I kind of wish hypos really affected me more, I might be more diligent to avoid them

Hi Clare,

My symptoms vary. Sweating is usually the first one. General weakness and numbness in my hands as well as tingling. When my heart starts pounding and I get really hungry I know it’s really bad. I often get dizzy and disoriented too.

The worst one I had was in the middle of a meal- my heart started pounding like crazy, I felt dizzy. I felt like I was having a heart attack and I had a really weird feeling in my stomach, like I was hemorrhaging. I drank a glass of oj & within two minutes I started to feel a lot better.

I also often feel giddy, giggly & weepy. I can feel this way anywhere from the 80’s if im going low to 43 which is been my lowest number so far since I was on insulin. If I am sitting down or in bed I don’t seem to notice it that much until I stand up. Then hunger & sweating are the first sign. I almost always treat in the 60’s. Unless I don’t notice it or I find out from the test first. sometimes I wake up in the 50s and 40s feeling nauseous and sweaty or have a bad dream. But sometimes I also wake up this way or have other symptoms and I’m not low! Lol

I am a "newly" diagnosed T1 (back in Feb of this year, 2012). I wouldn't think I could be hypo-unaware just yet, but who knows. I've only gone low once where I actually felt it and at that time my BG was 35. I was still completely in control, aware, and could take care of it, but did have the symptoms. I got incredibly sweaty, hot, but the first clue was tunnel vision that would expand and contract. The sweats and slight shakiness followed shortly after that. Other than that I haven't had a low where I felt it.

When I was first diagnosed I routinely would test in the 60s or mid to high 50's. I felt completely fine at those levels. I didn't like being much above 100 actually (but that was coming off readings of 280, 360, 533 etc right before seeing the doc and getting an official dx). At any rate, my endo said the going low is kinda fluid and varies. At least in her book, if you feel okay and are above 55-60 then you're probably okay. I recently just started using a pump this past week and am going through the training and stuff they have. They're pretty adamant about treating a BG below 70.

Short answer: I don't feel it until around 35.

I think I have some of those symptoms too Jackie, the mental ones, as well as feeling jittery/ hands shaking and tunnel vision. I also seem to get palpitations when I go high or low, as well as sweating and fatigue. Last night I thought I was low, but I had gone up.

I feel your pain, I’m hypo-unaware as well. I have gotten down to 24 without feeling much but once I read that bg level I certainly started feeling it! Weird!!!

My endo (and she rules) told me to keep my bg a little higher for the next few weeks and then the awareness should return. Double edged sword I say bc I always try to keep myself at a normal persons bg, through diet, exercise minimal apidra with meals and 12 units lantus at night. I have only had T1 for about a year and a half so I’m still also getting used to it. Dx at 29 years old, strange stuff.

Bg was 770 when admitted to ER, a1c was 12!!!
Now my a1c is about 5.3

I am scared to keep my blood sugar highr than I normally would. Some doctors call us too strict but I say ■■■■ complications right? I’d rather feel a little lit headed and sweaty from time to time than go blind, lose a foot or have excruciating pain in my limbs!!

I'm with you 100%. A lot of PWD have also said the same thing. If you purposefully keep your bs around 180 or so for a couple of weeks the hypo-unawareness should go away. But the thought of being in the 180's for an extended length of time for me is just not worth it. I have been doing this for 37 years, so I have a few on you but my blood sugar was only 324 when diagnosed and they didn't even have A1C's back then so I have no idea what it would have been. You may be still honeymooning as far as insulin use goes, but time will tell. 5.3 is a good A1C so if it works, then why mess with it. My primary said yesterday that there is absolutely no evidence in the literature that says anything less than 6 is beneficial for avoiding complications. In fact if you are hypo-unaware a really low A1C could actually be deadly. Mine is at 6.4 right now and I'm perfectly ok with that.

That's ***exactly*** it! A hypo is no big deal as long as you don't pass out! Eat some ice cream and 1/2 a bag of potato chips (depending on IOB...) and you're good to go. I totally agree that I'd prefer to be light-headed and sweaty (although I seem to have lost the "sweaty" too..)to being blind, amputated or neuropathic. Although I have this weird itchy spot on my leg I'm starting to think may be D-neuropathy related? eeek...

Maybe it's poison ivy ? eeek A hypo is a big deal if you are behind the wheel of a car and you don't know it.

My son is 9 (dx'd at 18 months)and is hypo unaware. He doesn't usually notice lows until he is 40 or lower. I can't tell he's low either. Scary times for a d-momma.

Why would it be necessary to run over 180? I think the only key is to avoid having hypos for a period of time to bring the awareness back. But then some docs are more hypo paranoid then we are and want us to run high so we don't go low. I only correct to a goal of 110 so that usually keeps me from going too low. I wish I got as few highs as I get lows!!

Meanwhile, has your endocrinologist or CDE suggested to elevate his blood sugar for a couple of weeks to see if he can re-capture the awareness ? Some here have said that works.

I don't think it's that. We had poison ivy at our old house and, while it put MrsAcidRock in the hospital, I didn't get any effect off of it at all? I don't do a lot of trial running. It's just a spot. It's been itchy for a while. I'll talk to the endo next time I see her but it doesn't seem like a big deal so I always forget about it.

I agree that hypos behind the wheel of a car are a big deal but have a CGM and keep fairly close tabs on things? I also generally don't eat a lot so IOB isn't a huge hazard and 3-7 jelly beans seem to "cover" a lot of hypos, or I'll pound a glass of skim milk to get me up. I do quite a few little tactical maneuvers to keep my BG from going too low but I don't freak out about it and would rather be 60-70 than 140-150 100% of the time.

I find I get a headache if I am 60-70. I'd much rather be at or around 100. I don't have a CGM so I check before I get in the car. But I also do a fair number of tactical maneuvers as well. My fruit of choice right now is cherries and I always have some around, but I too do not freak out at a "low" certainly not the way the endos and CDE's do. I think in fact that in order to actually become a diabetologist or CDE you should be required to be hooked up to an insulin infusion set with a CGM and actually experience the highs and lows. I don't think going to class and "learning" about what PWD experience is enough.

We've tried everything it seems. His BG is like a roller coaster every day. It's really weird because sometimes he reacts to insulin and sometimes not. He's on the OmniPod and it has helped his control a little. When he was on Lantus his body didn't know what to do. He'd either use up the Lantus all in one swoop and we would have really horrendous persistent lows, or it seemed that he didn't use it at all, and would have persistent HIGHs with ketones.
He does react more predictably to Novolog, but still not as expected.

I can't even imagine the frustration you must feel. The roller coaster blood sugars are what got me to even begin considering a pump and I am most likely going with the Omnipod if I do in fact switch. But lately with really careful carb counting and tweaking basals and I:C ratios, the roller coaster ride has smoothed out. In fact over the last week my highest bg was 203 and my lowest was 52 but both the high and the low were explainable. It's those inexplicable bg's that I think are the most frustrating. I use Lantus and Humalog and have a fairly predictable reaction to both, so I guess I am lucky.

Hello Clare:

Let me ask you a question... play devil's advocate for a moment, o.k.? Lets pretend we Do have symptoms, but they are too subtle, too easily overlooked or mistaken for exhaustion, fatigue, irritability... some common feeling(s).

If that were the case, how would you figure yours out?

Dr Cox out of U. VA. began the B.G.A.T. (Blood Glucose Awareness Training) and peers say its so. Been that way since c. 97. and appears to work. Raising the daily numbers higher than we have been for a bunch of days is like hitting the "reset" button.

Its the reverse of folks who are always "high" and believe that is how normal BG is supposed to feel. Dangerously too low, why are we surprised we crash and burn only flying six feet off the ground at full speed, you know? Raise it up stay higher than we have been for a bunch of days, we get a different perspective of normal and finally enough time for the proverbial alarms to be able to go off. Flying six feet off the ground at Mach2 and the signals don't have time to happen...

@ac...; I had a itchy spot on my left leg ;I thought it was diabetes related ; it did not go away and finally mentioned it to my GP , who did take a biopsy ...it was cancer : basal cell carcinoma and had surgery in March ...don't want to scare you , but have it checked , please !

Hi Stuart,
What I got from the web cast with Gary Sheiner on Friday when I asked the question, "how does one restore hypo-awareness ? The answer was fairly simple, avoid hypos for at least 2 weeks. It that means maintaining a blood sugar that is slightly higher than one would ideally like then that is the way it has to be. In an effort to do that I have cut back my basal insulin a bit and have taken less humalog before what I know is a fairly carb packed meal and I am trying to raise it. Only problem is I exercise just about every day, take the dog for a walk, play golf,tennis do yardwork (which gave me poison ivy) which complicated the whole process as well. So every day there are variables that I need to account for. Never mind I don't like the feeling I get when my blood sugars are higher. Take yesterday for example woke at 176 which is high, spent the day in my normal way, walked the dog, cleaned the car, never went below 79 and got as high as 187, took 13 units of lantus at 9pm usually take 14, but heck this is an experiment. Went to bed at 110. I was pretty happy with that. Woke at 2:43 no symptoms was at 51 drank some juice, fell back to sleep and woke at 58. My husband can always tell when I hit 40-50, he says I stop making sense. Only problem is my husband cannot be with me 24/7 so I have to really search for the subtle clues. Problem with that is if you are already be-fuddled by being low, searching for some subtle clue might be impossible.

I think if we wake up at 51 after taking whatever to raise bg it's a good idea to wait 15 minutes and retest before going back to sleep to see if you are above 80 or higher... you could still go low again but I think it is less likely to happen if you get yourself to a 90 range. I consider myself to be pretty hypo aware so far but some of the worst ones came on very quickly while I was distracted by having my mind focused on other things like gardening/reading on line etc. I tend to get very irritated when I'm hypo too, so that should be an early sign for me, but sometimes I miss it until I'm really low. I just end up testing a lot because I sometimes have the hypo symptoms when I'm not hypo or hyper and sometimes have the same symptoms when I'm going up, I usually start sweating at almost any change in my bg, so that should be a sign to me that something is changing, this almost always happens every time I eat and it happened before D also- of course then I had no idea my bg was involved maybe.

At 2:45 in the morning, I was pretty sure a 1/2 juice box would do the trick, and if that wasn't effective enough then my liver would more than likely intervene. I'm not going to stay awake another 15 minutes to make sure I am going up. It may be a good idea, and it is certainly what the CDE's all are programmed to say when they get out of "how to treat a low class" but from a practical standpoint staying awake extra time to be sure the juice I have drunk 1000 times previously to increase my blood sugar actually does increase my blood sugar is not something I am willing to do. And I actually slept late today which also makes me happy.