Hypo unawareness, Is it happening to me

I've been having a few hypo's lately. They are not unexpected I have been working on a lower carb diet. My hypos have not been real bad mostly in the low 60's upper 50's. What concerns me is that they seem to be sneaking up on me. I had a low today of 60 and really didn't feel the usual symptoms, all I noticed was an uneasy feeling. I usually feel numbness in my tongue and lips, slight vision problems and sometimes slight confusion. But this time nothing just a feeling that something was not quite right. Had I been really concentrating on the task at hand I might not have noticed.

The thought of being hypo unaware scares the hell out of me. I am behind the wheel a large part of my work day and I need to be confident that I am in full control.

So does this sound like hypo unawareness to you and if it is what is the strategy for living with it. I know the best thing I can do is avoid hypos but no matter how hard one tries they are still going to happen.

Gary S.

Have you had a fairly large cluster of hypos during this period of changing your diet? Have they all snuck up on you? If so, yes, you might have developed a bit of hypo unawareness. But if you decrease the number and frequency of hypos (which I'm sure you'll do as you adjust your regimen for your new diet) your awareness will come back.

If it isn't all hypos that sneak up on you, though, I think it's fairly normal. I find that my hypos, especially the marginal ones (I don't even treat for anything over 60) sometimes sneak up on me and sometimes I feel them. When it gets lower - like 40s I always feel them. I really think awareness has to do with a lot of factors, like what we're doing at the time. When I'm more active I can miss them, when I'm relaxing alone I don't usually.

I struggled with hypo unawareness for years, and was able to get rid of it by letting my BGs run high for an extended period of time. At this time, I generally feel my hypos come on, especially once I'm under 60.

That said....there are a few that I have only caught by regular testing. And a couple of these were in the arena of what I consider "scary low" (i.e., 50 or lower). I don't think my hypo unawareness has come back, but I have discovered that there are certain conditions under which I just won't feel a hypo come on - such conditions include focusing really hard on something at work or being en route somewhere (particularly on public transportation).

The best way to live with hypo unawareness is to avoid it as much as possible. My endo is always very concerned about hypos because, while mildly-high BGs pose a long-term threat, severe hypos pose an immediate threat to you and others around you. So, I no longer aim for an A1C under 7.0. For me, it's just not possible without lots and lots of lows. I consider my A1C only a snapshot and focus more on the frequency of lows and highs and my average standard deviation.

I personally think that the intense focus on lowering the A1C is sometimes doing more harm than good. There should be some balance here.