What is a hypo?

A hypo is hypoglycaemia. hypo = low, glycaemi* = blood sugar. Stick the two together, and, hey presto!

My body is not much good at regulating my sugar, and when I measure it, it can easily vary 300% during the course of a single day. Ideally, it should be a low value anyhow, and shouldn’t vary much beyond that.

I take insulin to lower my sugar, and it works brilliantly, except if I’m not careful it works too well! I can dip too low. So, I also need to stay high enough – which means I need to eat regularly, to keep my sugar above that lower-limit. Not, like, every 10 minutes, but I can’t afford to skip meals. Insulin is quite powerful stuff, because if I our sugar does go too low, we go kaput. Too much is fatal, too little is fatal. So if I suddenly stop posting one day, that’s why! (unless I was really pissed with someone the day before 🙂).

Over the years I have spotted trends. If you’re diabetic, I really can’t recommend that enough – to measure your sugar, learn how your body responds to different foods. A few times, I have measured myself every hour, all day, just to build a picture of how my body regulates (or not) itself. My lowest points tend to be in mid-afternoon (so I can’t leave lunch too late) or the middle of the night. I’m highest around six o’clock – just before my evening insulin – especially if I eat a larger lunch than I ought. I tend not to get lows very often, because I like my sugar to run at maybe 25% higher than a non-diabetic. I can tweak my insulin to take account of what my sugar is, and what I want it to be, but it’s not an exact science.

Foods which I consider good (i.e. they don’t much raise my sugar) are things like nuts and cheese. I enjoy tofu and stir-fried vegetables, this is also good. Foods which are bad are things like bread (white bread in particular), pasta and potatoes. Basically, carbohydrates. Ironically, chocolate or candy don’t make much of a difference – I guess that’s because (a) I’m very aware of eating them, and (b) when I do eat them (and who can resist a bit of chocolate now and again?), it is just a few grams, so it doesn’t make a big difference. Crisps (chips) although generally not sugary, are potato and therefore quite bad. In case you’re wondering, corn chips tend to be just as bad as potato – I’m not too sure why this is. But there is this impression, fuelled by the media, that links sugary food to diabetes, and that’s way too simple a model, although there is a passing resemblance.

So, a hypo. Despite not having them often (at least that’s the plan!) there have been two times recently, and several in the past, where I thought I could feel a hypo coming on. You can feel them coming on – you recognise the feeling, it’s like the rumble of distant thunder. If you’re asleep, you can wake for no apparent reason, and then you feel the rumble. In fact, two distinct feelings inter-mingle.

First, there is that feeling of exhaustion. That you just want to drop, to rest. Yep, even if you just woke up. You have to fight this feeling like crazy, because if you give in to it and don’t take any action, you’ll just continue to go lower.

Second, you feel ravenous. As in, eat everything in the house ravenous. It really is an effort not to eat everything in the house! And, bear in mind that when you do eat something, there is a lead-time before it gets absorbed into your body. For that lead-time (which varies depending on the food you eat, but most people on insulin will keep jelly babies – a fast hit – to hand) your sugar is still low, so you have to train yourself to eat, then to stop eating.

When you mix these two effects, it gets interesting. Imagine being really hungry, but being too tired to eat. I know, it’s perverse, but that is what happens. Do you know sometimes when you eat a meal which involves lots of chewing, and you sometimes just need to stop chomping and give your jawbone a break? Again, it is mind over matter. You tell yourself that you have to eat something before you crash out.

One other effect of a hypo is loss of co-ordination. The food you eat needs to be ready-prepared, or at least quick to prepare. You don’t want to bake a soufflé here! You can’t be doing intricate things with your hands, and sometimes even walking is difficult. The closest I can think of, ironically, is drunkenness, where that straight line is oh so elusive.

Hypos are not limited to insulin. With any med that actively lower your sugar, you run the risk. It gets complicated because not all diabetes meds are aimed at lowering sugar – some are aimed at promoting your body’s natural sugar-combatting abilities. If you don’t combat sugar much anyway, these meds are pretty ineffective, but they won’t cause a hypo.

And, it is possible to have phantom hypos. All the feelings are there, but you measure your sugar, and there is no need to worry – it’s not gonna be fatal. I suppose your body gets used to a certain sugar level, and if it dips below that, these feelings start to kick in. Withdrawal.

In fact, the medical advice is, as soon as you feel a hypo coming on, to measure yourself and check. With respect, bullshit. That’s fine for the text books, but when you feel one coming on, you have one urge, to eat. You can worry about the numbers later.

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All of this is a very long-winded attempt to explain why I was eating jelly beans at four o’clock the other morning 🙂.