Hypo recognition.

Hello,

Since doing a DAFNE course in November, I have experienced a lot of hypo's, often 1 or 2 per day and sometimes 3.
Normally I am able to identify hypo's quite easily, however in the last few days, I have experienced a 3.2 result at breakfast, when feeling well. Also on a couple of occasions I have felt hypo, checked my blood and got 9.6 & 8.2 readings, only to be 1 hour later down to around 2.4
Could it be that having had so many hypo's I am losing my awareness or could there be any other factors?
I have had Type 1 for 30 years and was beginning, for the first time, to feel more in control of my sugars. At least I no longer have so much up and down.

I am not a HCP but I seem to recal my time in DAFNE it was mentioned that after such a long time Hypo's can go un-noticed not sure what the reason was!?

I have only been diagnosed 9yrs and done my DAFNE 1 yr ago and like you i feel 'low' and test and it is 9.2 or 8.4 similar to you although had one a few months ago that was 3.0 and felt fine!

Lets hope a HCP replies!

Good Luck

Unfortunately shazz, it would appear not. Not to worry though, I have made a few adjustments, which, hopefully will help reduce the amount of hypo's.

Hi,
May I recommend you read the online handbook that gives you the answer here . You don't really need a HCP just a better memory ;-)

Thanks Marke, so much to take in. Cant remember what I did yesterday, let alone three months ago. guess we all need a bit of help occasionally.

Hi,
Just a quick update to the info that's currently in the Handbook (which is due to be re-issued later this year). We now recommend:

1. Keeping your BG within DAFNE targets, i.e. do not allow it to drop below 4.5mmol/l at any time and try to avoid hypos at all costs (be more cautious with corrective QA doses, particularly if you have had a hypo already that day)

2. Aiming to be at the upper end of the target range before meals, i.e. BG around 7.5mmol/l (8mmol/l at bedtime). You should not need to run your BG above DAFNE targets in order to regain hypo warnings.

Hope this helps

Hi Carolin,
Thanks for making contact, it is much appreciated.

Last two days have been much better, only one hypo, results are hovering around 8-10. Aim is to keep things as they are for a couple more days and see where we are.

Keep up the good work.

Vic.

Carolin,
Can you clarify what you are saying, are we talking about Hypo recognition or DAFNE generally. I would have thought all diabetics try to avoid hypos, believe me its not something we particularly enjoy ;^) . We also try to keep within DAFNE targets which is the point of DAFNE. However if we are talking hypo awareness and lack of it then of course avoiding hypo's is a priority.

When you talk about aiming at the upper end of the range, is this connected with trying to restore hypo warnings ? Is there any guidance over how long it might take to regain warning signs. Obviously individuals will vary in both their warning signs and the time it takes to regain them, however a rough indicator on how long the aim of top end DAFNE BG's should be maintained would be useful.

Hi everyone,
This is a really important topic! From recent research and experience, (I am a diabetes nurse) most people need to run at the top end of the DAFNE targets if trying to regain symptoms, for at least 2-3 weeks, and that also means during that time having no hypos whatsoever. This is easy to say but not necessarily easy to achieve, particularly if you're prone to lows overnight.
The theory is that if you've had a lot of hypos, the body 'resets' what it thinks is a hypo, so you may only get symptoms wghen extremely low indeed. This makes you more likely to have a severe hypo, where you need help from another person. It is linked to how long you've had diabetes too, which you can't do much about, and is one of the reasons why not everyone aims for lower HbA1c results immediately after DAFNE courses; you have to take it steady! Ask your health professional direct for advice as sometimes two heads are better than one - and congrats Vic on steadier results, I'm sure that will help you sort things out.
Cheers, Clare

Clare,

Thanks for the information and help. Results have been better - not so many low's - but the occasional double figure reading which is a worry. Difficult to run at the top end of guideline as I always seem to fall within the blue or red zones. Happy to share my diary if it will help. Possibly the more worrying matter for me, was the signals of hypo when 8-9 only for a hypo to come on an hour later.

Great to get help from the HCP's, keep up the good work.

Regards, Vic.