Having Hypos in Public

There was a story in the news this week* about a BBC presenter who had to apologise to listeners after having a hypo while on air.

World Service presenter Alex Ritson has type 1 diabetes, and apparently, his introduction to an early morning news programme left him stumbling over words. He later explained what had happened, and said it was appropriate, as the programme would also be running a story on new research into diabetes published in The Lancet.

I’ve often wondered how public figures who have type 1 diabetes cope with hypos. Those of us who aren’t famous only need to worry about treating them—and sometimes that isn’t always easy—but what about if you’re in the middle of presenting a news programme, or fighting with other politicians a la Theresa May?

[Perhaps she can blame low blood sugars for the immense confusion that currently surrounds Brexit. Some people get violent when they are hypo too so she could use that as an excuse to punch Boris.]

When you have experienced hypos over the years, your body adjusts to them, and the symptoms you get are nowhere near as severe as they were the first few times. Nevertheless, confusion and brain fog still occur.

I remember sitting at meetings or trying to explain myself at work and scrabbling around for words that suddenly seemed to vanish. You get a split second where you panic—where are the words, where are the words—before realising what is going on. I reckon that’s what happened to Alex Ritson, and the panic was probably vile because he was on-air and knew millions of people were listening to him.

Alex later said on Twitter that having a hypo on air had been a recurring nightmare for years, but the Twitter community responded really well with people sympathising, and the JDRF tweeted a handy infographic that showed the signs of hypos, a useful guide for family, friends and colleagues of we type 1s.

*While researching this article, I found out that actor James Norton is a type 1, which made me happy. Nothing at all to do with the fact that he’s exceptionally good looking, #T1DLooksLikeMe…

 

 

Hypo or Not?

A “serious and important” hypo.

When do you feel the symptoms of a hypo?

The November/December issue of Balance, Diabetes UK’s magazine, reported that researchers have proposed that we need to take a fresh look at defining low blood glucose levels.

At present, a ‘hypo’ (low blood glucose level) is 3.9mmol and below (70.2mg/dL in the US), which the researchers feel isn’t all that low.

A severe hypo is one where someone needs help from another person to recover, something that rarely happens in clinical trials. Rightly so, as letting someone go so low without help wouldn’t be ethical.

Researchers suggest that there should be three levels of hypo – low, lower and oh f*****g shit. I’m kidding, obviously, but they are looking for the level that, below this point, a person’s health is seriously affected, i.e. where their brain, blood and cardiovascular systems are compromised, the risk of death begins to rise, and the level that has an impact on mental health.

Current research suggests these begin to take effect at about 3.0mmol (54mg/dL in the US). The team’s three definitions are:

  • Level 1: 3.9mmol or less –a hypo alert
  • Level 2: less than 3.0mmol – serious and important hypo
  • Level 3: serious hypo, requiring external assistance, even if none is available.

Like all of us, hypos are individual. One person’s “I’m fine at 3.9” is another’s “oh shit”. I sometimes feel the symptoms of a hypo coming on at 4.6, say. Other times, I’ll prick my fingers, get a 3.9 and wonder where it’s come from.

As you can see from the picture, I had a “serious and important hypo” this morning, thanks to undereating and walking too enthusiastically yesterday. Oof. It happens.

Keeping your blood sugar levels stable without going too low is a huge challenge. One of the reasons we promote low-carb eating for type 1s in particular is that the risk of hypos can be reduced because you don’t need to take as much insulin.

If the researchers could include advice about how to avoid hypos, while also achieving good HbA1c results in the long-term, we will cheer them on…

 

*Some good news! The NHS has approved flash glucose monitoring technology – i.e. systems such as the FreeStyle Libre. I’m off to investigate the possibilities of getting one. Also, big love to the NHS, a wondrous, wondrous institution.