Rosie Walker (Health Care Professional)

Hypos can be a very emotional aspect of diabetes. An occasional one might be tolerable; you might accept a few if you know that it means you are keeping your blood glucose in your target range. However, having a lot of hypos can be draining, both emotionally and physically, particularly if their pattern doesn’t make sense, nothing you do seems to work or they are getting in the way of your daily life or disrupting your sleep. Having a conversation with your health care professional (HCP) about hypos is (or should be) a usual part of your routine consultation, but you might want to put hypos centre stage and discuss what you can do to avoid them or deal with them better.

Here are some ideas on how to explain your thoughts and feelings about how hypos are affecting you and how to overcome difficulties with them1:

  • Have a think in advance of the conversation, what you would like to achieve from it – maybe information and ideas? maybe some tests? maybe a different medication or regimen? Or simply for your HCP to understand and acknowledge the effect of hypos and the efforts you’re making? Whatever it is, make a mental or physical note so you can bring it to mind easily when you get there. Or if you’re in touch with your doctor by email or phone, let them know you’d like to discuss it. You may want to take a copy of this article to start the conversation off, if you think that would be helpful. All of these preparations will help you keep calm during the discussion, especially if your current hypo experiences are upsetting you a lot.
  • Be prepared to accept and consider any comments your HCP might make as explanations or suggestions for your hypos, as well as to put forward your own points and ideas. They may have learned from the experiences of other people they’ve seen, that have worked well and wish to pass this on. Or they may know about some new research into hypos that they’ve done or learnt about at a conference.
  • Assertively challenge any attempt by the HCP to dismiss your concerns or ‘normalise’ your hypos as simply a part of having diabetes. Hypos are not inevitable and they can be managed, and you may need support to make this happen. An HCP who dismisses your worries, fears or actions may be one you wish to change and this is possible if you are not being listened to. If you believe the HCP isn’t well enough informed, and you are really struggling with hypos, you can ask for a referral to another HCP or even a specialist in hypoglycaemia to help you.2
  • Be clear about what is going to happen after the consultation. If you’ve made a plan to change your eating, medication, exercise or testing or your management of hypos, how long is the plan to last for and how will you let them know the outcome? If your doctor has agreed to take an action, how will you know when they have done it? Having realistic expectations of the next steps, especially if you want hypos to be less of a burden, is important3. If the action plan isn’t clear, be brave and ask for more detail and to have your questions answered. After all, you are the one who is going to be doing all the hard work and be left with the consequences!