# How many hypos?



## aymes (Jan 20, 2009)

I'm just interested in seeing how often most people here have hypos, what's seen as a normal number per week say?
Inspired to ask the question as I've always felt myself to be pretty lucky in that no more than once a week is normal for me but have been having dramatically more recently- nothing I'm hugely worried about as I'm pretty sure why and having done dafne I'm confident that I can sort it out! We were told on dafne that 2 or 3 a week was expected with good control.


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## sofaraway (Jan 20, 2009)

Just looked back through my meter and I've had 1 hypo this year a 3.7 on the 14th.  Been running generally higher though.

I would say about 1 mild hypo a week on average. usually due to my miscalculation of lunch bolus. 

I have never been able to get out of a professional how many hypos is 'too many', it's interesting that they said on DAFNE 2-3 is ok.


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## diagonall (Jan 20, 2009)

1 or 2 a month now as on a pump.


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## Northerner (Jan 20, 2009)

Interesting that you should ask this as I was going to post something about a recent experience. Generally, I have been very good, with readings in the low 4's to 5's, but over the past couple of days I had the following readings (all pre-meal from breakfast Sunday):

4.1, 4.6, 2.8, 3.1, 3.9, 3.2, 2.4, 6.1.

I carb-count and am usually pretty accurate, hadn't done any out of the ordinary activity, so can't really account for these lows. And yes, I am losing my hypo-awareness as I only really became aware with the 2.x ones.

Is it harmful to have all these lows? I'd usually get maybe 1-2 a week that I know of, although suspect I'm having nighttime hypos. I'm currently testing in the middle of the night so I have something to take to the clinic next week as I think I may need to split my lantus.


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## sofaraway (Jan 20, 2009)

Northerner said:


> Is it harmful to have all these lows? .



I think the worst thing is what you are experiencing in that you don't feel hypo until your blood sugar drops lower, your symptoms don't kick in until a lower point. I would be very careful about stating that you are losing hypo awareness, implications of having that on your record might cause people to question if you should be driving. 

Looks like your lantus might be a bit high as these are all pre-meal lows, 
you might want to run yourself slightly higher for a while to avoid hypos, even for a couple of weeks should help you to regain awareness for the 3.x's 
hopefully you'll get more suggestions at your clinic appointment


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## Northerner (Jan 20, 2009)

sofaraway said:


> I think the worst thing is what you are experiencing in that you don't feel hypo until your blood sugar drops lower, your symptoms don't kick in until a lower point. I would be very careful about stating that you are losing hypo awareness, implications of having that on your record might cause people to question if you should be driving.
> 
> Looks like your lantus might be a bit high as these are all pre-meal lows,
> you might want to run yourself slightly higher for a while to avoid hypos, even for a couple of weeks should help you to regain awareness for the 3.x's
> hopefully you'll get more suggestions at your clinic appointment



I don't drive, so that's not a problem for me, but worried about the possible harmful effect low BG might have on my poor beleagured brain. I did try reducing my lantus a while back, but my pre-meal tests went up to 7s and 8s which surprised me on such a small reduction, and the nurse suggested I go back to my previous dose.

I've only been at this a few months so I'm still getting a feel for things. I suspect that my lantus is working too quickly and 'runs out' late evening. I also suspect that my novorapid lasts longer than 4 hours - but not sure if that's logical!


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## aymes (Jan 20, 2009)

Northerner said:


> Interesting that you should ask this as I was going to post something about a recent experience. Generally, I have been very good, with readings in the low 4's to 5's, but over the past couple of days I had the following readings (all pre-meal from breakfast Sunday):
> 
> 4.1, 4.6, 2.8, 3.1, 3.9, 3.2, 2.4, 6.1.
> 
> ...



Sounds similar to what I've been having since Saturday. I've had 10 hypos in the last three days (5 on sat!) and have been very close to it most of the time, very unusual for me. 
I'm pretty sure it's just my basal rate needs adjusting, which I'm working on. I've lost a fair bit of weight very quickly over the past week and I think that's thrown it off, I've always found that my basal is very closely linked to my rate, I only have to gain or lose about half a pound for it to be thrown off course!


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## diagonall (Jan 20, 2009)

Northerner said:


> I've only been at this a few months so I'm still getting a feel for things. I suspect that my lantus is working too quickly and 'runs out' late evening. I also suspect that my novorapid lasts longer than 4 hours - but not sure if that's logical!



It could be that your pancreas is having a fling and pumping out insulin (Honeymoon) Hence the unexpected lows.This can go on for a year with some people.

Many people also find Lantus doesn't work 24/7 So as you have already sussed you might be a lot better off splitting the dose.


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## WorzelGummidge (Jan 20, 2009)

I think I've had two this year.


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## Emmal31 (Jan 20, 2009)

Quite a lot really at least one every other day if not more I'm still trying to get used to carb counting am going on a course called BERTIE which is like dafne which will help me a lot.


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## Caroline Wilson (Jan 20, 2009)

it is normal for me to be between 6 and 8 although recently I have been below 6 for several evenings on the trot and for a couple of them below 5.

I get the signs of hypo when I drop below 5 so have something sweet, which helps and I am soon back to my normal sweet self...


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## emma1972 (Jan 20, 2009)

I have around 2 hypos a day but then Im running around like a blue arsed fly all the time. I usually feel symptoms when around 3.5 and easy correct it on the go. I had been taking 17units of lantus and found my basal level to be between 4 and 5 which is too low as I am so active and dont want to be eating all the time! If I drop my dose by just one unit to 16, I wake up between 7 and 8 and have basal rate about the same. Can t believe one unit makes such a difference, also it hurts like hell. It was so unbearable the other day I had to take the needle out before Id finished injecting the full dose. The air was blue that night! A very slim nurse in the hospital told me she has hypos all the time just because she was so active and didn't get the time to eat properly.


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## MarcLister (Jan 21, 2009)

I've had 8 this month so far! 

All at my blood test before lunch, thus indicating I'm taking too much insulin for my breakfast or not eating enough at breakfast. I was eating Bran Flakes to begin with, hadn't eaten these since my diagnosis last November 11th 2008, obviously 8 units of Novorapid was too much for my bowls of Bran Flakes.

So I went back onto toast in the morning with Marmite. Still had hypos despite it being same amount of insulin, same type of bread and same number of slices. 

Can only guess I'm getting cold or something between breakfast and lunch. Maybe even too hot as well. I have the heater on to warm me up and perhaps I go from being too cold and dropping blood sugar to getting too warm and dropping blood sugar again.

Started taking 6 or 7 units of Novorapid at breakfast now and its looking better.


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## sofaraway (Jan 22, 2009)

Marc do you carbohydrate count? Looks like you might benefit from it so it will make it easier for you to work out how much insulin to give.


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## MarcLister (Jan 22, 2009)

I did start but I kept forgetting. 

Even if I did, I still do not understand why eating two slices of toast with marmite in the morning and 8 units of Novorapid are giving me BS of less than 4 at lunch when the BS at breakfast was OK. Same amount of carbo as before, BS OK at breakfast, same number of units of insulin yet something going on there.


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## emma1972 (Jan 22, 2009)

Marc

If I had two slices of toast with marmite I would be looking at 3 to 4 units of novorapid assuming breakfast levels are ok. This would be about 1 unit to 10g depending on the type of bread (one slice anywhere bet 13-20g carbs). 8 units seems an awful lot of insulin. Dont eat the breakfast to suit the insulin eat what you want. I too was diagnosed Dec 2008 and have learned the hard way, better to underestimate the insulin and correct at the next meal than overestimate and hypo. Apparently your liver puts out a lot of sugar in the morning so you can get up early, test, be normal and then the liver dumps its load, you add onto that your breakfast and hey 8 units required. If your test happens to be after the morning sugar dump from your liver (which your lantus should deal with) then less novarapid needed with breakfast. 
Have just read it back and I make no sense at all sorry... I too am on learning curve!

Emma


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## Northerner (Jan 22, 2009)

emma1972 said:


> ...Apparently your liver puts out a lot of sugar in the morning so you can get up early, test, be normal and then the liver dumps its load, you add onto that your breakfast and hey 8 units required. If your test happens to be after the morning sugar dump from your liver (which your lantus should deal with) then less novarapid needed with breakfast.
> Have just read it back and I make no sense at all sorry... I too am on learning curve!
> 
> Emma



Hey, you've just explained why my insulin requirements are higher with breakfast! I generally have porridge and some fruit juice which ought to be 5 units novorapid, but 8 seems to be what keeps me on track until lunch. Thanks Emma!


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## MarcLister (Jan 22, 2009)

emma1972 said:


> Marc
> 
> If I had two slices of toast with marmite I would be looking at 3 to 4 units of novorapid assuming breakfast levels are ok. This would be about 1 unit to 10g depending on the type of bread (one slice anywhere bet 13-20g carbs). 8 units seems an awful lot of insulin. Dont eat the breakfast to suit the insulin eat what you want. I too was diagnosed Dec 2008 and have learned the hard way, better to underestimate the insulin and correct at the next meal than overestimate and hypo. Apparently your liver puts out a lot of sugar in the morning so you can get up early, test, be normal and then the liver dumps its load, you add onto that your breakfast and hey 8 units required. If your test happens to be after the morning sugar dump from your liver (which your lantus should deal with) then less novarapid needed with breakfast.
> Have just read it back and I make no sense at all sorry... I too am on learning curve!
> ...


Interesting. I shall try out less insulin tomorrow.


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## litto-miss-loz (Jan 22, 2009)

hey all

yh usually in the mornin i need more insulin as it takes time for the lantus to set in wen i take it in the mornin, then by lunch time its normal but then i need less insulin for more food, but before at breakfast i need more insulin for less food lol if that makes any sense lol 

i got hypo alot since im quite active at work so im gradually bringin mah insulin down a unit or two to try and suss it out. 

im goin on the carb course in september  after two long years on the waiting list -yawn- lol but hey lets hope it was worth the wait. 

xx


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## emma1972 (Jan 23, 2009)

I have learned so much from people on this site who have been so helpful. I still have so much to learn especially when it comes to regulating the basal thing. If anything Ive said is of use to anyone else on this site than I will be over the moon. I saw a graph on the internet which showed the normal times that the liver excreted its sugar and it happened in the early hours of the morning and then really strongly at breakfast time with pretty much little else during the day, which is maybe I can easy skip breakfast if Im early shift, and eat at lunch having had normal figures. The graph showed the liver putting out its sugar around 2am also but the amount put out depended on the individual being asleep. I am a shift worker and suspect that I am messing my liver about as I am often still awake at this time which would affect this process.
The whole thing seems impossible at times and I have decided that no longer will I strive for perfection!!!!!!!


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## sofaraway (Jan 23, 2009)

emma1972 said:


> The whole thing seems impossible at times and I have decided that no longer will I strive for perfection!!!!!!!



I think thats good striving for perfection will only drive you mad. sometimes things just happen and you end up high or low for know known reason, trying to work out what caused every single reading is too much.
We have diabetes and are manually doing the job of a complex organ and the majority of us are doing a pretty decent job when you think about it.


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## Freddie99 (Jan 23, 2009)

Hi All,

I've just had a look at my spreadsheets that I use to record my blood sugars on. Over this month and I've had twelve hypos. A good month I think.

Tom H


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## mikep1979 (Jan 30, 2009)

at the min i have between 2 and 4 hypos per day (not so good at the mo) but i am having real problems controlling my bg levels and i cant figure it out either.


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## diagonall (Jan 30, 2009)

mikep1979 said:


> at the min i have between 2 and 4 hypos per day (not so good at the mo) but i am having real problems controlling my bg levels and i cant figure it out either.



Mike have a read of this page and read the symptoms towards the end of the page
http://www.iddtinternational.org/gmvsanimalinsulin/index.htm


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## angie watson (Jan 30, 2009)

I have 1 per month on average,I have done dafne but was told 2/3 a week is quite a lot as the more you have the more more your brain gets used to the symptoms and the less warning you get. That is not until BG drops way low. Having said that its not easy is it and 
3 a week is way better than 6 surely. so well done.


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## mikep1979 (Jan 30, 2009)

i have read the page before sue and even asked my consultant and dn today about it as i had to go for my 2 weekly check and they were both in agreement that its nothing to do with the type of insulin i'm on, but more likely due to my poor control for many years and that my body is not used to having insulin to use. we have all agreed to monitor it for the next 3 weeks and if it carry's on the to look at something else.


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## diagonall (Jan 31, 2009)

mikep1979 said:


> i have read the page before sue and even asked my consultant and dn today about it as i had to go for my 2 weekly check and they were both in agreement that its nothing to do with the type of insulin i'm on, but more likely due to my poor control for many years and that my body is not used to having insulin to use. we have all agreed to monitor it for the next 3 weeks and if it carry's on the to look at something else.



The trouble is MIke no consultant will admit that the insulin is at fault. Now if a diabetic using porcine or bovine had the problems you have that insulin would be blamed.
I had exactly the same problem with a particular insulin as you are having a change of insulin solved all problems.
I have a young friend who was moved to lantus and novolog the result was dreadful so they then moved him over to levemir. Now this lad has always been compliant with his diabetes. He ended up with 14 DKA in 11 mths his blood sugars would go from 1.1 to HI in a matter of an hour. Now that meter was not being friendly by saying Hi was it?
He was blamed for the bad control told he was a mental case etc. I told him about the animal insulins.
He had to fight dam hard to get it but he did get it and the difference in him is amazing. He is now in control again and he feels well for the 1st time in years.
You have to remember these so called insulin's are a lot of chemicals and additives mixed in a pot. So theres a very good chance you are reacting to one of the ingredients.


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## mikep1979 (Jan 31, 2009)

thats what i asked my consultant when this all started sue and to give him his due's he arranged for me to have allergy tests to rule out ingredients in my insulin. he has told me the most probable cause is my bad control for years and that once my body gets used to havin control again it should settle down. however he has also said if itsnt better by the next time i go he will look more closely at swapping my insulins round as he has had patients in the past who had reactions to being swapped from synthetic to bovine/pork insulins.


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