I have had Type 1 Diabetes for almost 20 years. I have low blood sugars a lot. I know that in the past I have also had some really severe lows. My question is what are the long term affects of having repeated lows say under 50? I have asked my doctor in the past but they said it doesn’t have an affect on you long term.
The recent article on this site addresses this. Here is the link. Alzheimer's = Type 3?!?!? Scary stuff.
I made my husband read that. I have been T1 a very long time and have had devastating lows over the last 10 years (Hmmm...a meter reading of 10?) I know my brain no longer works like it used to--I forget things I have been told for instance. But generally I remember all the things that don't irritate my husband when I don't remember--testing, appointments, etc. He says I don't listen to him. Maybe, but I also know I forget things easily.
My forgetfulness makes him crazy. But, it is what it is. I can't change T1, so.....
I'm sure one of the more scientifically oriented posters will chime in about the long term effects off low blood sugars. If nothing else, frequent low blood sugars lead to hypo unawareness which can be dangerous!
My question is have you been unable to tweak your doses to prevent a lot of lows and also I see you have a CGM; doesn't that alert you to trends so you can treat before it gets way down there?
I’ve had Type 1 for 36 years. I’ve had my share of lows, but I seem to be seizure-resistant and have only lost consciousness twice. I don’t feel that lows have had any long-term effects for me. I have moderate lows often, but rarely have severe lows. I have the Dexcom G4 to thank for warning me to take action before lows get too bad.
No control my BG levels---I still do not have the same abilities I had ten years ago. I hear and often forget.
Oh my. It is worrisome.
There is some epidemiological data suggesting that severe lows can cause asymptomatic brain damage, that is theorized to possibly contribute to dementia and other cognitive impairment in one's senior years.
Nothing definitive I've ever read (which doesn't mean squat about whether it's out there), but I have encountered many times the hypothesis described above.
My endo told me that below about 66 mg (3.7 mmol), you start losing brain cells (see Reference). Repeated lows can also lead to unawareness.
You still get the swings with the pump! The insulin is the same.
If you don't want swings, you need to eat less carbs, or lower GI carbs.
After listening to both segments of this must-hear radio program, I am starting to move to a low carb diet. As a fit 40-year old, I am already on 5 medications for high blood pressure. This can only be explained by the damage to my blood vessels from high blood sugars. I can only hope it will reverse somewhat.
Good link, thanks. This mirrors what I was told 40 years ago.
I haven't seen any long-term effects from hypos. I've had oodles of them. I've probably been to the ER maybe 6-10 times, more when I was younger although I had a couple of more recent "outliers" after I got my pump and all of that. I have the same problem as Spock about not hearing MrsAcidRock all the time but I don't see it being related to diabetes as much as being married for 20 years. I am less sensitive, in that I don't seem to get sweaty the way I used to however that may be because the lows are less pronounced as I have had better control in the last 5 years, w/ pump and CGM. I still feel "buzzed" when I drift a bit low and that's enough for me.
I was diagnosed in 1945, when I was 6. There were no meters for testing during my first 40 yeas, so I never knew what my BG was at any time. The urine testing was totally unreliable. There were many lows, and the ones occurring during my sleep would sometimes cause seizures. Those seizures were quite an ordeal, and it was very difficult for my parents to bring me out of them. I was using animal insulins until the mid 1990s and there was no basal-bolus control. I am sure that I must have had 200 or more seizures during the 50 year period, prior to using the insulins we have now. Despite those seizures, and many many less serious lows, I completed six years of college and became a college professor, teaching mathematics. I do not believe that the very low BG's I had have caused any permanent damage.
I am now 74 and have been type 1 for 68 years. There are no diabetes complications, except for some mild nerve damage. My first A1c was 12, in 1980. My A1c's were consistently higher than 10 for many years, until there were meters available, and there was good information for having great control. My A1c's have been no greater than 6.1 for the past ten years, and I have not needed assistance with a low BG since July, 2007.
I definitely have some forgetfulness, but I am sure that is due to my age, and not the lows I had in the past.
This is a little off topic, but wow Richard, your story is encouraging! I like hearing about people with diabetes who don't let it get in the way of achieving anything. I am only 2 yrs. into my diagnosis, it's humbling to think how far diabetes management and care has come.
In 30 years with T1D I've had three lows where I seized. I'm sure there are others I could put in the same category but happened while sleeping and I woke up once my liver responded with glycogen.
I've had a noticeable decline with memory function but I haven't been able to convince myself that is caused by lows alone. I consider swinging BGs and high BGs also could affect memory function. I've been on and off statins in the last several years and I wonder what role they may have played. There has been some coverage of the possible deleterious effect that statins may play with memory function. I'm currently off of statins now and I think that my memory has improved but it could be my brain responding to the "placebo effect."
I once had an endo that was startled with the number of lows I experienced as he reviewed my BG record. I took the attitude, "Hey, don't worry about my lows. I take insulin. It comes with the territory. I'm very good at detecting and neutralizing lows. I'm a pro. Can't you help me overall get better control?" Effective suggestions never came from the doctor. they would just give me the platitude, "to control the highs, you must first eliminate the lows." Well, that's easy for them to say.
My biggest fear is losing my cognitive function. No one, absolutely no one, knows how to run my BG control program like me. If it gets handed over to the modern medicine machine, my days will numbered. And it will be a small number. I would rate the typical hospital's and nursing home's ability to run a BG control program as lower than an informed and motivated beginner. Sorry for my digression!