Can't tell when I'm low

I have had type 1 diabetes for over a year now and I used to always sense when I was low or when my blood sugar was dropping…every time without fail.



I went to the endo a couple of weeks ago and my basal insulin was increased just a tad, which has brought on some lows. The weird thing is the lows that I have had since then I couldn’t even tell that I was low! For example yesterday I was swimming (I disconnected my pump so I had no insulin for a couple hours) and my blood sugar shot down to 39! I have no idea why I didn’t have any symptoms! Is there any reason why people suddenly can’t “feel” hypos anymore?

Have no idea why but about 6 years in I lost my signs that I was going low. All of a sudden one day driving home from a Dr. appointment I blacked out and rolled my car. First time I went low with no warning. Ever since I have had a hard time recognizing a low. Sometimes there’s nothing, sometimes it’s very subtle, like a headache or not able to concentrate or irritable. The problem is it’s constantly something new so just about the time I figure it out, it changes to something else!
I’ve been into the 20’s and quite often into the 30’s and will argue with my husband that I’m fine. Luckily he knows before I do and will make me check and get me juice. The secret is test, test, test, test! Also a glucagen kit in case of an emergency. I’ve just gotten approval for a CGM and hopefully that will help. It’s very dangerous while sleeping.
I’ve been told that consistent lows will bring this on and raising your average BS - eliminating lows, will bring them back.
I’ve had this problem for 30 years but also had excellent A1c’s so I guess there’s a trade off.
Good luck! Just make sure you check a lot!

They call it hypoglycemia unawareness.

John Walsh’s book Using Insuiln talks in detail about it.in Chapter 21. I am sure it is probably discussed in Pumping Insuiln, but I don’t pump, so I don’t have that book yet. You really should read that book, if you haven’t.

He says it occurs in approx 17 percent of type 1’s. The lower a person’s average bg, the higer risk for hypo unawareness.
It may be triggered by the following:
Frequent low bg’s (typically the cause), rabid drop in bg, having diabetes for many years, stress or depression, alcohol consumption in the last 12 hours, low bg in the last 24 to 48 hours, and use of certain beta blockers.

This book says that preventing all lows for 2 weeks increased symptoms, and preventing them for 3 months will result in a return to nearly normal symptoms.

Thanks Barb! I was thinking about CGM the other day because I know they really help with the lows. I’m just really reluctant about having another device on me. But if this keeps happening then I think that would be the best idea.

Also, Jade, your insurance may cover it if you hypo unawareness. You should check into it. I pay for my CGM completely out of pocket, b/c I had too many lows at night, but the insurance co wouldn’t cover it b/c I don’t have hypo unawareness. I know I am blessed to be able to afford it,but it is totally worth it for me.

Interesting! I haven’t read that book which is probably bad since I’m a pumper! I should get on that!

Being low frequently is the usual cause. You may have lows overnight that you’re missing, if you test a lot during the day. Our bodies get used to lows & to highs.

I have lows that I feel & lows that I don’t notice. I’ve had lows that weren’t terribly low where I felt awful & bad lows when I felt fine.

My endo recommended having BG run a bit higher to get the awareness back, as Tanya said. It worked.

Pull yourself up a bit so you ride 100-120. After two weeks you should have awareness again. The body adjusts both ways.
I went into hypoglycemia unawareness within about 4 weeks of going on insulin many years ago. I was shocked with it happening so quickly.
But with easing down my basal insulin, I got awareness back no more than two weeks later. My signature is terrible if I’m even at 70.
However, read this:
Just last evening I was playing Scrabble & realized I must be low: I was at 35. I won the game, but I had very much overestimated my food’s carb needs, given probably a unit too much, and It was a warning that I’d better do what I recommend: ride 100-120.
Decrease the basal just a tad. Only you can know.

I’ve complained about this many a time; why I tried the CGM, why I thought about getting a diabetes alert dog, and other actions. It is something that happens to us at a non-specific time in our Diabetic lives. All the best advice will say “test, test, test!”.

Careful with the “basal” making you low, that seems like too much… good luck!