• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

What numbers do you consider to be a hypo...?

-Artemis-

-Artemis-

Well-Known Member
Messages
533
Type of diabetes
Type 1
Treatment type
Other
As above really :-)

I'm wondering as I read a fair bit about the importance of not having too many hypos as you might lose hypo awareness - but I've never been told what a hypo number actually is...?

I know there are times when I have hypo symptoms - shaking and sweating etc - but I'm not sure if they're actually real hypos or not... So would be good to know what numbers others call a hypo :-)


Sent from the Diabetes Forum App
 
Hey, for me it's anything below 4. Sometimes I'll get to 3.5 before 'the feelings' but usually 4 :)
 
I saw you are new to insulin and wouldn't have done a course yet
this will give a lot of background info, but ofcourse see your Dr/nurse for any adjustment

There is an online course for background and an idea to it. Free to registerhttp://www.bdec-e-learning.com/

This set of workbooks are worth reading and practising working examples only of carbs and doses
Don't change dose without nurse approvalhttp://www.diabetesinscotland.org.uk/Publications/9224 Overview

Workbook 1http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
Workbook 2http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb listhttp://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

Diaryhttp://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

Basal testinghttp://www.diabetes-support.org.uk/info/?page_id=120

Sick day ruleshttp://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf
Sick day rules flowcharthttp://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf
 
4 is the Floor is a saying used in diabetes circles.
 
DAFNE sets hypo at 3.6 or below. 4 used to be the figure quoted, but with the better insulin we have these days and the education programmes, I guess they decided we don't need such a huge margin of error.

Personally, I'm happy to go a little below that under certain circumstances. Depends on what and when I've eaten, how much active insulin I have on board in terms of basal and bolus, when I intend to eat next and what I.m doing. I'm happy doing this because I low-carb and know that I won't have the sudden drops in BG that come with high carb, high insulin doses.

Smidge
 
Depends whether you are talking about a level at which you should be aware that should be doing something about it or a level that you need to do something about it
As Nigel and others say 4mmol/l is often used as the level in the UK and certainly if you are driving you want to make sure not to be below as you could quickly fall a bit lower. Our meters aren't infallible either.
If you read papers written in the US then they tend to use 70mg/dl which converts to 3.8mmol/'
My doctors (France) would tend to note levels under 65mg/dl (3.6mmol/l) and call them hypos, they wouldn't comment on 70mg/dl as a before meal reading.
At what level you do something to raise glucose levels , I think depends on whether you have a large amount of fasting insulin on board or not and what you are about to do. (ie if it's a couple of hours since you injected rapid insulin then you are likely to need to do something about a level of 4mmol/ (70mg/dl) , similarly if you are about to go for a walk but if you have a well adjusted basal and it isn't long before dinner then 4mmol/l would be fine as long as you don't inject more rapid insulin until you actually eat )
.
This presentation from DAFNE confirms what Smidge says, It has two slides which suggest the difference between eating at 4mmol/l and treating at 3.5mmol/l

http://www.dafne.uk.com/uploads/224/documents/Myths and Misconceptions.pdf
 
We're still told anything under 4 is going hypo (Canada), personally I don't feel it till I'm around mmol 2.5 or 2.3 (I've hit 2.1 n not known it once).
 
Ah.... it seems the general consensus is 4, or there abouts... I've had a fair few 3.5 to 4's - though only one low 3, and definitely nothing below 3... so I guess I just need to be careful not to "get used to" having the lower 4's and higher 3's - to prevent me losing awareness...

I have been slightly worried, as most of the 3's and 4's I've had, I've not really been all that aware of - I've just had a vague feeling something might be up - plus I test loads everyday anyway - which is why I've seen them... I mostly get the shakes etc when I've spotted and treated it - and am on my way back up - which is what I've seen other people say too.

At the moment I tend to only see the lower numbers in the first two weeks of my cycle - so I may adjust my doses according to where I am, cycle wise.

@jack412 - you're spot on - I've not been on any course at all yet - though think I'm getting some sort of carb counting meter next week...? Will read through those workbooks :-)

@smidge - you said something about higher carb and insulin use = more sudden drops... currently I'm "medium carb" - around 100g a day - and my insulin is between 2-4 units of novorapid with meals... does that mean I'm 'less likely' (as much as we can judge these things) to experince very sudden drops...?

@phoenix - in the link you sent me (thank you :-) ) it says to treat with "CP's" - what are they...? :-)

Really useful info as always, muchos thanks all :-)
 
Nyxks said:
We're still told anything under 4 is going hypo (Canada), personally I don't feel it till I'm around mmol 2.5 or 2.3 (I've hit 2.1 n not known it once).
Click to expand...

Is this a little like drinking where other people know you are drunk long before you do? Has anyone ever spotted it before you did?
 
I was told anything under 4 too. Sometimes I start feeling it around 4.8, I have got as low as 0.8 without feeling it, 2.8 seems to be my average for realising something is up
 
manicarrie said:
I was told anything under 4 too. Sometimes I start feeling it around 4.8, I have got as low as 0.8 without feeling it, 2.8 seems to be my average for realising something is up
Click to expand...

Oh my goodness - I didn't even know you could go as low as 0.8 without something fairly disastrous happening :-/
... Were you ok?


Sent from the Diabetes Forum App
 
It's an interesting question to bring up actually, because recently there have been times where I tested jar because it's pre meal times or whatever, and my bg would be 3.5/3.6/3.8.... No real hypo symptoms just vague feelings of low energy.., so I'd hold out for a few minutes, and then test again and it'd be up above 4.... Maybe just reading error/ lchf diet making hypos less symptomatic
 
-Artemis- said:
Hmm... Interesting @bellabella - I'm high fat, medium carb... And have also wondered if the high fat blunts the low feeling...?


Sent from the Diabetes Forum App
Click to expand...
I've wondered the same: certainly any hypo I've had since cutting the carbs has been much milder than any one I've had on high carb western style of eating. However I've also noticed that ie often felt shaky and sweaty, thinking I'm hypoing, and tested only to discover that the bg is like 8/ 9! I'm very new to the whole diabetes thing though so I guess it takes times to distinguish pseudo hypo from real hypo!!
 
For me below four, but there have been times where my BS has been 2 before I got any warning!
 
-Artemis- said:
@smidge - you said something about higher carb and insulin use = more sudden drops... currently I'm "medium carb" - around 100g a day - and my insulin is between 2-4 units of novorapid with meals... does that mean I'm 'less likely' (as much as we can judge these things) to experince very sudden drops...?
Click to expand...

Two to four units per meal is a pretty small dose really - that helps avoid sudden drops - it can still happen, but if you think about it, a 20% dosing mistake for you is between 0.4 and 0.8 of a unit - for someone who is taking 30 units with a meal, the same 20% dosing mistake is 6 units, so it stands to reason that smaller mistakes result in smaller drops. Having said that, I do find that certain carbs make my BG rise rapidly and drop sharply - especially bread and cereal for me - so i mostly avoid those or eat them in very small amounts.

Smidge
 
Back
Top