Developing an insensitivity to lows? Who knew...?

Lately, Eric has been showing his lows less and less. Used to be that he’d wake up crying from his nap or from sleep if he dropped below 70, but no more. In fact, there was one day we woke him to find he was at 35! And during the day, if he’s running around, he can go as low as 55 without any change in behavior, where he used to get grumpy and cry. Given that he has just moved to his own bed (turns 3 today! woo hoo!) this is more than a little alarming. The clinic said that it’s probably related to the change of weather - he’s more active, so his average blood sugar is lower and he’s had more lows than previously (so many, in fact, that I had to adjust his basal rate downward for a few weeks) and they say this probably has made him less sensitive to the symptoms. They suggested I work at bringing his average BG up so he’d start feeling it more.

I had no idea that sensitivity to lows was something you could lose... or regain.

My daughter never felt her lows while she was sleeping. Now for the past two years, she hardly ever feels them at all! We’ve tried the CGM but she just doesn’t like them (she’s 16 now) so we constantly check her sugar. Usually one hour after most boluses. I’m hoping that some day soon she’ll change her mind about the CGM - would like to try the Dexcom 7. The only time we keep her a little high is when she goes to sleep because she actually trends downward as she sleeps without any insulin at all! I basically get no sleep lol. I sure hope your able to work it out with the little guy! Has your endo mentioned CGM at all?

Your body adjusts to the blood sugars that it sees. If you spend measurable amounts of time with your blood sugar below 70 mg/dl, it will start to feel normal. You won’t release stress hormones and you will become hypo unaware. There is clear evidence that by keeping your blood sugar back in normal range you can restore hypo awareness and that is probably very true for children. Try to make a special effort to keep your son from going low, even to the point of correcting numbers below 80 mg/dl. I bet you find that he restores some of that awareness. The other thing you need to be aware of is that your son may have started to change his interpretation of those feelings and he may still have the feelings, but just ignores them. This may also be something you need to work on.

Absolutely, hypo unawareness is a BIG deal.

For my first decade or two as a T1 diabetic I never had hypo unawareness issues. Then I ran a long string of hypos… unawareness issues got worse and worse… until my wife couldn’t wake me up one morning and called 911. I got a glucagon shot and a trip to the ER from that one.

For me, hypo unawareness is worst if I have been running a string of hypos. Having numbers dip below 70 a couple times a day is a sure way for me to cause hypo unawareness. If I can stay at 80 or above most all the time, then my hypo awareness comes back.

so YES, running bg’s low for a stretch really does a doozy on hypo awareness, and raising them for a while really helps bring it bck.

I’ve never been able to feel hypos until the 30’s and 40’s… even from the beginning. I remember my VERY first week on insulin (I was using NPH) no one really mentioned the whole “you absolutely HAVE to have a snack” aspect of it… I would test in the low 30’s mid-morning and really didn’t even have a clue how low that was. No one told me it was “that” bad. I still wonder if all of those early lows didn’t somehow damage my system so I don’t even feel when I’m in the 50’s or 60’s.

I do wear a dexcom and that is often useful for catching lows, but it still misses them sometimes and I still don’t feel them. The dexcom helped me realize that I was often going low after meals… as well as skyrocketing higher than I ever imagined… by only testing at a set time after I ate I was missing it all.

I had gotten the impression that hypo unawareness was intrinsic to the individual but now I see that’s not the case, and actually it makes sense - when the weather changed he did have a string of lows until I wised up and lowered his basal for a couple of weeks. He does have fairly regular snack and meal times, but the exercise quotient is pretty variable and that was always a key factor in the times he went low. Thanks everybody!

PS Eric is too young for CGM at this point - last I heard, they’re still testing it out in kids under 7, and I’m not sure they’re going any lower than 4 yet even in experimental settings. If anyone knows otherwise, please tell me… My doctor would probably be willing to prescribe it but I can almost guarantee that Anthem wouldn’t pay because it’s not an approved device for kids his age. Sigh…