The Impact of Hypos in Diabetes

Do you hate hypos as much as me? Hypos can be a real problem and are probably one of the biggest fears for people with diabetes and their family members, and the impact of hypos in diabetes can be huge.

Hypoglycemia, or hypos as often called by many of us, is technically when a person’s blood glucose drops below 3.5 mmol. A “normal” (hate that word!) blood glucose is about 4.5 mmol – 8 mmol.

However as a person with type 1 diabetes I consider anything under 5 mmol to potentially be a hypo and have felt hypo at much higher levels. This is due to the fact that if you are sitting at higher levels, when you drop, the body will experience some of the same feelings as when in a true hypo.

The Impact of Hypos in Diabetes

In a hypo, the brain demands glucose as it can not store this and sets off a series of hormones which result in us feeling shaky, sick, confused, having palpitations, sweating, mood swings and a range of other things related to hormones such as adrenalin. It is the body’s way of trying to encourage the liver to shoot out some glucose stores.

These feelings can be like feeling drunk, anxious and even like you are dying. Fear is a big feeling for many people. Education tells you to “eat 5 jelly beans, have a piece of bread and then wait”. Experience tells you “eat eat eat eat eat eat eat” until you feel better.

I have found that a hypo at 3.5 – 4.5 mmol is quite ok and I feel off, but manage it well. Under 3 mmol I start to get more serious symptoms. I am very lucky that I DO still feel hypo symptoms. Some people don’t. Some people go to the point of passing out….

When I got diabetes at the age of 12 years old, the hospital had a planned “hypo day” where they put you into a hypo and then made you experience all the mood changes, even made me walk a straight line to prove I couldn’t and then would not give me food for ages! It was abuse really.

There is a sense of panic and urgency created by the brain in a hypo which drives you to eat. It does not matter how often you have had a hypo, sometimes you eat too much. And then, this leads to being high later and then having to take insulin to get down again and so you get into a cycle of swinging up and down. Sometimes this is hard to stop. I have tried sitting with a clock, watching to tell myself when I can check my blood glucose again to see if it is coming up can help – sometimes it works, sometimes it doesn’t. It is worth a try if you find this a problem.

And how GOOD does food taste when you are hypo!!

Dealing With Hypos

Hypos can also ruin your exercise plans, screw up your weight loss attempts and wake you from your sleep – which is actually great as you do not want to sleep through a hypo…

It is an ever present, unpredictable, awful part of diabetes, and in particular, type 1 diabetes and one that is very tricky to tame. The tighter  your control, the more hypos you have and so the very act of trying to keep tight control to increase your health and wellbeing, leads to more days with the hypo monster.

I have spoken to many people and experienced myself, the need to keep blood glucose higher in situations such as caring for a baby, driving a car or presenting at a national conference – due to the fear of a hypo happening. In the short term that is ok but if you keep this up over time due to hypo anxiety it can really damage your health. This is when you should reach out for some support to work through this very real anxiety.

How do you feel about hypos and how do you manage them?

Helen x