Hypoglycemia without symptoms

DiabetesForo's profile photo   12/05/2010 3:43 p.m.

Hi how are things?
I have been diabetic for many years and lately when I notice the symptoms of hypoglycemia I am 20 or less and I can barely react.The truth is that I am afraid and I am looking at glycemia every two by 3. Sometimes I have 1h hypoglycemia after eating and the truth worries me a lot.I am very sensitive to insulin and since they invented the fast insulin analogs my hypoglycemia are severe.Sometimes the effect of fast insulin lasts 4h and sometimes even more and sometimes to compensate for a hypo I have to eat a lot.
Does anyone know if there are feathers of half units and if the continuous sensor of glycemia could be a solution for me?

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DiabetesForo
12/05/2010 3:43 p.m.
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Well, I agree on many of the things you say: this month is going to do 13 years that DM1 was diagnosed, all these years I have been with insulin (insulatard nph + actrapid) and not analogues of insulin (among other things because analogues existrelatively little time).

I have changed the treatment and now use insulin analogues (Lantus + Apidra), I have been with the new treatment for about six weeks and I see good things and not so good things:


  • PLEASE:

  • More physiological in terms of meals (bowling) since they can move a bit without generating problems in the rest of the glycemia of the day, which is well, it is an improvement in what is called "quality of lifeof the patient ".

  • I have been with the new treatment for so little time, I have not put it into practice, I try to maintain the greatest number of constant things between them the hours of breakfast/food/dinner, more than anything to avoid problems but by power it can be done.
  • Against:

  • As for the basal I think it is less physiological for several reasons:

    1) The insulin that covers the basal (in my case the Lantus) does not work the same during all the hours that lasts, the graphs with curves are very beautiful but it has its peak in the first 6-8 hours (risk of hypoglycemia) and inThe latter only lets themselves "fall" even sometimes does not arrive (risk of hyperglycemia).

    2nd) To me the lantus makes me many strangers especially in the end, the same one day lasts 24 hours as another day does not arrive and leaves me sold at 10-23 hours, if it always happened at least you could try to apply any strategyBut it does it randomly.

    3rd) Insulin needs to meet the basal are not equal during all hours of the day and in some cases they are considerable differences, you do not have to be a child or a teenager or a pregnant woman to have a dawn/phenomenon of the very marked dawn, I do not belong to any of those groups and I have problems to stop it.


  • People who use Levemir with 2 punctures per day are more physiological in terms of basal, to differentiate the needs of nightly insulin with one of the punctures and to differentiate the needs of diurnal basal insulin with the other puncture, butWith Lantus that is not possible and using lantus in guidelines of 2 punctures per day is to lose the grace of the Lantus (last? 24? Hours?) And is it eating hypoglycemia at all hours.

    4º) Use an insulin that covers the basal and only the basal I am seeing that it is a very prone treatment to deviations, but deviations both up (being a little high) and down (hypoglycemia even if they are slight).


  • Many things that influence diabetes, too many, many of those things can not avoid, our emotional state, a situation of stress, our state of health (a small cold, a little fever, ...) evenSleep a little (not that I am someone who sleeps always but I have seen that the few times I have done it I got up without come to mind).
    It is also a groceries when you have a hypoglycemia even if it is mild, having to measure the millimeter what you take to get out of that situation to be able to get to the next meal is a fear movie, the minimum you are in values ​​too high and of course too high... how is an insulin that covers the basal and only the basal or waiting for the next meal and fix it with the quick of that food or you put an extra injection with a very low dose ... often business.
  • I have eaten more hypoglycemia in these last weeks than in the thirteen years I have been with diabetes and it is no exaggeration, in fact the issue is so serious than right now after these last two weeks eating me hypoglycemia day yes and day too (whenThey were not two per day) that right now I did not find out about hypoglycemia, whenEntero is too late and it is the body that has taken me to beast (I find out that I have had a last bull, in a later control, after having eaten the hypoglycemia plus the rebound).

    In this forum I see that there is a current in favor of the brutal insulin anologists, I have not yet seen the business to the lantus issue, I see it difficult to achieve better hemoglobins now with analogues than with the previous treatment of "mixtures."

    In this forum I see many people take pests on the mixtures that were used before and that are still used today in some cases (under 6 years, pregnant women, ...) I only have to say that I am totally againstof the mixtures _comerciales_ but only against the _comerciales_, the mixtures in insulating nPH syringe and actrapid (for saying what I used before) also work and it is equally easy to find the doses as with the analogues.

    People should disappoint and see that in certain cases (children, adolescents, pregnant women) the level of hormones in these groups makes the treatment that is put, the same, the type of insulins that are put on, control the diabetes in thoseCases is very difficult and it is not the fault of "mixtures."

    In the end ... that maybe all this is the fault that I have been with the analogues for very little time, I look forward to seeing the business to this treatment PQ what is today the conclusion that I arrive is that not even the previous treatment wasSo bad or the current treatment with analogues is so good, both have their things in favor and their things against.

    (Sorry for the roll).

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    DiabetesForo
    12/05/2010 6:38 p.m.
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    For all that you tell is what I have more and clearer than the best treatment is insulin pump.I was diagnosed 10 years ago, I used the NPH very little months and a mixed one, it did not go wrong but I immediately marketed Lantus and it was very well combined with Humalog, but I certainly stay with the bomb.Now I can customize the treatment and adapt the basal to real requirements due to schedule, flexibility is total.
    Yaiza have you raised the use of pump?I think it could be a good solution.

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    DiabetesForo
    12/06/2010 6:16 a.m.
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    The fate is that we have an arsenal of insulins within our reach to achieve the best possible control ... one guy and others are doing well.

    The closest thing to the physiological, today, is the bomb ... and if it is combined with the continuous meter, better than better.
    Outside that, it seems to me that the combination of the ultrarapida+combination is the most effective.

    Levemir is much more stable than lantus, it has much less peak of action and therefore less hypoglycemic potential ... it has the advantage that when you increase in dose you also increase its duration and you can unfold the dose in 2 punctures (yes, a roll is a rollprick more) in case of very differentiated needs according to the schedule sections.

    As in all insulins, it costs a while to take the calm and force, at the beginning, to be very exhaustive to control everything that is done.

    If with Bolus+Basal treatment there are hypoglycemia, the causes within a trend mustWe must look what we do because something fails.

    In any case, what rules is glycosylated hemoglobin and glycemic variability (not having large glycemia peaks)

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    DiabetesForo
    12/06/2010 7:09 a.m.
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    Good night, Yaiza

    Ask your endocrine: I think once (but years ago) I heard that there was some units.If there is not, you will have to talk to your doctor and ask him to return to the syringes, or think about adjusting the pattern much more.What guideline are you still and what time do you inject insulin?Maybe that would help us.As for not noticing the hypos, it is clearly due to excess ... it would be solved by keeping the highest figures, but of course, that precisely the problem.Let's see if we can help you.

    TNT, as for what you say ... I went well with both methods but I was very little with the mixtures, the truth.In any case, think that those who defend here the analogues is not to defend absurdly, it is because we obtained results, and obviously we have to say if they ask us.That it seems that we do it because yes, without ton or are, and in blood and in Nazi plan ... as Owash says, each one is better.That he hears, also from the bombs all wonders say, and I have come to eat 6 hypos on a day of the first days of a bomb.I came to sleep with the sugarman and a bottle of water on the bedside table.And the pump is also supposed to be the best in the world and that it reduces hypoglycemia ... but of course, only if it is adjusted.

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    móntrial
    12/06/2010 7:26 p.m.
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    Thanks for answering.I have heard wonders of the bomb and I used it for 2 years and I had tb hypos and as I had a low basal sometimes I did not enter the insulin and put me at 500 mg, also without a glycated bomb of 7.2 and with a bombOf 7 and I had a nocturnal hypo with loss of conscience I think it does not solve me too much.I think that the solution for me is the continuous sensor of glycemia I have tried 7 days but it is very much and goes 10 min later than the blood.Does anyone know if you can get a better price?

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    yaiza
    12/07/2010 4:36 a.m.
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    Yaiza How much basal did you have scheduled when the basal did not enter?Because I also have a very short basal 0.3 most of the day and it never happened to me so far ...

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    DiabetesForo
    12/07/2010 4:58 a.m.
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    Yaiza, I also have been in many years and indeed, hypos with the most modern insulins can be much more severe, because they are simply more powerful.

    I also had many hypos problems as soon as I eat, until I realized that my gastric emptywithout the stomach having prosecuted it.Solution?delay the puncture.I never shed before eating for years now.Always then.Sometimes I look at half an hour or an hour and continue with the same value of the pre;70 ... 90 ... So I have to wait even more to click.Other times the thing goes up quickly and for when I punctuate, I already have two hundred and peak.But at least I avoid the hypos as soon as I eat, always very delicate and in which it is very bad to overcome.

    Me, like you, I have been losing the typical sensations of a hiccup.It is something natural over the years in diabetics.And obviously, it is one of the risks that is increasing according to evolving with our diabetes.Now the symptoms are much more subtle, but probably, if you are attentive, you recognize them.I always just recognized it.And the truth, following the thread of the negative points that you comment above with respect to the new insulins, that is at the same time - sometimes - also a negative point.And I mean its short duration.Well, once we have spent that short period of effect, any type of hypoglycemia will be at the time of little insulin efficiency, and being almost only with basal, we will never have severe problems in a hypo.

    But if it is still very complicated to recognize the dowers, it is when the use of the insulin pump is prescribed.You may be one of the candidates for her.Tell him with your endo, as I tell you, inadvertent hypos are one of the criteria that are handled to pump.

    HanSolo's profile photo
    HanSolo
    12/20/2010 7:23 a.m.

    ISCI / debut: 1986 / HbA1c: 5,5%

      

    I link a very interesting article on the subject of hypos:

    It is a very technical article. So I recommend reading.

    DiabetesForo's profile photo
    DiabetesForo
    12/20/2010 12:48 p.m.
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    I just read the document and there is one thing that surprises me and scares me a little: "The HBA1C was lower in diabetics with HS (6.76 ± 0.16) compared to 7.67 ± 0.15%;But that hypoglycemia can cause long -term complications that did not know.He believed that the problem of hypoglycemia was to lose knowledge and that in children they are dangerous due to the development of neurons, but in an adult patient I did not know.Do you know how hypoglycemia affects in the long term?
    And another doubt, assuming an extreme case, how long can you spend if knowledge is lost by hypoglycemia?The case that already raises on another subject, you live alone and at night it gives you a low and up to x hours nobody realizes that you have not gone to Tabajo or whatever, what can happen?How long can it happen?Would glucagon be segregated and the hypoglycemia would go back?
    These questions are still a bit tremendous, but lately I am quite worried with the diabetes theme, I have been diabetic for so many years ... and I still have 26 to start thinking ... and I alone start to wave ...

    tica's profile photo
    tica
    12/21/2010 9:05 a.m.

    Miembro del equipo de moderación del foro
    DM1 desde 1988
    Mamá de 2 niños y a la espera del tercero
    Bomba + Dexcom

      

    T ica, I have either read or heard that ever. It is always said that the risk of complications is reduced by reducing glucosilada, with the disadvantage that they can increase hypos with their well -known acute risks.
    Yes I have heard that when a retinipoty is already installed, suddenly improving control and having hypoglycemia, they can damage the vessels more, even that hypoglycemia can produce infarctions or strokes, but all due to acute problems, without increasing the risk of micro or macropathies.
    I hope you have understood it well and that it is an errata of the article, because if you would not have to change many things ...

    Regina's profile photo
    Regina
    12/21/2010 10:16 a.m.

    Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
    Fiasp: 4- 4- 3 Toujeo: 20

      

    The dangerous diabetes are 2 things:
    - Hyperglycemia.We all know this too well why it is dangerous.
    - Glycemic variability.Having peaks (high and low and very repeated) very pronounced glycemia helps the appearance of complications (Ictus have been described for this reason, as Regina points out) ... It is like stretching and compressing the gum often, in the endBreak ...

    To which you ask tica ...
    There is no fixed time ... but the body does not respond only ... yes you can segregate glucagon but if the hiccLittle glucose that has to operate vital organs (brain mainly).
    This, unless you do the barbarity of clicking a lot of insulin and not eating any hydrates (or that you grab a tremendous drunkenness), it does not usually happen ... Night hypos usually detect most of the people.

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    DiabetesForo
    12/22/2010 1:38 p.m.
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    Hello everyone, I am also a diabetics for more than 30 years
    Regarding the feathers of half units I have to say that of course they exist, I use it when the glucometer tells me
    They are called Novo Pen echo and it is from Novo Nordisk but the endocrine has to be prescribed because it is cataloged as foreign medicine and the hospital pharmacy is supplied to you.It is recharged with insulin cartridges that also supplies you the hospital itself you belong
    all the best

    DiabetesForo's profile photo
    DiabetesForo
    12/27/2013 3:49 p.m.
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