Hypoglycemia unaware?

Anyone else unaware of lows or highs? Been using Dexcom due to this issue … thank God for the alarm. Doesn’t matter if I’m 300 or 30 I don’t feel either. I’m not insulin stacking or over under treating…bad this morning at 55 with arrow straight down… woke to the alarm double checked on my meter twice and went and got some juice…no shaking or sweating…

i dont always become aware and when the dexcom alerts me im like oh, i didnt feel that. i double check by checking my sugar levels as well just to confirm it. but i become unaware sometimes

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I don’t feel a vast majority of lows and don’t feel highs until I get way up there. I recently went for a week without any Dexcom sensors and had numerous severe lows (<2.5 mmol/L or <45 mg/dl) with no symptoms at all. I often had to test twice before I’d believe my meter. No symptoms whatsoever. Sometimes I’d start to feel it as I came up. When I do feel lows, it’s usually pretty subtle; no shaking or sweating but sometimes feeling a bit weak and like I can’t concentrate. A few weeks ago I had a bad low where I nearly passed out while walking downtown (not sure how low I was as I didn’t test before treating, Dexcom was just reading LOW). I thought using the Dexcom was helping with hypo awareness, but I think just seeing that I’m low helps me to feel it. When I don’t see that I’m low on a meter or CGM, I often don’t feel anything until I’m on the verge of passing out.

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I am now in false hypo territory with a major change in meds. 70 feels like seizures to me. I have had seizures due to a brain tumor. I can not believe lower than 70 would not set off an alarm.

I feel a little warm and shaky as low as 60. Not fun.

I feel a little slow and slightly heavy at 210. But I monitor well, so neither of these happen often.

Jen your Hypo and Hyper symptoms very much mimic mine. We also speak the same language, mmol/L, so what meter or meters do you use?

Concentration is my best indication of a hypo below 2.9 mmol/L. Although rare, there have been a few occasions when the hypo (mid twos mmol/L) has been much more severe than both my meters, Accu-Check Performa and FreeSlyle Optium have indicated. Although I have already treated the hypo, I have had no concept of what was happening. My tongue feels numb and tingles and I get the cold sweet.

I have been down below 1.8 mmol/L Performa (ALWAYS DUE TO MY OWN STUPIDITY) where shear panic sets in but I was still very capable of self treating.

Closing my eyes is a good sign, for me, of the hypo zone. White blotches appear if Performa BGL is 3.0 mmol/ or lower.

Because I have to drastically change my pm Basal, after a couple of days of physical hard work, and if I don’t get it right, I will have a hypo around 3 to 5 am. I wake up because I am having a weird dream that I know, can not be real. When I test with both meters, the result is usually about 3.2 mmol/L.

I am also unaware of lows but boy can I feel the highs! I hate the highs and will do anything not to be up there!
But the hypo unawareness is very sneaky. I didn’t know I had the problem until I was in a very serious car accident. The on,y explanation was unawareness. When I was a kid, I got all the classic symptoms, sweating, shaking,emotional upheavals. But over the years, lost all of them. I have been told you can “retrain”yourself to recognize lows by running blood sugars a little higher for awhile and not having any lows. Just so hard for me to do as I swing out of range at least once (or more) each day. Thanks goodness for CGM’s. My family and I would be lost without the alarms. I really don’t know how I did it before. Very spoiled now!

I went through a period of many years with hypoglycemia unawareness. Carb-limiting combined with my CGM allowed me to reduce the frequency, intensity, and duration of lows. This led to the restoration of my adrenaline response which dependably kicks in right around 65 mg/dL or 3.6 mmol/L.

I think my liver is too tired to help out as my gallbladder was removed…so no glucose being released… but who knows scary thing to not feel your levels

I think the key here is reducing the frequency and severity of lows – not necessarily not having any, and not necessarily running a little high. I was previously extremely hypo unaware. I could be below 35 and feel perfectly fine, and at night would often end up sweat-drenched and zombie-like. Getting a CGM last spring has helped enormously in heading off those lows before they occur, and serious lows for me are now few and far between. After eight months, I find I can often tell when I’m approaching a low, often before my Dexcom alerts me (at 80), so my awareness has returned to some degree, and may yet improve.

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mskdka, I’m pretty much like you. no sweating or shaking (not since decades ago when on animal insulins). I do stack, so I’m more prone to getting low following a high. I HATE being high, so I’m aggressive with bolusing sometimes…well, more like “often”. :slight_smile: the Dexcom catches the lows if my drop rate isn’t crazy fast. and it’s awesome at alerting me during sleep, when I go too high or low.

Yes it is awesome at waking …dropped low again last night double arrows down again :joy::joy::joy::joy: happy for the alarm

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I also am “blunt” to my lows. The Dexcom is a life saver especially at night. I have my alarm set at 60. I can go as low as 39 and not feel anything. I rarely have highs exceeding 230 and that happens when I eat wrong so I know the reasons. With the low comes an uncontrollable hunger, not just juice, coke, or glucose tabs, but I almost vacuum anything in sight into my mouth. This of course solves the low issue but the excessive calories (mostly proteins or salty things) are not good for weight control. Any hints on how to control this being so famished with lows? Tricks? Things to eat more healthy and filling for a very low low?

Nope, no hints on that as if I’m super low I’ll eat a ton of carbs also. What I’ve found for preventing the potential high from eating excess carbs is to wait til my head is clear, count the carbs I ate (if I remember it all) and then bolus for 1/2 of the extra carbs. I don’t do that til I’m over 100 or so and won’t be engaging in physical activity.

As of about a week ago, I’ve stopped eating all the junk that requires that I take a ton of insulin. Having far less IOB or none at all, my lows are gentler and therefore I don’t have to overeat which contributes to my weight gain. I only need to lose about 16 or so more pounds, but I get very uncomfortable and annoyed if my weight goes over my goal weight. I don’t have clothes for various weights so I have to stay within a narrow range in order to wear what’s in my wardrobe. :slight_smile: The holidays are tough times for all of us watching our weight and our bg’s. When I overeat I might take well over 30U for a meal. Not good! Now I take 3U or less.

Before I had my CGM, I’d be seriously low before I felt it, and would always overtreat, and then of course have to deal with the rebound high. Once I got my CGM and could be alerted before I was actually low, I no longer craved the sweets. After decades of habitual overtreating, it was a big surprise to me to discover that taking just one or two glucose tabs could avert a low. No longer do I get up in the night to stuff my face with cookies.

You might experiment with setting your low alarm a little higher, say about 80, so you’re alerted before you’re actually low and can take preventive action before the sweet cravings take over. See how few glucose tabs (or your preferred treatment) will bring you back up into target range, and if you’re not going to be having a meal for a while, have something like a few crackers with cheese to tide you over.


For me, the hunger is linked more to dropping blood sugars than absolute low levels, to the point where if I’m high, I can tell the moment my correction insulin really starts to kick in because I suddenly get a bit hungry. It’s why for me, stabilizing blood sugars was a key component to weight loss, because that rollercoaster drove a lot of appetite. I’ve also learned that when my blood sugar is fueling unnecessary appetite, whether I want to eat more than what I need for a correction or food as I’m coming down from a high, to try to have diet/no-cal beverages, chew sugar free gum, have some veggies, something to feed that snacking impulse without any or a lot of calories. I also don’t keep much in the way of super tempting snack-y things in the house, since I would tear through that if I was really low, and it was around. I know and respect the limits to my self control, heh. That said, if I do overtreat, which still happens time to time, I have no problem taking insulin to cover the extra food, even if that means taking a shot while still low.

Oh, and I should note that for real lows, the low cal stuff comes after something like smarties (US ones)/sweet tarts (basically less expensive/tastier glucose tabs) or some fruit/dried fruit or something fast acting sugar to treat the low.

Thanks. I will try setting the alarm a bit higher. I have started to preempt going to bed in the 80’s with some orange juice and cheese. Since I am on a pump, the basal level sometimes keeps me going down at early at night even when it is set to a low level. Morning “bloom” keeps it OK after 4am.

I am very insulin resistant and have to use U500 and pills. The combo works great for my A1c, but I still need to lose 30 pounds more and over treating and over snacking make weight loss hard.

Thanks to all for the great help!

I-got d’d at 22 months of age. Now will be 49 Jan. SometimesI 'm as low as 1.8 and feel Nothing. This disease is not easy.

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I’ve been as low as 25 (1.4 mmol/dl) with no symptoms, at least that’s what my Freestyle LIte meter read. Most recent of those was when my CGM was in warmup. Feeling that something is off would often prompt me to check BG between about 35 and 50. CGM has cut down on the number and severity of low BG and I rarely have highs (over 180) anymore.

I had the problem when I was a kid where I would feel the symptoms of a low but because I was paying attention in class or playing a game, I wouldn’t connect the dots and would pass out before anything could be done about it. Nowadays I can wake up out of a dead sleep if I’m having low symptoms which is a blessing.