Today, I am at the Diabetes Victoria and Baker IDI Health Professional Symposium and the first session has me thinking – and sitting down the back of the auditorium banging out this post.
The keynote presenter for the Symposium is Professor Herzel Gerstein talking about hypoglycaemia. He made a wonderful point in the Q and A portion of his presentation, one that I think is frequently overlooked.
The language (yes, I’m talking language AGAIN) we use around hypoglycaemia is misleading at times. Generally, we have severe hypoglycaemia and mild hypoglycaemia.
Severe hypos refer to those we need assistance to treat. It may inolve unconsciousness or seizures. Severe hypos sometimes need paramedics’ assistance, or a trip to the hospital.
Mild hypos are those that we can manage ourselves without too much hassle.
The problem with using these two terms is that it makes it sounds as though mild hypos are nothing. They’re just a part of living with diabetes, deal with it, off you go.
That may be the case in practical terms. A so-called mild hypo may mean grabbing a handful of jelly beans, waiting a few minutes and then off you go. Or it might be slightly more than that and take longer. But whatever it is, it’s termed ‘mild’ because no assistance was required.
But the thing with ‘mild hypos’ is that they do have the potential to weed their way into your psyche and suddenly become very significant.
If those mild hypos mean that you are often running late for things, you start to wonder if others are questioning your reliability. If those mild hypos have you needing to sit things out for a moment, you worry your friends or your kids or your family think you are disengaged, not wanting to participate. If those mild hypos result in you being a little vague for a while in work meetings, you start to fear your boss or colleagues think that you are not paying attention, not interested, don’t understand.
These are not ‘mild’ things. These are really significant and mean worrying and stress and anxiety and anger and sadness and fear and guilt and all the other things that diabetes makes you feel. There is nothing mild about it!
I think this is a really important issue for healthcare professionals to remember. By brushing away mild hypos as just a short-term-complication-everyone-has-them notion, the actual impact on the person living with diabetes is ignored. it’s minimising just how big a deal mild hypos can be and not providing any strategies for coping and managing with the emotional side of these episodes.
A mild hypo may not necessarily be terrifying in the moment, it may be quite manageable at the time, it may not affect anyone else or draw too much, if any, attention to the person having the hypo. And this is good!
But don’t for a minute think that it doesn’t mean a silent feeling of dread (and possibly a silent word of thanks to the hypo gods that it was nothing more!) or feelings of significant distress afterwards.
7 comments
Comments feed for this article
May 22, 2015 at 1:35 pm
Jeann
Great post Renza! I experience quite a few ‘mild’ hypos and they drive me nuts as I try to hide them from family and friends so that they don’t worry. And I become frustrated when I can’t work out why they occur. And yes, I do become disorientated and lose the thread of what I have been doing.
I am looking forward to the Expo tomorrow…even if I do have to leave on the 7.54am train!!!!
LikeLiked by 1 person
May 22, 2015 at 7:58 pm
bluesingingdragon
What a great post – thanks for sharing. I was reading (again!) about the requirements for a funded insulin pump here in the UK and I need to be experiencing “severe” hypos, which I don’t very often because I work hard to avoid them. I do, however, experience “mild” ones relatively regularly and find them as hard to recover from as the more “severe” ones. I’m glad someone is finally recognising the impact of them x
LikeLike
May 22, 2015 at 9:56 pm
Bec Humphreyscongratulations
I was treating a hypo at work last week ( as you know I am a diabetes educator) and a dietitian who was waking by said to me ‘you should know better than that!’ …. You can imagine my response! That is all 😏😞
LikeLike
May 23, 2015 at 6:19 am
Jeff
Totally agree Renza, and “mild” is so inappropriate as a label for these experiences. It would be good to find a better term that reflects the mood and energy change many “mild” hypos leave, which is often quite long lasting and has a significant effect on our behaviour, be it concentration level in a meeting or unenthusiastic response to a friend’s question. It’s important HCPs understand this, but even more that friends, family and especially workmates, because they’re the people we’re with most of the time and are most affected. They’re also the people we get most support, understanding and reassurance from, in my view. Thanks.
LikeLike
May 23, 2015 at 11:21 am
Lucia Maya
Yes, very true! I’m low as I was reading this, and still a bit low as I write… This one is a long, stretched-out low that’s taking a while to come up from. While I think/hope my brain is working well enough, I really didn’t want to eat as much as I just did, and just before dinner too!
“Mild” lows affect us in many ways that are not always obvious, and are almost always a nuisance. Thanks for this post!
LikeLike
May 23, 2015 at 10:02 pm
Sue
Great post Renza! I can’t remember anyone, EVER before acknowledging the social and workplace impact of the not-understanding people around us, and the ignorant judgements they make, and how that impacts us.
LikeLike
May 25, 2015 at 12:09 am
stareetika
Such a beautiful article. Speaks my heart out. Mild hypos require just as much attention. Unattended hypos are so dangerous. Initially I used to be shy about treating it in a public place in the middle of something happening etc. But I realised (from an experience) it’s always good to stop whatever I am doing and just have glucose! Health before anything else:)
LikeLike