# Hypo symptoms



## Dylans mom (Feb 28, 2020)

Hi my son has been diagnosed for 2 months now with type 1. We are managing quite well but recently he has been getting sympathy of a hypo but no hypo when we check his bloods.  Hes getting shaky and it's really annoying him and causing him to be angry.  Nurses have said there is nothing I can do. Any help is appreciated please


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## rebrascora (Feb 28, 2020)

Hi

It may be that he is experiencing a false hypo. Ie his blood sugar is decreasing quickly from a high level and even though it is not reaching a hypo reading of less than 4 his body/brain detects that glucose levels are dropping sharply and starts to shut down non essential functions. If this is happening 2-3 hours after food it may be that experimenting with timing his bolus insulin would be worth while. 
For instance, my breakfast insulin takes ages to get going but I am very efficient at digesting food, so unless I jab my breakfast insulin an hour before eating breakfast, my BG goes very high for a couple of hours and then comes crashing down after that. This is particularly bad if my fasting reading is already high. If I wait between 1hr-1hr10mins between injecting insulin and eating breakfast, the insulin release and glucose from breakfast meet each other at just about the right time and I don't get a huge rise and fall. Lunchtime and evening meals don't need as much pre bolus time at about 20 mins for me but it is different for everyone so a certain amount of experimentation is needed to find the correct timing for each individual...... Some people with slower digestion would hypo after waiting 10 mins so take it carefully.  
If you think this may be the problem, slowly increase the time between the injection and food by 5 mins each day or monitor his BG levels and give him his meal when his BG just starts to drop. This is obviously much easier if he has a Freestyle Libre Sensor than if you are finger pricking, but I have figured my timescales out by fingerpick tests. Breakfast time is often made more difficult by Dawn Phenomenon so his BG may rise after his fasting reading even before he eats anything which just makes it worse. 
Hope you are able to understand what I am getting at, but if not, say so and I will try to explain it better.


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## Dylans mom (Feb 28, 2020)

rebrascora said:


> Hi
> 
> It may be that he is experiencing a false hypo. Ie his blood sugar is decreasing quickly from a high level and even though it is not reaching a hypo reading of less than 4 his body/brain detects that glucose levels are dropping sharply and starts to shut down non essential functions. If this is happening 2-3 hours after food it may be that experimenting with timing his bolus insulin would be worth while.
> For instance, my breakfast insulin takes ages to get going but I am very efficient at digesting food, so unless I jab my breakfast insulin an hour before eating breakfast, my BG goes very high for a couple of hours and then comes crashing down after that. This is particularly bad if my fasting reading is already high. If I wait between 1hr-1hr10mins between injecting insulin and eating breakfast, the insulin release and glucose from breakfast meet each other at just about the right time and I don't get a huge rise and fall. Lunchtime and evening meals don't need as much pre bolus time at about 20 mins for me but it is different for everyone so a certain amount of experimentation is needed to find the correct timing for each individual...... Some people with slower digestion would hypo after waiting 10 mins so take it carefully.
> ...


Thank you I'm still trying to get my head around it all lol my hubby understands a bit better so will mention this to him. My son is only 13 and he just gets so fed up


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## Thebearcametoo (Feb 28, 2020)

What are his numbers like generally? Has he been running over target for a while and now back in target? Sometimes your body gets used to being high and so being in target but lower than the body expects can give false hypo symptoms. You can also get hypo symptoms when being hyper so it may depend on the numbers when you test. A sharp drop is also possible. Teen hormones can have a big impact on glucose levels and on his emotions so he has a lot going on. If there’s a psychologist attached to his team then it’s worth having an appointment. We found the first month or so after diagnosis was ok as everyone was concerned about the practicalities but it soon hit my daughter that this is now permanent and we had a rough few months (plus everything always seems to change).

We’re here to support you through the frustrations and up and downs.


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## Dylans mom (Feb 28, 2020)

Thebearcametoo said:


> What are his numbers like generally? Has he been running over target for a while and now back in target? Sometimes your body gets used to being high and so being in target but lower than the body expects can give false hypo symptoms. You can also get hypo symptoms when being hyper so it may depend on the numbers when you test. A sharp drop is also possible. Teen hormones can have a big impact on glucose levels and on his emotions so he has a lot going on. If there’s a psychologist attached to his team then it’s worth having an appointment. We found the first month or so after diagnosis was ok as everyone was concerned about the practicalities but it soon hit my daughter that this is now permanent and we had a rough few months (plus everything always seems to change).
> 
> We’re here to support you through the frustrations and up and downs.


We have managed to stay between 4-7 few hypos at school , thought his hormones could be to blame too, we have saw the physiologist once and have another appointment in march. Cant say it has been easy as he was taken to hospital with dka then our whole lives changed, his hair started to fall out but that's stopped thankfully, he has said he would rather not be here , he has meltdowns and has become quite clingy. Life is pretty hard some days hes ok some days he is not. Thank u


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## Thebearcametoo (Feb 28, 2020)

It’s a huge thing to happen and take on board and any hypos or hypers can leave a hangover of symptoms after them. You all have a lot to take in and it is a huge adjustment. I think probably harder as a teen than the age my daughter was diagnosed (just before she was 9). 

Don’t forget you can self refer to CAMHS if you have concerns about him being depressed, suicidal or self harming. This would be on top of not instead of the psychologist attached to the diabetes team. It’s good to keep your GP in the loop too. We found the GP supportive through the time my daughter was struggling.

It will get easier.


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## rebrascora (Feb 28, 2020)

Do you have a freestyle Libre or are you relying on finger pricks for testing? If the latter, I wonder if a bit of tech would pique his interest and maybe make it seem a bit "cooler" by being able to swipe his arm for readings and get a graph of the results, rather than one off finger prick tests which only shows you a moment in time. This might shed more of a light on what is happening on the occasions when he is feeling unwell and therefore help you to find a solution. You could certainly discuss it with your DSN. ...It is a sensor which goes on his arm and lasts 2 weeks.


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## Dylans mom (Feb 28, 2020)

Thebearcametoo said:


> It’s a huge thing to happen and take on board and any hypos or hypers can leave a hangover of symptoms after them. You all have a lot to take in and it is a huge adjustment. I think probably harder as a teen than the age my daughter was diagnosed (just before she was 9).
> 
> Don’t forget you can self refer to CAMHS if you have concerns about him being depressed, suicidal or self harming. This would be on top of not instead of the psychologist attached to the diabetes team. It’s good to keep your GP in the loop too. We found the GP supportive through the time my daughter was struggling.
> 
> It will get easier.


Thank you for replying and helping.


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## everydayupsanddowns (Feb 28, 2020)

Sorry to hear about the symptoms your lad has been experiencing. Diabetes is tricky enough to manage already without the body and mind playing tricks on you!

Hope these non-hypo hypos disappear in time.

Sounds like you are doing an amazing job all round.


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## Dylans mom (Feb 28, 2020)

everydayupsanddowns said:


> Sorry to hear about the symptoms your lad has been experiencing. Diabetes is tricky enough to manage already without the body and mind playing tricks on you!
> 
> Hope these non-hypo hypos disappear in time.
> 
> Sounds like you are doing an amazing job all round.


Thank you that's very kind we are trying our best, hes really getting frustrated though with the shaking and it's not a hypo, he said he has just had to stop playing his computer as his hands were shaking I'm at a total loss and dont knowhow to make it better


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## Pumper_Sue (Feb 28, 2020)

Hello Dylans Mum what insulin does your lad use? I ask because I wonder if he has an allergy/adverse reaction to the insulin he is on. I know at one time there were many reports about Lantus causing problems.


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## everydayupsanddowns (Feb 28, 2020)

Dylans mom said:


> Thank you that's very kind we are trying our best, hes really getting frustrated though with the shaking and it's not a hypo, he said he has just had to stop playing his computer as his hands were shaking I'm at a total loss and dont knowhow to make it better



Sounds like it is happening quite frequently and affecting his quality of life.

It would be worth discussing with his clinic/DSN if you’ve not mentioned it already. Do you have contact details?


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## Dylans mom (Feb 28, 2020)

Pumper_Sue said:


> Hello Dylans Mum what insulin does your lad use? I ask because I wonder if he has an allergy/adverse reaction to the insulin he is on. I know at one time there were many reports about Lantus causing problems.


Hes on nova rapid and lantus


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## Dylans mom (Feb 28, 2020)

everydayupsanddowns said:


> Sounds like it is happening quite frequently and affecting his quality of life.
> 
> It would be worth discussing with his clinic/DSN if you’ve not mentioned it already. Do you have contact details?


I mentioned it to a nurse this morning and she said there was nothing I could do... gonna wait til my favourite nurse is back off annual leave and ask her, if not I'm going to try and get a doctor's appointment for him.


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## everydayupsanddowns (Feb 28, 2020)

Dylans mom said:


> I mentioned it to a nurse this morning and she said there was nothing I could do... gonna wait til my favourite nurse is back off annual leave and ask her, if not I'm going to try and get a doctor's appointment for him.



how frustrating for you. Hope you get more practical suggestions from your favourite!


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## Dylans mom (Feb 28, 2020)

everydayupsanddowns said:


> how frustrating for you. Hope you get more practical suggestions from your favourite!


Me too for my sons sake before he goes insane


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## Thebearcametoo (Feb 28, 2020)

You can request he tries a different basal. My daughter moved from Lantus to Tresiba because she said it stung her.
Don’t be afraid to call the out of hours numbers you have for the team over the weekend. We got some different ideas that way when we were having difficulties.


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## Dylans mom (Feb 28, 2020)

Thebearcametoo said:


> You can request he tries a different basal. My daughter moved from Lantus to Tresiba because she said it stung her.
> Don’t be afraid to call the out of hours numbers you have for the team over the weekend. We got some different ideas that way when we were having difficulties.


Ok thank you very much


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## Hayley130 (May 20, 2020)

Hi 





Dylans mom said:


> Hi my son has been diagnosed for 2 months now with type 1. We are managing quite well but recently he has been getting sympathy of a hypo but no hypo when we check his bloods.  Hes getting shaky and it's really annoying him and causing him to be angry.  Nurses have said there is nothing I can do. Any help is appreciated please


 Hi my daughter is 13 and been diagnosed with type 1 two days before lock down how is your son in coming to terms with everything, telling friends ect. My daughter is only getting phone calls from everyone due to covid. She suffers with hypos but dont always recognise them. Its hard i know.


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## Dylans mom (May 20, 2020)

Hi sorry to hear of your daughters diagnosis it's such a hard thing to come to terms with and takes a while,  he seems to be coming to terms with it a bit better at the mo but I think that's probably because he is at home in his safe space. He hasnt and wont tell anyone at school to be honest he doenst like anyone enough to tell them and believes he will get bullied anyway so at the moment it's his choice. He still gets the odd hypo where he doesnt realise but hes managing ok at the moment it all takes time we are now nearly 5 months in and it does get slightly easier x


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## Dylans mom (May 20, 2020)

Hayley130 said:


> Hi


Sorry I did reply just replied above


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## Hayley130 (May 21, 2020)

Hay Dylans mum 
Its so hard with teenagers  my daughter has been told by the diabetes psycholoist she needs to tell friends she didn't like that.but i dont think she will even be back school till September. I think maybe we should lay off her a little and give her time to process. Im so sorry your son thinks he will get bullied if he tells someone at school. Has the school not suggested anything to help him. They both need to realise its nothing to be ashamed of its part of them. Oh my this is deffo a coffee and cake chat lol  if you need to chat anything over please message me. Im knew to this myself but two heads and all that. Take care Hayley xx


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## Dylans mom (May 21, 2020)

Hayley130 said:


> Hay Dylans mum
> Its so hard with teenagers  my daughter has been told by the diabetes psycholoist she needs to tell friends she didn't like that.but i dont think she will even be back school till September. I think maybe we should lay off her a little and give her time to process. Im so sorry your son thinks he will get bullied if he tells someone at school. Has the school not suggested anything to help him. They both need to realise its nothing to be ashamed of its part of them. Oh my this is deffo a coffee and cake chat lol  if you need to chat anything over please message me. Im knew to this myself but two heads and all that. Take care Hayley xx


Yes dylan was told a few times by the physiologist to tell people but hes not interested,  most kids assume if u have diabetes it means your fat so he doesnt want to hear that even though hes not fat. School haven't been fab to be honest,  in the early days he said he would rather be dead than keep going this but thankfully that's gone now. Honestly give her time it's a lot to accept. Dont know how u found out but dylan was nearly in a diabetic coma and they was talking about brain damage at first luckily he was fine but it was a stressful time for all. Carb counting is a pain but it gets easier and like second nature. I'm here if u need anything xx


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## Hayley130 (May 21, 2020)

We found out early i think Paige was fine when she went in hospital well felt fine. So shes not have that bad experience like Dylan did. I think Paige has a problam with people thinking its her diet that caused it to. Its just educating people easy said then done i know. The first few weeks i was just like a robot doing what i need do until i had melt down with my scales, paper, and pen. Its so hard on everyone including us. I hope Dylan dose tell someone soon he needs to own it, not it own him but its important he gos his own pace and if its like paige's its nearly on reverse lol . Talk soon Hayley xx


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## everydayupsanddowns (May 22, 2020)

Hayley130 said:


> Hi  Hi my daughter is 13 and been diagnosed with type 1 two days before lock down how is your son in coming to terms with everything, telling friends ect. My daughter is only getting phone calls from everyone due to covid. She suffers with hypos but dont always recognise them. Its hard i know.



Sorry to hear about your daughter‘s hypos @Hayley130

Must be very worrying for you both that she doesn’t always spot them. Have your clinic mentioned Libre or CGM as an option - they can make it much easier to see what is going on ‘between the dots’ and to check in between times to head-off hypos before they happen.


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## Hayley130 (May 22, 2020)

No one has mentioned anything to us about anything like that maybe i should bring  it up.


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## stephknits (May 22, 2020)

Hi Hayley, my daughter who was diagnosed on 1st May has received her freestyle libre today.  In our area you get one funded by the NHS 12 weeks after diagnosis of you are under the pediatric service.  Normally (pre covid) there would be a requirement to go on a training session about how to use it, bit we did the freestyle libre online training instead and this was enough.  We have chosen to get the libre now and self-fund until she is eligible to get it on the NHS at the end of July.  We got the scanner and a trial sensor for free.  I myself use the libre and find it invaluable for noticing trends etc and for finding out what is going on at night.  I would definitely ask your team about it.


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## Hayley130 (May 22, 2020)

Shes had 3 hypos in the last 24 hours and didn't pick up on any signs with any.


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## Thebearcametoo (May 22, 2020)

That can happen sometimes. Is she mostly in target otherwise? It can help to give her a week of being in the 7-10 range to see if she develops hypo symptoms again. My daughter has gone through phases of having really good hypo awareness and phases when she’s had no clue.

Sometimes when you have a run of hypos you end up over correcting and then giving more insulin tha is needed at the next meal and ending up with another hypo. Our DSN says if you have 3 hypos in a day to have 10g carbs free in the next meal as well as the 10g carbs after the hypo treatment. If you’re at all unsure then give your DSN/team a call.

And it doesn’t mean you’re doing anything wrong btw. Sometimes it just is like that with diabetes. Knowing what to do when it happens is key. Over time you’ll get more confident about how to adjust for things like that.


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## Hayley130 (May 22, 2020)

Hi thebearcametoo
Thanks for your advice Shes had 13 hypos so far this month is that high ?. But shes had a few days where shes been fine no hypos at all. She has a free biscuit (no insulin) if her glucose level is below 7 at bed time and this seems to help with night hypos. And it works well for her . Il deffo try the 10g free. And believe me i need all the advice i can get still a learner deffo. Thanks Hayley


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## Thebearcametoo (May 22, 2020)

Your team would be best to advise on how many hypos is normal in the mix of all her other tests. At the beginning it can be really tricky to juggle it as her body may well be producing some of her own insulin. If we track patterns of hypos and highs (over 10) over a week or two then we get an idea of whether the insulin ratios are about right or not. To begin with though your team will be the ones to spot patterns. Some weeks we’ll have no hypos, some weeks several over successive days. Hormones, activity levels, growth, illness, excitement levels can all affect insulin needs so it really varies and you will feel like you’re constantly updating ratios or making changes.


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## SB2015 (May 22, 2020)

Hayley130 said:


> Hi thebearcametoo
> Thanks for your advice Shes had 13 hypos so far this month is that high ?. But shes had a few days where shes been fine no hypos at all. She has a free biscuit (no insulin) if her glucose level is below 7 at bed time and this seems to help with night hypos. And it works well for her . Il deffo try the 10g free. And believe me i need all the advice i can get still a learner deffo. Thanks Hayley


I think with the information about the good it would definitely be worth asking about a Libre.  It will make things easier for you both, as you can easily monitor glucose levels with just a swipe of the reader or her phone over the sensor.  So much easier and as it shows the direction in which glucose levels are going alongside the actual reading it is a lot easier to head of lows and highs before they become a problem.  It is also a lot less obtrusive doing the tests.


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## Thebearcametoo (May 22, 2020)

Yes that’s a really useful function on the Libre. My daughter won’t use one though  so we’re old school


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## stephknits (May 22, 2020)

I asked this question yesterday of my team and they said they were comfortable with 3 hypos a week. Otherwise they would be looking to adjust either basal or bolus ratios as appropriate


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## everydayupsanddowns (May 24, 2020)

I think the other really useful thing about sensors is that you can look at ‘time in range’ rather than number of events. So a horrid low that you battle with for 2 hours multi-treating, counts far more than just grazing 3.8 for 2 minutes then bouncing back to 5.5.

There’s a general consensus of suggested TIR for adults, and also during pregnancy, but I think it would be different in paeds.


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