I also had a “fell off a cliff” hypo last week, and though I might blame stress somewhat for that, then I’m not convinced that is the entire explanation for that one. Sure, I have had a very busy schedule the past month, typically working 9-12 h in the lab every day + a bit at the computer at home, and then last week actually had the possibility to leave early to do some work at home. Still, to drop from a save 10.0 mmol/l to 1.8 mmol/l in just about 1 h seems a bit drastic to me! Also, it was almost 3 h after lunch (usually I see the largest effect on my BG around 1-1½ h after a bolus) and my basal rates at that time of day are the lowest of them all. I left the lab around 14:30 to walk the 4 km to the flat, but only got about 2.5 km before I tripped and fell. I tried to get up and every time lost my balance landing me against a light post several times – severely damaging my laptop, I later found out – and finally sitting in a puddle of water (of course it had started raining again!) with my legs kicking to a degree that the helpful passers-by first thought I was suffering from an epileptic seizure! I can remember trying to communicate with them, oh so intelligible, to let me go once they’d gotten me back up on my feet, but luckily they didn’t. I spent the next 30-40 min (I actually don’t really have any feeling about how long it took) with an EMT, shovelling in glucose tabs – an entire packet of Dextrosol tabs – bread, fruit, chocolate, you name it, only seeing the BG increase ever so slightly.

I hate those “out-of-the-blue” hypos, especially when they are that severe. I’ve had numerous of those in the past, but like you, since going on the pump, they have been far between. I also have CGMS, but to add insult to injury, the sensor didn’t bother to send off a low alarm until I had already spent quite some time in the company of the EMT. I hadn’t checked the trends during my walk before I tripped, because it usually isn’t necessary, and I had easily been able to feel my hypos at just below 4.0 for weeks up until. Maybe that was my mistake, but still a drop of more than 8 mmol/l in such a short time should not happen without me having an idea of the fact that the BG was moving!

Anyway, glad that your husband was able to help you, and you are back to your normal self again

@ Alan – I love your unwritten check list and I have to confess I have my own mental version that normally comes up with something – stress, hormones, drugs, food, alcohol, exercise, stupidity, full moon etc but this time I’ve drawn a blank. I must study the alignment of the stars and see if that generates any pearls of wisdom

I generally find that HCPs go through an unwritten guide to HCPs checklist in these circumstances: “Probably the exercise at….”, “Were you stressed that day?”, “Ahhh – not all carbs are absorbed at the same rate y’know”, “Could have been the fact that you were driving on an unfamiliar/busy road”….. and other variants!

Bad night time lows are horrible though aren’t they? I was hoping that with a pump and CGMS they would become a distant memory. I am currently using a Medtronics 522 and have tried out CGMS – looking at self-funding in the likely event that my PCT will reject my request for funding. (but rather scared of the expense!).

Alan

I really hate extreme highs or lows which don’t seem to have any proper explanation – it’s that randomness which is really worrying.