Thank you to everyone who has taken the TuAnalyze hypoglycemia survey! We presented results from the survey at the International Society for Disease Surveillance meeting this past December.
At the meeting, we reported on the frequency of severe hypoglycemia and the experience of harms related to low blood sugar in the TuDiabetes community (if you would like to read the full abstract that accompanied the presentation, you may find it here.). We found that more than one quarter (28%) of TuAnalyze users have had at least one episode of severe low blood sugar in the past 12 months (defined as a time when they lost consciousness, had a seizure, needed glucagon or medical treatment or help of other people due to low blood sugar). In addition, 15% of respondents had ever had a vehicle accident or serious injury related to hypoglycemia. 42% also reported that worry about low blood sugar affects their daily life.
The chart below shows the percentage of hypoglycemia survey respondents who report that they limit/avoid these daily activities in order to avoid low blood sugar and related consequences.
While the frequency of these reported behaviors ranged from 20-50%, they are even higher among the group of users who report at least one severe low in the past year. Users with severe lows are also more likely to report ever having an accident related to hypoglycemia, and daily worry about low blood sugar.
Do these numbers surprise you? Are these reports consistent with your own experiences?
The TuAnalyze team is preparing a full report on hypoglycemia, prevention practices, and diabetes care. If you haven’t taken the hypoglycemia survey yet, the survey is still open and you can contribute your experiences to this research. You can find the survey by clicking here. If you have taken the hypoglycemia survey, make sure that your TuAnalyze A1c is up to date and that you have also completed the Care Overview survey and the two device surveys. These all provide complementary information that helps us to better understand glycemic control in the TuDiabetes community.
Once again, a big thank you to everyone who has taken part in the TuAnalyze project! This research would not be possible without your participation.
No not really does it surprise me. If u've ever went so low that certian things happen to u u tend to watch urself closer when it comes to those terrifing lows.
Holy cow! I'm shocked, actually. Maybe because my blood sugars shoot around regardless of what I do, it would never even occur to me to stay home or avoid driving, exercise or sex to keep from getting "low". If I wanted to avoid going a dangerously low the thing I'd have to remove from my schedule is sleep, as that's when it happens to me the most.
It worries me the number of vehicle accidents people report due to lows. For one, why don't people have stuff in their car (of all places) to raise their blood sugar; we are talking about more than just their own safety. I always keep small cans of apple juice and glucose tabs in my car. The irresponsibllity that causes the accidents is going to someday come down on all diabetics requiring additional steps in order to have/keep your driver's license. It is frustrating because as diabetics we have to be the one's in charge of our disease at all times, especially when operating a vehicle.
Alyne 33 You nailed it on the head. If you're that brittle please test yourself B-4 driving. I too have "sugar" in my car to raise my BG. I'm lucky to have a continuous meter so all I have to do is look at it to see my BG and I make sure it doesn't go below 100 when I'm driving contrary to when I'm at home or in the office when I might wait for eating time (noon or 6) and let it get to 60 or 70 as I know I'll be having lunch or dinner.
I'm surprised about the 20.7% avoiding sex, at my age you take what you can get, when you can get it, no avoiding there LOL.
Agree that keeping supplies in the car avoids the problem. As to exercise, it would be nice if the community at large could stop preaching "Exercise is good for diabetes."
The truth is that exercise is a hard-earned privilege that must be planned for in excruciating detail. Always after a meal with pre-meal insulin adjusted to permit the exercise. A hike with friends? What if one of them gets tired/injured? what if it rains and whole thing is called off?
I don't avoid it, but it has to be highly regimented and preferably alone, sad to say.
The full study did not seem to focus on hypoglycemia.
Relative to the comments concerning PWD having accidents as irresponsible behavior, if those people are hypo unaware, then it's not fair to label them as irresponsible. We all hear and say "your diabetes may vary". Walk a mile in their shoes. This survey only gives limited information and doesn't allow you to explain.
They may be hypo unaware and have a sudden drop in bg that happens so quickly there is no time to treat... I experienced this earlier this week but thankfully I was home already (after driving 30 min commute) when it happened and thankfully my husband was there to give me a glucagon shot as I dropped from 87 to 28 and still dropping, all in about 15 minutes. There was little time to treat and treating wasn't nearly enough. Supplies in the car might be effective for a mild low but if you're dealing with a low that's fast and hard, supplies may not be enough to help you.
I've thought over and over since then "what if I had been driving when this happened?". I test at least 12 times a day and have a cgm and it still happened. Just as a side note, I've never had an accident due to diabetes. I just don't think we should be judging the actions of other diabetics without all the situational information.
U know smileandnod whay u said is sooooo true.Yes to the other poster I've had those "sugar" things along with a couple of packs of sugar there too and No I didn't feel the low coming on. (hypounawarness happens after having d for so long unfortantly) I really hope that ppl "checking their bs b/f driving" helps them but for me at the time it didn't I went to low too fast see I done that and was 100 and fastly fell to 28 when the parametics got to my wreck. I had a paramedic in a plain car right behind me when it happened and he grabed my bs machine that was sitting right beside me in the car. Nope don't judge til uve been in those shoes.
Having a sensor can really help those that are more hypo unaware. Be sure to make use of the alarms that will warn you of a possible oncoming low, and if they come fast, set the upper limit a little higher, especially when driving. A sensor can tell you when your bg is dropping or rising fast too. My insurance paid for my sensor after I recorded my bg for a few weeks and showed I had lows under 50. Liberty Medical has a hardship program for low income people too that covered my portion. Check into it if you don't have one. And if your lows are coming on that fast, there is most likely an explainable reason for it that can help you prevent it from happening again (missing a meal, taking too much bolus, taking a bolus or exercising when bg is already going down, bolusing or exercising at a different time and not taking a higher basal rate into consideration, etc.). I have always had trouble with the dawn effect (blood sugars goes up during the night when I don't eat) so I have to have a higher basal in the wee hours. I started having very low bg at about 4 am sometimes. I found that if I refrained from taking a bolus before bed unless it was over 150, that helped. Also, if I ate a snack late, my body would not have the natural rise in bg from glycogen so I needed a smaller bolus because my higher basal at night would help cover the carbs. Sometimes it is difficult to figure out the cause of a low. Sometimes it seems like a fluke. But there is a definitely a reason for the fast, hard lows. Be diligent about tracking it down. Your life and those of others may depend on it.
I'm not judging those diabetics that don't feel the lows coming on, but the fact that you write that a person knows this about themselves and does not take every precaution is what frustrates me. I hate being grouped by the disease that is just a part of who I am and if I have to take additional steps to get my lisence because of it, I will be pissed. Not to mention if someone in my family is ever injured by a diabetic driving and experiencing a low. We have to take control of our disease and not be victims by it.
Thank you for the great comments on the hypoglycemia data. This discussion raises important questions about who is at highest risk from harms due to hypoglycemia and points out that behavioral strategies as well as devices may impact risks for some. The TuAnalyze hypo survey does include questions about hypoglycemia unawareness—we welcome your participation to better understand this issue. Currently, 39% of those who have taken the hypoglycemia survey report that they have hypoglycemia unawareness. As this discussion points out, risks for accidents, injuries and other harms are especially high for these persons: for example, more than 1 in 4 users (26%) who are hypo unaware have ever had a vehicle accident or injury due to low blood sugar, compared to 7% of the group that is hypo aware. 62% of those with hypo unawareness also report that they avoid exercise to avoid the risk of going low, compared to 42% of the hypo aware. Risks also vary for persons using different types of devices. While the hypoglycemia survey does ask about CGM use, you can provide information about your experience with monitors and CGMs on the device use survey, which we will incorporate with the hypoglycemia data. Thank you for participating!
Sue R- I use the Metronic sensor. Have you tried using you Fall Rate along with your Predict Alert? If lows come fast, I'd also suggest raising your number a bit for the low prediction to give you a heads-up earlier. I think mine is set to 80.
OK wait now. The GMC is a good thing for ppl who can afford the decetable.
Now I gotta say this to Alyne.......................Some of us DON'T feel them coming on and then it hap[pens to us. Also PLEASE know that this happened to me a loooong time b/f they came out with the CGM. (things have really changed since back when I 1st got it. Techonology wise that is) I DON'T DRIVE anymore b/c of the reason's u just wrote up there. I RELIZED that I was putting other's in danger so I just quit driving. Now I got that off my chest. Thing is you folks need to know how things were for those of us who were diagnosed waaaay b/f they came up with the pump, CGM, counting carbs or other stuff!
re: Medtronic CGM, it consistently ran 40 points higher than my meter BG. I gave up on it. It also woke my husband up long before me. Thanks for your suggestions.
Mine was always off too when I first started using it. I talked to a local trainer about it and she downloaded my sensor info on her laptop. The problem was my calibration timing. I have to calibrate at least 3 hours after I eat anything because the meds I'm on slow digestion to keep my bg from spiking and my insulin seems to stay active about 2.5 hours. She said there can be as much as a 15 minute delay between what my bg is and when it correlates on the sensor reading too because of the time it takes for the change in bg to make a difference in my tissues. Now that I am calibrating less often and at least 3 hours after food, the readings are much more accurate, sometimes actually exact. I have noticed if I wear the same sensor for more than 3 days though that sometimes the Isig number goes lower and the readings start getting less accurate. But not always.
Re the car issue, it's only recently that testing 7-10+ times/ day became the standard except with idiot medieval doctors and insurers who try to cut back on that.
The only time I ever go low at night is when I've consumed only a small quantity of meat or other protein. Conversely, if I have lots of protein, my blood sugar rises during the night.
The lows I have during the day invariably occur when I have been doing strenuous cycling or walking for over an hour, and haven't "budgeted" enough carbs before starting out.
