Im having difficulty identifying the traits of an actual hypo. I have shown my endo the graph trend on my android phone app OnTrack. It has shown i have had quite a few 3's (54) and he noticed these and said 'looks like you have had a few hypos'. The lowest i have seen on my meter atleast is 2.7 (48). I only ever get this way during physical activity, mainly swimming. But what i FEEL is just a lack of technique, loss of power, a little shaky, loss of energy. Maybe slightly 'doughy'. Nothing which says im going to pass out, freak out, etc. To me this tells me im low, but is it a 'hypo'. How does one define 'low' from hypo? Just curious how people define their hypo from low?

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You might try having the gel a bit earlier? I find that the maltodextrose gels take longer and last longer than "simple" sugar? I saw a race report from MeganJ, one of the Team Wild Runners that shared her coach's feedback (an interesting thing...) that mentioned this too.

Here's a link to her page, I like her race reports. She does tris too and might be a good source? http://www.tudiabetes.org/profile/MeganJ

@Acidrock: I suspect you have quite a bunch of residual beta cells. They help you to keep your blood glucose more balanced. Furthermore they will reduce their insulin production at lower numbers. This ability helps you to sail at 70 without problems. I might be wrong with that. It is just a gut feeling I have.

After 27 years? I guess they've found them in 50 year people too but I suspect the amounts are very trace. The times I lost basal due to pullouts and pump failure last summer, my bg shot up pretty quickly?

A "3" (3.0 mmol/L = 54 mg/dL) or a "3" (3.9 mmoL/L = 70 mg/dL) ?

I don't feel that 3.9 (70) is a hypo, just low normal.

I do feel that 3.0 (54) is a hypo.

Some people make the leap of low is the same as hypo is the same as severe hypo. But more realistically the DCCT does a pretty good job distinguishing "just a T1 trying to have normal bg's hypo" from a "severe hypo":

Severe hypoglycemia was defined by the DCCT Research Group as loss of consciousness, coma, or an unresponsive state relieved
by the ingestion of sugar (1).

I take a hydroaerobics class and we have an above ground pool in our backyard for the kids. I love my omnipod because it handles the water so well. For me, lows while I am in the pool are hard to feel. And, water activities burn through my sugar fast. I don't know why lows sneak up on me in the pool - maybe hard for me to tell my body temp (when I get low I get hot or really cold) or maybe I am just distracted. But, when swimming, in class, or at the water park I really have to consciously remember to get out and test. Which is a pain because your fingers are all wrinkly and the blood runs down the wrinkles of your skin instead of into the meter. And then, I make sure to disinfect the test site with antibac wipes when at a public pool. As a mom, I can't help myself, I have to say: please be careful when you're swimming. And eat your veggies and wear your bike helmet, I know... I know...but really please be careful. :)

Good stuff from everyone on what defines a hypo vs. a low. I personally don't make any delineation -- they are the same to me, though they can be more or less severe, of course. I've told people, when asked, what it feels like to go low (no matter the actual number) with this little metaphorical story:

I feel like I am standing in rising water... As the water rises up to my neck (as I go from say, 80 to 60) I am fully aware of what is happening, and I can say to myself, "Gee, the water is rising. Maybe I should do something about that..." That's a no-brainer, and what I often do to get the water level back down (i.e., get my sugars back up). If I wait, and the water rises to my chin (heading towards 50 now), I am both more nervous and skittish and know I must do something soon or the water will rise over me and I can drown. Shortly after this, if I do nothing the water will rise to my nose, and I am now at my shakiest, but still kinda know what is going on. And then the water rises above me -- as I get into the danger zone of the lower 50s and 40s -- impeding my ability to 'breathe', that is, do something about the low/hypo because confusion sets in. If I head into the 30s, my head is fully under water and I am all wet (metaphorically as well as realistically -- I used to tend to sweat a lot when going very low -- though less so these days). I don't know what is going on anymore, and often require some assistance to get out of the water, that is, get out of the low 30s and 20s. I'm drowning now, and I don't know why...

The story paints the picture in terms the non-diabetic can surely 'get'. Alls I knows is it sucks to go that low.

/\/\

Over the last week or so I've been exercising for the first time since my dx and have experienced two lows in exercising - both of which I could feel. These were at BG readings of 60 and 64 and it seems like my hypo symptoms really ramp up at that range (shaky, nervous, cold sweats) but not much so before that BG range.

I also felt that way just walking around in some pretty hot/humid conditions, which I've heard can lower BG pretty significantly.

When I was low when exercising (hiking) I ate a couple of Clif Blocks, waited 15 minutes and tested again before starting up. When I was just walking around in hot weather, I used my tablets to correct for the first time (16g got me from 60 to 155 in about 20 minutes - I kept walking around until we sat down for lunch about 30-45 minutes later, at which point I was back down to 79).

I've been able to catch downward trends while exercising before actually hitting a low (dropping to 90 from 135 an hour into an activity, for example, with more activity to come) and have popped a Clif Block to keep things closer to 100 and have just kept moving.

The Blocks seem to give me a more gradual, steady rise in BG, while the tabs clearly act much, much faster - good to know for those times when I need a fast correction.

It seems, for now, that 60-ish is my magic number for feeling anything but if I get a reading from 70-80 I may have a small dose of carbs to keep from dipping much further. My CDE already decreased my basal after our first meeting since it seemed a bit much based off my logs, and everything I've recorded since then indicates I'm prone to drifting a bit low and most likely honeymooning. I'll have a cup of tea or decaf coffee with about a 1/4 cup milk (3g cho) and that generally helps keep me in the 80-90/90-100 range if my #'s were threatening to get lower.

Hope that's helpful experience - I'm trying to figure this out, as well and have been wondering about my hypo symptoms, too: are they normal at that range, does feeling hypo at 60 indicate good or bad awareness, etc? I'm realizing more and more that the best mantra for me now (and perhaps the rest of my life) is test, test, test.

That's all good info there. I use Clif Shot Bloks and Gu Chomps interchangeably on my rides as they seem to react in me around the same as they do in you.

To answer your question, though -- I think feeling things at 60 mgdL is great. Not that it feels great (of course not), but that's the range right where you want to have awareness that you are going down and need to react to the low. Right now I've got my Dex CGM set at 80 so that I can get out in front of even feeling the lows.

Good luck.

/\/\

Thanks for the detailed report! I would say feeling hypo "at" 60 is pretty decent awareness. I will notice a drop off in "performance" (sic? LOL...) in the 70s on my meter (when I pull over to test...) as it seems to become harder/ more work to maintain the same pace? It seems pretty reliable but, at the same time, I'm not a huge fan of running to where I'm out of gas as it takes a mile or two before the sugar will hit and sort of dampens the fun? I'm not a huge fan of the cliff shots/ blocks/ etc. as I think the maltodextrin hits more slowly. That being said, I had one about 1/2 hour before a 1/2 marathon once and felt really strong. I also had one during my nightmarish Chicago Marathon last year and, while it didn't fix the cramps, it made me feel better for 30 seconds?

I found an interesting article about pre-race fueling while trying to see if it might help cramp-proof me to lay off milk, that also goes into quite a bit of interesting detail about eating and balancing and fueling for longer races, which is probably sort of like hiking, with less bears?

http://www.marathonguide.com/training/articles/MandBFuelOnFat.cfm

The article on fueling is really interesting - mightbtake a couple of readings for me to fully appreciate it, but there's a lot of good info in there.

Since we are talking about lows, I wanted to throw this question out there:

If you're sitting down to a meal, test your BG, andcrealize you're low (60-65) - what do you do?

I had this happen today at a buffet - sat down to order drinks and I was at 65 - I thought about treating, then testing, then bolusing, then eating but decided to try something else: I grabbed a plate of food with some rice and bread that I felt comfortable bolusing for and started to eat - mainly the carbs - before taking any insulin to give the carbs a head start. About five minutes after eating some rice I took a bolus for the entire meal which I calculated off the total carbs and my BG reading of 65. Basically, instead of the 3 units I'd take for the meal if I were at my target BG, I took 2 units and took them five minutes into the meal instead of 15-20 ahead.

So far it seems to be working - I'm still within two hours of the meal and will be testing shortly.

The only issue was that the rice/carbs took a longer to raise my BG than a tablet would so I still felt a bit hypo even after finishing off all the carbs I had taken.

What do you guys find as a useful strategy in similar situations - would you treat the low first with tablets, etc. and then eat or try to use the meal and bolus dosage/timing to make it work?

Apologies for the tangent - I figured it was somewhat relevant considering the hypo topic.

I think that was a good strategy, though interruptive. In the past when I'm in that situation, I just bolus less before the meal, then jump on the eating thing (right away). I might give your way a go, just to see how I do with it. Good job figuring this out for yourself.

/\/\

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