I don’t like to disagree with people, but in this case, I will have to say that Libby and Dee are mistaken about something, which unfortunately, is a very common mistake: hypoglycemia unawareness is not necessarily due to repeated lows (although that can make the situation worse). Hypoglycemia unawareness is more appropriately described as being the result of the interplay of insulin excess and impaired glucose counterregulation. What does that mean?
To understand this issue, you must understand a few basics. First, the basic difference between type 1 and type 2 is relevant here, because as you probably know, type 1 is caused when the body’s immune system mistakenly attacks (and ultimately destroys) the pancreatic beta cells (which make insulin and amylin). While the inflammation ultimately destroys the beta cells, all of the cells found in the Islets of Langerhans are impacted, therefore the alpha cells which produce glucagon are also damaged and can therefore no longer properly respond when glucose levels start to fall (this is not the case in type 2 diabetes, as even when the beta cells ultimately fail and the patients require insulin, virtually all still have a fully-functional counterregulatory response). That’s strike one.
Next, in patients with type 1 diabetes, as glucose levels decline, insulin levels do not decrease – they are simply a passive reflection of the injected insulin, which is strike two. As a result, the body’s first two defenses against hypoglycemia are lost. The one remaining defense is the epinephrine (sometimes called adrenaline) response, and unfortunately, that is also impaired.
Sometimes, lows can reduce this response even more, which is why many people tend to mistakenly blame the patient for hypo unawareness. It is true that the reduced glucose threshold for the epinephrine response is shifted to even lower glucose levels following a hypo, but it is factually inaccurate for anyone to claim that avoiding lows will "restore " the symptoms of a low, rather it may help shift the level a bit higher (therefore you get symptoms sooner), but the epinephrine response will still be reduced.
Although it is not as likely, the fact is that hypo unawareness has little to do when you were diagnosed, and everything to do with the extent of alpha cell damage your Islets have endured, as well as other things like the speed in which your blood glucose levels drop.
While the “symptoms” of hypoglycemia can be characteristic, particularly for the experienced individual with diabetes, the symptoms and signs of hypoglycemia are nonspecific, and may vary with each occurrence. Symptoms of hypoglycemia are idiosyncratic and may also be unique to a given individual. Thus, many people with diabetes learn their unique symptoms based on their experience.
I would add that symptoms of hypoglycemia may occur but not be recognized as indicative of hypoglycemia, particularly when your attention is focused on other issues. For example, a large number of patients report that they are less likely to recognize hypoglycemia while at work than during leisure activities.
Let me just add that your educator, quite frankly, sounds like she is reading from a textbook. The next time, you should ask her how many hypoglycemic events she has ever experienced and if they were the same each time. I would bet she cannot answer that!