabetic - its horses for courses
 
I read the post first time, I knew that I wanted to write about the different types of symptoms but I wasn't thinking very clearly. Then I felt cold, a bit lethargic and not surprisingly realised that I was hypo .....3 mmol, would I have realised it if the subject matter had been different?
No warning, no shaking,etc I could function well enough to understand the post, and to make lunch quickly (not the right thing to do, but maybe I wasn't thinknig clearly). I think I had some degree of cognitive impairment.

There are 2 types of symptoms, one are the ones caused by the side effects of hormones of the counter regulatory system,mainly adrenaline. The body releases them to counter the low blood sugar. Symptoms are those such as shaking, pallor, sweating, hunger. People feel those at higher levels when first diagnosed but at lower ones when they are used to more normal bgl (the speed of drop may add to the intensity of these feelings). Overtime frequent hypos may mean that these symptoms don't occur until lower levels. The counterregulatory system of some people with type 1 also sometimes becomes less effective (problems with alpha cells?).

The second type of symptoms are called neuroglypenic these are due to your brain not receiving enough fuel.. They more likely to happen occur when the drop is gradual and are far more insidious : headache,loss of concentration, visual disorders, fatigue, confusion, negativism, irritability, 'glassy' eyes , speech slurring, eventually seizures or coma. Though this usually happens at fairly low levels, the levels that they occur varies from person to person and day to day. Fortunately the lack of glucose to the brain doesn't normally have long term effects but the person may injure themselves or others because of the hypo (falling or crashing a car for example etc)

As lilibet says the use of insulin and sulphonylureas complicates matters enormously, If blood glucose is 4mmol and its a long time until the next meal, then its better to treat because it may very well go lower. 4mmol at bedtime needs something for most people. 4mmol or even quite bit lower just before a meal (on MDI) doesn't always need any treatment (just be careful with the knives !) but the next dose might need to be lowered. The DVLA says people on insulin shouldn't start to drive at less than 5mmol and should stop test, treat and wait for 45min if below 4mmol.
I don't think you should panic or be scared of hypos but I also don't think that people taking drugs that can cause hypos should put themselves at risk by not treating. The level of 4mmol might well be on the cautious side but its better to be cautious.
 
My mum's been over for the day and she was helping me prepare the tea. I had a bit of a headache but thought as I was minutes away from eating, I'd be fine but when I tested only a few minutes later, my reading was down to 2.4. Other than that slight headache, I felt fine. I am now realising that a headache seems to be the only warning I get now of a hypo.When my readings were overall higher, I would know much sooner and start to shake, get confused etc. etc. so I do think that because my readings are lower now, they are much lower before I get that only warning sign.........the headache.
 
phoenix said:
There are 2 types of symptoms, one are the ones caused by the side effects of hormones of the counter regulatory system,mainly adrenaline. The body releases them to counter the low blood sugar. Symptoms are those such as shaking, pallor, sweating, hunger. People feel those at higher levels when first diagnosed but at lower ones when they are used to more normal bgl (the speed of drop may add to the intensity of these feelings). Overtime frequent hypos may mean that these symptoms don't occur until lower levels. The counterregulatory system of some people with type 1 also sometimes becomes less effective (problems with alpha cells?).
Click to expand...

Also in my case losing my temper or becoming whiny.

The second type of symptoms are called neuroglypenic these are due to your brain not receiving enough fuel.. They more likely to happen occur when the drop is gradual and are far more insidious : headache,loss of concentration, visual disorders, fatigue, confusion, negativism, irritability, 'glassy' eyes , speech slurring, eventually seizures or coma. Though this usually happens at fairly low levels, the levels that they occur varies from person to person and day to day. Fortunately the lack of glucose to the brain doesn't normally have long term effects but the person may injure themselves or others because of the hypo (falling or crashing a car for example etc)
Click to expand...

My legs go first, it's like overdosing on scrumpy. I can remember incidents of this occurring going right back to childhood. One time I'd been out on a school trip, been OK all day and was dropped at the edge of town to walk home. I got about half way and my legs just *went*. I could barely drag myself to the phone box and rang my father to come out of work and fetch me. I was also starting to get whirling blacknesses. If I'd known then what I know now I'd have kept some sweets about my person, munch some sugar and sit for a while and I'd probably have made it home on my own.
 
Hi all,
Right my two pennys worth.
I`m T2 and have been for almost 18 months. When I get down to 4.3 I get Stomach pain like I`m the ball when a rugby player kicks a goal. When I get this it`s always 4.3 right on the dot.
Graham1441 :twisted: :twisted:
 
Hi, when I was younger I'd always saw a miserable hypo as a time to reward myself to a choccy bar, for being a good diiabetic the rest of the time!
I'd like to know if anyone suffers the follwing symptoms of hypo; If my BS has been low, often just above 3, for a time, especially if I've not noticed, my tongue goes tingly. It's an unpleasant feeling and doesn't happen for every hypo, and the feeling goes when my BS rises.
Been type-1 for 20 years and still have symptoms thank god-often just realise my thoughts aren't clear, get muddled and can't think straight or feel cold , sick or hungry. I also get visual disturbances, or start yawning(not all at once!) '
The worst hypo I ever had, I woke up with 4 paramedics at my bed :) My husband had got up for the loo bout 3 in the morning and discovered me sweating and unrousable. The paramedics adminstered an injection of glucagon to bring me round. I realised straight away what must have happened and tried to speak; I couldn't talk properly. It was frightening- it took bout 20 minutes before my speech was back to normal. Took me a while to get over the shock of it, and realise I am only here because of my husband's weak bladder. Scary for my young kids too, who were woken up by the commotion.
I do wish doctors who choose to restrict prescriptions of test strips had a clue how frightening and inconvenient it is to live with the risk of hypos every day. Blood testing is not an indulgence it's a necessity.
Does anyone else think lucozade should be available on prescription :lol: !!
Jus
 
Help. Not sure of symptoms. newly diagnosed last week. I'm feeling light headed. a bit sick but hungry and the same time, sometimes!! Feel drunk actually. My reading was 7.6 when last tested. Even when I eat I don't feel much better afterwards. What am I doing wrong.
 
I can always tell if i'm under 3.5 as I tend to shake but i'm no longer on Insulin so it doesn't happen as much.
 
JMS41

The feelings you described may be a 'hypo' for you at this time as your body becomes used to dropping numbers after diagnosis. Although not 'truly' hypo by NHS standards, it will give you the same feelings
Also, a fast drop can also make you feel hypo

However, if you feel sick and it doesnt go away afterwards then it might not be hypo. Maybe tell us a bit more about yourself - type, medication etc
If you are on Metformin then this has gastrointestinal side effects
 
JMS41 said:
Help. Not sure of symptoms. newly diagnosed last week. I'm feeling light headed. a bit sick but hungry and the same time, sometimes!! Feel drunk actually. My reading was 7.6 when last tested. Even when I eat I don't feel much better afterwards. What am I doing wrong.
Click to expand...

JMs41.
Have seen another post of yours mentioning depression and thyroid stuff which you haven't said here ? I think you were told to see a GP. I think that's good advice my friend. You have a lot going on it seems ? :?

D.
 
I can quite happily function at 3.1 with no hypo warning symptoms. I won't treat a 3.1 with fast acting either. I just have an oatcake or something similar. Don't have any idea how low I could go before getting symptoms but don't plan to find out!!!! Consultant thinks my symptoms would maybe kick in at 2.5 or so as I am so well controlled.

Caitycakes x
 
I'm starting to realise that the ONLY warning I get now is a very slight headache. Felt a bit of a headache earlier this afternoon, just sitting at the computer. Did a test to find my lowest ever reading....1.6. :shock: I test about 6 times a day as it is but even that is obviously not enough.
It is a bit worrying to go so low without more awareness.
 
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