Im having difficulty identifying the traits of an actual hypo. I have shown my endo the graph trend on my android phone app OnTrack. It has shown i have had quite a few 3's (54) and he noticed these and said 'looks like you have had a few hypos'. The lowest i have seen on my meter atleast is 2.7 (48). I only ever get this way during physical activity, mainly swimming. But what i FEEL is just a lack of technique, loss of power, a little shaky, loss of energy. Maybe slightly 'doughy'. Nothing which says im going to pass out, freak out, etc. To me this tells me im low, but is it a 'hypo'. How does one define 'low' from hypo? Just curious how people define their hypo from low?
To me "low" and "hypo" are interchangeable terms. But hypos definitely vary both in terms of severity and our own experience of them. I think a 54 and a 34 are way different things. And you have to be quite low to pass out. What you describe sounds like a pretty typical hypo. I also think our subjective experience of hypos not only varies person to person but for each of us. I've had numbers in the high 30s where I could barely function. The other night I hit my own personal record - a 28 and I really didn't have many symptoms at all!I was able to reason and problem solve: I kept going down despite taking glucose tabs and it was getting late and I was sleepy. I was anxious that one more "step down" and I could lose consciousness (I live alone). I went through the thought process of: "Should I call 911? No, overreaction. Should I drive to the ER? No, not safe. Ok, I'll take two more glucose tablets (I'd already taken 8!), and eat a snack and I'm going to, of course, stay awake until I get into a safe range". Pretty functional. I think the variation in how we feel often has to do with how fast we go down among other factors. So yeah, I'd say your 48s or 54s are definitely hypos, but not severe ones.
how did you bs go after ingesting all the tabs? did you skyrocket back up eventually? Kinda scary when your hitting the glucose and your bs doesnt go up very soon afterwards!
When I had my worst and most stubborn low (around 37) it took about 2 hours and more carbs than I can remember to take me out of the 50s. I went to bed that night at around 120 and woke up a couple hours later around 200. Corrected, went back to sleep and 2 hours later I was around 180. It took one or two more corrections to get down to about 125 the next morning. Stuff happens.
Maurie
As I still have hypo awareness, I call a low with symptoms a hypo, and a low without any physical/mental changes a low. I seem to have a threshhold of 50; anything 50 or over I don't notice. I hit 48 yesterday and definitely knew I was too low. Sweating, shaking, tough to walk. I drank some OJ and some of my daughter's leftover frozen cappucino, and had a spoonful of PB for longer action (not a great choice, no idea why I did that). An hour or so later I was in the 120s, then 1/2 hour later 99. I think I still had some IOB from what I now know was overbolusing earlier.
I've been very low, about 25, and felt fine. I've been about 70 and felt terrible. A telltale sign for me is losing the ability to communicate. First, a little confused and incoherent. Sometimes, I can think words, but am unable to speak. Sometimes sweating. Sometimes I can feel my eyes rolling back in my head. I've had blackouts, convulsions, been in shock for hours and woken up in the hospital, throwing up. It's not pretty.
Fortunately, it hasn't happened for years. Just be careful.
I am hypo unaware, but my family knows when I start acting frunk--slurry words, lack of coordination, silly..that I need some sugar quickly.
The worst for me is that it is almost always followed by a high and they make me cranky and very tired. It seems very hard to ingest jut teh right amount of carbs to get out of the danger zone-even when doing the eat/drink and test every 15 min thing..
so yeah, stuff happens
Symptoms
Fast Heart beat
Nervous
very very VERY weak, no strength to open a bottle of tablets,
occasional headaches,
sleepy, I would fall asleep in the middle of a conversation at the dinner table.
I usually feel this way when I'm 59 mg/dL and lower. The lowest I've ever been is 20 after a hard core workout.
I consider a Low to be between 60 & 79 mg/dL.
& Hypos 59 and lower.
In the forum there are many examples of how a low might feel. The problem is that I see a tendency here to trivialize the low. The healthy body will NEVER experience a blood glucose lower that 70. Even 70 is unlikely and can be taken as an indicator for a health issue. This tight control is in place to guarantee that the nervous system and the brain are always sufficiently supplied with glucose. With a blood glucose beyond 60 your brain can not keep up all activities anymore. There is a risk of a chaotic dissonance between different areas of the brain. The result can be a seizure. The health risk is very high in this state because very imporant low level processes could be affected - like the breathing. If it comes to a seizure or not is hard to tell. If you have some kind of awareness for hypos left then you will fight the low as soon as possible. If not the risk will increase the longer you wait. Thus you should always vote for very fast acting carbs to fight lows. I also think that the summary of lows will have negative effects on the performance of the nervous system. Comparable with the summary of highs there is a complication tag on lows. The enourmous stress of a low is another factor the older you get. Thus I would treat lows with the same respect as the highs. A patient with the A1c of a healthy person but many lows still has a problem with his glucose control he has to resolve. I do not want to spread fear here but respect for lows. I think/hope the JDRF is wrong with their claim "1 in 20 people (an estimated 2-4 percent and 6 percent in patients younger than 40 years old) will perish from severe hypoglycemia". But even 1 in 40 is way too high.
I think we'd hear about more deaths if the 1 in 20 number were correct? I did a quick search and didn't really come up with much which makes me suspect that the number of cases may be apocryphal? On a case by case basis, tragic but it almost seems like the medical community like to have a "Damocletian Syringe" hanging over us that may be, at least statistically, a myth? Since my "party" days, I've lumped insulin in my head as a "hard" drug, in that it can kill you like coke/ heroin/ liquor unlike pot and I certainly feel it should be treated with respect. I would also add that there may not be a ton of room between "loss of technique" and keeling over? I don't differentiate between a "low" and a "hypo" although perhaps in my head, I would reserve hypo for when I actually keel over?
Re hypos, I prefer the 80s to the 70s but don't mind the 70s if I'm not swinging wildly. I will fix the 60s, not always with a lot of carbs as I think the 15/15 is more than I need. I like 5-10G of carbs (more for lower, or insulin on board?) and waiting about 20-30 minutes to retest, if at all.
I have perceived the "lack of technique" too, particularly running, I have a Garmin and, particularly on a shorter run, it'll be apparent that I can't maintain my pace when my BG drops. Swimming has always proven to reliably kill my BG. I have sort of drifted away from it a lot since I have had the pump/ CGM, to me, good sites are more valuable than playing in the water and, as a bonus, I don't have to clean up lows. I'd be concerned for timmy in that the swimming is the first leg of a triathlon and would lead to starting the bike ride section without enough fuel. Although a plus is that it's easier to lug extra carbs along on a bike!
fortunately the swim is only 300m on the short courses, 750m on the long. I have done 1 'long' and didnt havent enough insulin on board and had a shocker. Call it a learning curve. I chug a gel about 15 mins before i go, and have another one opened and the first transition ready. That sees me through the ride and run since they are only short. Often i have to bolus when im finished.
I havent heard about the 1 in 20 either, thats a frightening stat if true!
A "3" (3.0 mmol/L = 54 mg/dL) or a "3" (3.9 mmoL/L = 70 mg/dL) ?
I don't feel that 3.9 (70) is a hypo, just low normal.
I do feel that 3.0 (54) is a hypo.
Some people make the leap of low is the same as hypo is the same as severe hypo. But more realistically the DCCT does a pretty good job distinguishing "just a T1 trying to have normal bg's hypo" from a "severe hypo":
Severe hypoglycemia was defined by the DCCT Research Group as loss of consciousness, coma, or an unresponsive state relieved
by the ingestion of sugar (1).
You might try having the gel a bit earlier? I find that the maltodextrose gels take longer and last longer than "simple" sugar? I saw a race report from MeganJ, one of the Team Wild Runners that shared her coach's feedback (an interesting thing...) that mentioned this too.
Here's a link to her page, I like her race reports. She does tris too and might be a good source? http://www.tudiabetes.org/profile/MeganJ
@Acidrock: I suspect you have quite a bunch of residual beta cells. They help you to keep your blood glucose more balanced. Furthermore they will reduce their insulin production at lower numbers. This ability helps you to sail at 70 without problems. I might be wrong with that. It is just a gut feeling I have.
After 27 years? I guess they’ve found them in 50 year people too but I suspect the amounts are very trace. The times I lost basal due to pullouts and pump failure last summer, my bg shot up pretty quickly?
I take a hydroaerobics class and we have an above ground pool in our backyard for the kids. I love my omnipod because it handles the water so well. For me, lows while I am in the pool are hard to feel. And, water activities burn through my sugar fast. I don't know why lows sneak up on me in the pool - maybe hard for me to tell my body temp (when I get low I get hot or really cold) or maybe I am just distracted. But, when swimming, in class, or at the water park I really have to consciously remember to get out and test. Which is a pain because your fingers are all wrinkly and the blood runs down the wrinkles of your skin instead of into the meter. And then, I make sure to disinfect the test site with antibac wipes when at a public pool. As a mom, I can't help myself, I have to say: please be careful when you're swimming. And eat your veggies and wear your bike helmet, I know... I know...but really please be careful. :)
Good stuff from everyone on what defines a hypo vs. a low. I personally don't make any delineation -- they are the same to me, though they can be more or less severe, of course. I've told people, when asked, what it feels like to go low (no matter the actual number) with this little metaphorical story:
I feel like I am standing in rising water... As the water rises up to my neck (as I go from say, 80 to 60) I am fully aware of what is happening, and I can say to myself, "Gee, the water is rising. Maybe I should do something about that..." That's a no-brainer, and what I often do to get the water level back down (i.e., get my sugars back up). If I wait, and the water rises to my chin (heading towards 50 now), I am both more nervous and skittish and know I must do something soon or the water will rise over me and I can drown. Shortly after this, if I do nothing the water will rise to my nose, and I am now at my shakiest, but still kinda know what is going on. And then the water rises above me -- as I get into the danger zone of the lower 50s and 40s -- impeding my ability to 'breathe', that is, do something about the low/hypo because confusion sets in. If I head into the 30s, my head is fully under water and I am all wet (metaphorically as well as realistically -- I used to tend to sweat a lot when going very low -- though less so these days). I don't know what is going on anymore, and often require some assistance to get out of the water, that is, get out of the low 30s and 20s. I'm drowning now, and I don't know why...
The story paints the picture in terms the non-diabetic can surely 'get'. Alls I knows is it sucks to go that low.
/\/\
Yes, it is a bit scary, but it doesn't happen very often for me. Usually I take the glucose tabs and it goes up. After all that, I was fully expecting to wake up in the 200s but woke up at 51! Then the rest of the day it normalized. No clue, but after awhile you accept (or try to) that sometimes things happen that don't make sense and you just deal with them. If they're a pattern, then you look to make changes but this wasn't.
Btw I was watching a show last night (Touch - good show) and a man walked in and found another man unconscious. He called the last number dialed on the man's cell phone (after 911 of course) and the guy he got said "he's diabetic, go in the fridge...." and I was expecting a glucogon kit "and give him a shot of insulin". Ayyyyyyy! (He came around and was fine)
haha, oops. Bad research on the shows part!
Over the last week or so I’ve been exercising for the first time since my dx and have experienced two lows in exercising - both of which I could feel. These were at BG readings of 60 and 64 and it seems like my hypo symptoms really ramp up at that range (shaky, nervous, cold sweats) but not much so before that BG range.
I also felt that way just walking around in some pretty hot/humid conditions, which I’ve heard can lower BG pretty significantly.
When I was low when exercising (hiking) I ate a couple of Clif Blocks, waited 15 minutes and tested again before starting up. When I was just walking around in hot weather, I used my tablets to correct for the first time (16g got me from 60 to 155 in about 20 minutes - I kept walking around until we sat down for lunch about 30-45 minutes later, at which point I was back down to 79).
I’ve been able to catch downward trends while exercising before actually hitting a low (dropping to 90 from 135 an hour into an activity, for example, with more activity to come) and have popped a Clif Block to keep things closer to 100 and have just kept moving.
The Blocks seem to give me a more gradual, steady rise in BG, while the tabs clearly act much, much faster - good to know for those times when I need a fast correction.
It seems, for now, that 60-ish is my magic number for feeling anything but if I get a reading from 70-80 I may have a small dose of carbs to keep from dipping much further. My CDE already decreased my basal after our first meeting since it seemed a bit much based off my logs, and everything I’ve recorded since then indicates I’m prone to drifting a bit low and most likely honeymooning. I’ll have a cup of tea or decaf coffee with about a 1/4 cup milk (3g cho) and that generally helps keep me in the 80-90/90-100 range if my #'s were threatening to get lower.
Hope that’s helpful experience - I’m trying to figure this out, as well and have been wondering about my hypo symptoms, too: are they normal at that range, does feeling hypo at 60 indicate good or bad awareness, etc? I’m realizing more and more that the best mantra for me now (and perhaps the rest of my life) is test, test, test.