[Diabetes] How many low blood sugars do you have and do you notice them coming?

CathyMoran

I just wondered how many low blood sugars people have and do they notice when they are having them. I have on average 2 a day, my HbA1C is very good but that is no consolation. I also notice that I loose hypo awareness if I keep my blood sugars low all the time.

robinph

When I'm being a good diabetic I'd probably only get slightly low once a month (ish). I would know that it's coming though and have plenty of time to sort myself out before things go proper funny. I've only had a handful of times where I wasn't with it enough to sort myself out though, and most of those times have also involved large quantities of alcohol as well.

In the last few days though I've had a couple of times that I've felt low, but was only actually at about 4.1 - 4.5. That is due to the fact that I was running high for too long over the last couple of months so the sense of what is high and low gets a bit out of sync with reality after a while. When being good I'd not feel it until I'm in the mid 3's but would still be able to sort myself out until it gets down to 3 or below when I'd start to struggle a bit.

tbh

Same as Rob, really. I always wonder when they ask you at the clinic "have you had any hypos in the last six months" - they must mean serious (i.e. passing out) ones, right? Cause otherwise the answer would always be "Of course!!"

robinph

That question about hypo's always confuses me as well so I just say no. I think it's probably a distinction that a non diabetic wouldn't be able to understand as there is a huge difference between starting to feel one come on and dealing with it or if you miss it and reach the incapable stage.

I've only actually gone "unconsious" once which was due to me having taken my humulog and then the meal being late in turning up on the table, a few minutes later walking along the street and down I went, a Garda then stole a bottle of Lucozade from the nearest shop and I went back to work a few minutes later with a bit of a headache (from the hypo not the pavement). Although I technically wasn't unconsious as I can remember everything that happened I was certainly not capable of doing anything usefull to sort myself out.

tbh

fair play to the guard!

CathyMoran

I have gone unconscious quite a few times, the last time was yesterday, it really scared me that one.

tbh

wow seriously? I've never gone under at all. How did you come out of it?

robinph

I thought that you were testing some really huge number of times a day though so I'm curious as to why you would be going low so often. Are you levels just really erratic due to to other reasons, different meds you might be on maybe, or are you delibrately trying to keep your levels what I might consider too low all the time which might then remove any warning signs from happening?

CathyMoran

I was taken in an ambulance to St James, I was on the bus into Shane. Not a good experience. I think that I tend to keep my blood sugars too low, if I see a blood sugar over 6 I panic and give myself insulin. I have to cut back on that. Yesterday I was too busy texting as I got good news (I have an interview next week) and forgot to mind the low blood sugar I had. Not good, not good at all.

tbh

wowsers, thats a drama

Ever since I've started on the carb counting I've had much better control, I don't really give myself insulin without eating anymore (although sometimes I will). Out of interest, how many units did you take? My scale is that one unit of insulin will reduce my b/s by 2, so if I was six, it'd only be a half unit back to five so I wouldn't bother. I'd really only dose if I was over 8 or so. The carb counting taught me to use small amounts of insulin (novorapid) which was tough cause on the mixtard I was taking 30 units at least a time. Anyway, hope you're feeling better now and good luck in the interview!!

robinph

CathyMoran wrote:

...if I see a blood sugar over 6 I panic and give myself insulin. I have to cut back on that.

:eek: :eek: :eek:

Apart from the "I'm not a doctor so don't know what I'm talking about" disclaimer, you definately need to stop doing that imediately.

Have you told your diabetic nurse that your doing that kind of thing and what did they say?

mike65

Cathy that is seriously dangerous though you seem to understand that fact!

6 is perfectly fine in fact most would be thrilled with 6 any time they test.

I have only passed out twice, once was a stupid "wake up on a low" moment - I injected twice Ended up in Ardkeen with a nurse looking down upon me so it was'nt all bad

CM what prompted you to start worrying about the number 6?

Mike.

Snake Plisken

I always start to feel kind of hungry and start to sweat and tremble a bit when I get a hypo, even if I'm asleep I'll wake up when ones coming on (happened to me on Sunday night) and go down and eat some sweet stuff to bring it back up. I've never passed out from them.

Snake

mike65

Having a good low is not as much fun these days, back in the day with a two injection regime using animal pork based insulin a hypo was usually well flagged and the symptoms quite severe by modern standards so you could go mad with mars bars and not send your sugars through the roof.

Mike.

CathyMoran

Up until when the cancer struck we were trying for a baby , it is hard to give up that level of control. I am finding it hard to balance eating small amounts with diabetes, plus the tablets that I am on (anti-nausea, stomach emptying drugs). They do not have anyone to compare me with so the doctors are not of any use. Sorry, that thing yesterday really scared me, plus I am worried about test results on Thursday.

Alanstrainor

I've been i diabetic for 9 years now and i've gone through periods of too many lows myself, i've lost all sense of being low at some times too. Considering the severity of your situation i would:
1: write up a food/ blood sugar diary
2: Cut back on your insulin intake by 10%
You say your averages are good and i know all too well that us diabetics like to keep them that way, but if i were in your situation i would let my blood sugar control go, just a little bit, and allow myself 1 week of above average readings, nothing serious, That should drastically increase your sense of lows. That advice is what advice i was given by my Diabetic nurse a while back. There was another bit of advice i was given, and that was to take one day and check my bloods every 30 minutes for 24 hours, and that will give you a complete picture of your daily Blood sugars, and allow you to spot times when you need less/more insulin. Now i understand that you may not have the time to do that last thing but i really would recommend it you would certainly benefit from it.
Cheers,
Alan,
i hope everything goes well for you,

europerson

I've been diabetic since 1999, and I've passed out twice, once after doing physical work and obviously not having enough to eat beforehand, and again when I was waiting for food in a restaurant. It was strange, in that I can usually "feel" a hypo coming on, but not on those two occassions! They were both when I was on Mixtard twice a day. Now that I'm on basal-bolus, things are a lot steadier.

DrIndy

If you are frequently too low, then you lose the ability to gauge a dangerous low and without warning become unconcious.

People who are well up on their diabetes benefit from a much more active sliding scale where you can change your insulin dynamically depending on the meals.

It doesn't really matter if you take the short acting 6 times a day or 3 times a day - just you need to eat that amount of times and suffer the needles much more often.

If you can't manage 3 big meals a day - then switching to a different scale is a good idea and your diabetic CNS can help to no end here.

Is your long acting insulin too much?

Novarapid can also be taken after the meal as its ultra short acting which helps to no end if you don't know how much you will be able to eat with every meal.

Keep a really rigorous blood sugar/insulin regimen as alanstrainor recommends for a few days and then see the trends.

Give your diabetic CNS a call - I would actually recommend this to anyone that came into hospital under me with a hypo as they usually need some fine adjustments done.

tbh

doc - when you say "a hypo" - do you generally mean someone who's passed out from a hypo?

DrIndy

even symptomatic hypos would still fit the bill - but the significant hypos are unconciousness or confusion which could render you unable to correct your glucose requirements. If you are getting these, you definitely should talk to a CNS on short notice.

By definition - less than 4 is a hypo.

The very tricky thing to do for all diabetics is to keep your blood sugars down - which docs never stop harping on about as it protects from the latter effects, yet at the same time avoid sudden hypos which can be very dangerous.

It does require a lot of and ongoing fine tuning of your insulin regimen - and not every diabetic centre has enough support to do just that.

CathyMoran

I have been keeping a very close eye on my blood sugars and accepting that they can go up to 10 occasionally after food, fingers crossed no low blood sugars so far, though my average is probably around 7 now but it is better to be safe than sorry. The other day was a real wake up call. I have not gone back to the doctor, am seeing another one (my surgeon) tomorrow with the results of the CT so that is enough of doctors for the moment. I do not have much faith in my diabetic doctor at the moment (he said that my cancer was just stress and refused to scope me) and am in the process of changing him so will not go near the diabetic team for a while.