What’s with all the snacks? #HypoAwarenessWeek2020

I’ve only heard the term ‘hypo’ in my professional life, when it referenced high performing talent and succession plans at work.

But there’s another type of hypo that very recently came onto my radar.

Three weeks ago, my life was up-ended, shaken vigorously and I’m not sure all of its contents have quite landed yet. My seven year old daughter, S, was suddenly diagnosed with type 1 (T1) diabetes.

Until then, my knowledge of diabetes was, at best, limited. I thought there was a link to weight, I’d heard of diabetic jam and I thought that it could be reversed if a healthy diet was followed.

Except that I was way, way off. And I’ve spent the last three weeks learning and researching, feeling like I’m preparing for the hardest exam of my life with zero study time.

What is T1 diabetes? It’s an autoimmune disease where the pancreas suddenly decides it can’t produce enough insulin. There’s no reason or cause. It can’t be reversed, and diet has nothing to do with it. Your body needs insulin to control your blood glucose levels, so once diagnosed, you are then responsible for administering insulin yourself. Everyday, for the rest of your life. About 400,000 people in the UK have T1, of which 29,000 are children.

There is a difference between T1 and T2 diabetes. T2 means that either your body doesn’t make enough insulin, or the insulin it does make doesn’t work properly. T2 can be influenced by a range of factors, including weight and age. Following a healthy lifestyle can often reverse the T2 diagnosis..but not always. (Disclaimer - I still don’t know too much about T2 as it’s a different disease so hope you understand why this piece is tailored towards T1.)

Within hours of S being diagnosed, my partner and I had to understand how to count carbohydrates, administer insulin, interpret blood glucose readings and importantly, how to spot and treat a ‘hypo’ - a hypoglycaemic episode.

So here we are, three weeks on. And I couldn’t let #HypoAwarenessWeek2020 pass without, hopefully, nudging up the awareness and understanding of the importance of being hypo-aware. Because this time it’s personal. It’s my wee girl, and one day she’ll be mapping out her own career and I want to try to reduce those moments of “wow, what’s that white plastic circle you have on your arm?” and “why do you always have snacks in your bag?” as much as possible. (That white plastic circle monitors her blood glucose btw, and I’ll get to the snacks.)

So - if your knowledge of diabetes, and indeed hypos, is as limited as mine was just three weeks ago, please take the next min or two to add to your inclusion-related toolbox by understanding what a hypo is, and why you may see someone with T1 dipping into a plentiful supply of snacks:

? Having a hypo means blood glucose drops to below 4mmol/l. That number on the glucose reader being below 4 is important, and dangerous, for someone with T1. T1’s will check their blood glucose levels about 10-15 times per day. It’s pretty straightforward to check and why you might see someone scanning their arm if they have a little monitor or using a little finger pricking device.

? There are typical symptoms, but they present themselves differently from person to person. For S, symptoms can include feeling shaky, hot, fidgety, dizzy or, as a 7 year old so clearly articulates, “just not right.”

? The world then stops as the hypo needs treated there and then. For S, it’s three glucose tablets and we sit and wait for 15 mins. This means she has to stop her PE class, sit in the bus stop on our walk home from school, or let her tea go cold. Everything stops for a hypo.

? After 15 mins, we recheck her blood glucose. If she’s over 4, great. She gets to eat a 10-15g carbohydrate snack. That's about 1.5 digestives or a small carton of apple juice. She still has to take it easy - hypos are tiring, and she might be a bit out of sorts. We do the whole process again if those numbers are still below 4.

? And then we recheck her blood glucose in 1 hour. Sometimes she stays above 4, sometimes she drops quickly below 4 again. And we roll again, back to point 3.

Quite simply, the lower those blood glucose numbers are, the more dangerous it can be for a T1. There’s no real pattern or explanation, and it can happen within minutes. Catching a hypo quickly and treating it promptly is key.

S has at least two hypos a day at the moment. This will, I’m told, settle in time once her body settles into its new way of life. However, for now, it’s a constant state of alertness for all of us, ensuring she’s surrounded by people who know what to look for and what to do when it happens.

There’s a whole lot more to living with T1. I’ll leave insulin, carb counting or care plans for another day. For now, my hope is that when someone you work with mentions they have T1, or are caring for someone with T1, that you are in a more informed position to offer them support..and maybe even a snack! (Just 10-15g of carbs though...check the label!)

So, in #HypoAwarenessWeek2020 and on behalf of S, please look out for our amazing type 1 friends and family. They’ll be happily living a normal life, but that will be because they are doing a hell of a lot behind the scenes to allow that to be the case.

For further reading or to learn more, check https://www.diabetes.org.uk/diabetes-the-basics. Diabetes UK also released this short film this week, showing more of what a hypo might look like. It's geared towards adults with T1, but useful.

Thanks for reading.