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.