Losing hypo awareness

Up until a few weeks ago I could feel a low sugar comming around 60 or so. today I was at 29 and had no Idea. No shaking, no nervousness…nothing. has this happened to anyone else and if so what does it mean? I can’t get in to see my doc for 2 weeks.

Hypoglycemia anawareness is common in type1 dibetics,they used to say it happens with complication of diabetes,when it affects the autonomic nervous system,but it happens from early on to most, if not all ( from my experience with my patients)
The best thing is frequent testing especially if prolonged activity is inivitable,once BG is 100,you have to raise it with a snack if going for activities missing a meal or snack…

It tends to happen if you have a lot of lows frequently. Do you? Maybe due to our bodies adjusting to the lows.

When I’m really active, I test a lot. Sometimes I go low, sometimes I go really high.

my endo had me keep my blood sugars a little higher than normal for a while and it really helped me detect my lows a lot better.
I think after a while you just get use to the feeling of being low.

I have had issues hypoglycemia unawareness. The only thing that is saving my is that i test 10-16 times a day. That seems to catch most low blood sugars. I also have been tried running my blood sugars higher and that did not help. I have used things like peanut butter/peanuts that seems to help stabilize my blood sugar. http://www.amazon.com/Dr-Bernsteins-Diabetes-Solution is a book some people say has helped them with hypoglycemia. Hang in there.

Charles: When you do see your doctor, don’t rely solely on whatever your a1c is. You also need to look at whether you have been having wide swings in your BGs. I went through a period of unawareness several years ago when my control was not that good and I often experienced wild swings. When I took steps to get my control better, the awareness returned, albeit not perfectly. My endo said that part of the problem was the wild swings – going from lows to highs quickly and then back again. The return of awareness came fairly quickly for me – within a couple of months of being in better control (my a1c actually went up, but the swings stopped), I was much more able to sense being low, or at least something being physically wrong enough for me to test and realize it. The bigger problem I had was hypoglycemic denial – being low, being told I am low, and refusing to admit it or test to find out.

I check about 6 to 7 times a day and most of the time I range from 70’s to 140’s with an occasional low of 60’s and high of 150’s. I don’t do a low carb diet but count and weigh everything very carefully. My currant ratio is 10/1 with 20 units of lantus first thing in the morning. I will start testing more often and discuss this with my doctor. Thanks for all of your input. It is much appreciated.

I just started pumping with the Omnipod and lost awareness of Hypos for a while. Now that my basals are getting more in line my awareness seems to be coming back.

Maybe I had to get all of that Lantus out of my system.

this phenomenon — hypo unawareness striking everybody from noobs to the long-timers — seems to have coincided with the rise in synthetic insulin usage (read: virtually all insulins). curious coincidence, to say the least.

myself, i went for 14yrs without ever having experienced hypo unawareness, but within 48hrs of introduction to synthetic stuff, i had the first of millions of episodes of HU. 16yrs of hypo unawreness followed (amongst many different flavors of synthetic insulins), but immediately after returning to natural (porcine) insulins, all my warning signs are back and as dependable as they ever were in the first place, 30yrs of type 1 be damned.

I have never ever experienced symptoms of a low whether it was was beef, pig or synthetic. I have been as low as 18 and not been aware. I was in the hospital today having my first pump programmed and the first test I did that stored the BG in the pump was <60. The nurses started to run around looking for snacks but I felt fine, no need to worry.

Lows can happen for dozens of reasons and I have not yet (in 40 years) been able to put my finger on one thing that I could avoid.

You can do like Tarra does in the time before you see your doc … test a lot more often.

By the way … my pump is a 722 and I think it’s great.

Thank you all so much for your input. I have looked into a pump, however being in the military still they decide which pump I would use and I want to wait until I have the ability to make my own choice. I have been looking at the animas 2020. Does anyone out there have experiance with this pump? I need something very rugged so it will last through the demands of the Marine Corps. Thanks again everyone for your comments.

I find that I lose my hypo awareness only when I work out or I’m really active. I think adrenaline masks that to an extent. I try to get my BG between 150 and 200 before a workout. I’ve gotten off a treadmill after an hour workout … and tested 30-40 and felt like i could do another mile and a half right there - no affects of hypo what-so-ever.

Hypoglycemia unawareness is usually the result of a compex failure of a number of different endocrine systems. I gave a response to a post a while back which may be worth visiting for more information (see http://tudiabetes.com/forum/topics/583967:Topic:117099). In some cases, avoiding lows may help to restore symptoms, but realize that as with anything related to diabetes, what works for one person is not assured to work for everyone. Although more frequent hypos can make a bad situation worse, hypoglycemia unawareness is not necessarily due to repeated lows. 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 also impacted, therefore the alpha cells which produce glucagon are also damaged and can therefore no longer properly respond when glucose levels start to drop (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 miraculously "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 and may be unique to each instance as well. Thus, many people with diabetes learn their unique symptoms based on their experience.

I would add that the biggest danger is when symptoms of hypoglycemia occur but are 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. For this reason, many people find Blood Glucose Awareness Training to be a valuable treatment, as it focuses not on the basics of diabetes care but putting those elements into relevant context.

sometimes i react strongly sometimes i barely realize it. i can sometimes tell u within a close range what my sugar is