Low BS Unawareness

How long before I become unaware of my BS lows? I have been diagnosed for 3 years and am still very aware of lows, I feel them as soon as they start dropping, usually in the 70’s. Sometimes, they are very fast, however, or I am busy and not paying as much attention. One endo told me I would never lose my sensitivity, maybe because I was diagnosed late, at 50?..but that is a huge fear for me. I will be on the pump one of these days, but hope to hold out until the monitor and pump are one unit…almost the dream artificial pancreas.
When did you lose awareness?

I’ve only been diagnosed for 3 months and a bit, so haven’t lost awareness yet. But I have had lows that I’ve been unaware of, stray 2s and 3s that I catch in a random test, or the sort where a teacher asks if I’m alright because I’m pale as anything and not acting ‘right’. So low BG unawareness scares me a lot. Those moments are the lows that scare me most. I actually wrote a blog post about one of them the other day.

Your experience does sound scary…You are probably lucky to be in an environment a lot of the time with people around you that care about you and know how to help. I am fearful of passing out in public, alone. I have had a few scary lows, the worst were when I over compensated for post meal spikes with insulin…I won’t be doing that again. One time I was in the grocery store and now everytime I go to the store, I start to feel low and worry. …every twinge of anything starts to feel like a low. It is a very vulnerable feeling. I guess one of our nightmares coming true would put us on the CGM.

I think it varies with each person. Sometimes I can feel mine and other times I can’t. I have noticed though that when I am not showing signs of low blood sugar, something just makes me think to check my sugar, but I haven’t nailed down what the feeling is. Also sometimes medications you are on can also block the bodies response to low blood sugar. I know I am on 2 that could possibly do that.


As I understand it (and this has been borne out by my own experience) hypo awareness is based on how frequently you go low. The body defines “hypo” in reference to your usual blood sugar.

When I was first diagnosed I was having strong hypo symptoms in the 80s, because my body had never been in the 80s. It took a lot of work once I started insulin to get the body use to the normal range. For several months I’d get rebound highs if I got to 83!

But once the new “normal” is defined, the hypo range drops lower.

Unfortunately, if you spend a lot of time hypo, the body mistakenly defines the lows as normal and won’t put out symptoms when you drop that low.

So if you can keep your blood sugar no lower than 70 at all times, you may keep your hypo awareness.

FWIW, as I gradually got down to normal levels, the level at which I feel sick and poisoned from high blood sugars has dropped, too. I used to feel toxic in the middle 200s. Now it happens in the middle 100s!

Jenny…Thanks for the info. From having read everything I could and asking a lot of questions, I had been given this before, but somehow, you have made it more clear to me. You obviously have worked hard to be so in tune and keep your #'s so even.

I know you eat healthfully…how restrictive are you with the carbs.? I eat mainly good quality carbs, so felt a bit protected, but have found that was just wishful thinking. The amount of fiber or portion size or lack of refining or the rest of the content of the meal doesn’t seem to make much of a difference. I may need to dose higher and watch closly to eat again should I need to, but I have not been consistently good at that, partly because the lows are so frightening. Also, if I am working, or my attention is needed elsewhere, it is hard to stay focused on the BS until it is in an bad range (high or low.)

I know what I need to do, now I need the motivation and discipline.

I have had that feeling as well, Cody, but I don’t think that I am as in tune as you are because I am just as likely to be up than down when I check. I think it is just fear that reminds me to check sometimes.

Boy…if other meds are hindering your awareness…that would be hard to combat. Are you considering a CGM? I understand that it is hard to get insurance coverage.

I can’t even get medicare to cover the insulin pump for me. I am on betablockers which hinder the body’s ability. I can normally tell if i am going to low to fast as well, but I have been dealing with this for 4 years.

Lots of challenges… Good luck to you and keep working at it.

Becoming hypo-unaware isn’t at all inevitable. After 31 years, I still detect mine. I can generally sense if I’m still dropping, while in the low 70’s (when awake) and I’ll wake up when I fall into the 60’s. I’ve never made a trip to the Emergency room or even required assistance from anyone else to deal with a low (though I have had some close calls). It all comes down to your own normal range. As long as you don’t frequently fall into the 50’s or 60’s, then your body will probably keep detecting those levels as abnormal and generate some symptoms that you’ll detect.

My dog has woken me up when I have went low. I have been in the 30’s and never had to go to e.r. I carry glucagon kits with me everywhere

Cody…I LOVE that your dog woke you up…lets just say, “saved your life,” to make your dog all the more wonderful. I have been waiting for a year to get a dog, while I have been settling into a sort of routine in a new home/town/life. That’s the final thing I needed to motivate me!

Aren’t you lucky to have your sweet pet(s…I can’t help but notice there is something on your head.)

yea one of my 8 cats. He loves to sleep like that

Ken, Thank you for the encouragement. You also must work hard to maintain great control…you are all so inspiring to me. Am I correct to think that in 31 years you have also not suffered any db related complications?

Elaine seems like I’m the only one replying that has no awarness but then again I’ve had it for 35 years and started losing my awarness about 10 years ago! Yes I do get low quite often now with all the adjusting to my dosage after 35 years maybe that’s why I’m having all those problems now. But mt Dr has told me it’s b/c I’ve had it so long.

Well this just turned out great, here we are talking about lows and my sugar goes from 150 to 86 in 10 min. I start shaking, sweating and puking anytime I have something with high sugar. I also have a glucagon shot and even that didn’t help. Paged doctor, and now i am downing pepsi, gatorade and anything else with sugar in it and forcing myself not to throw up

Cody…you gave yourself a shot? At 86 you are so uncomfortable? Are you OK?

I gave myself a shot of glucagon because my blood sugar was going to low to fast. I had to do something to stop it from going to the 30’s and putting myself at risk of passing out. Glucagon is glucose in injectable form which is sugar. When I go to low, I normally go dangerous levels low.

It was scary… it’s more scary looking back on it, I don’t think at the time I really felt too scared. I was trying to stay concious… My doctor’s making me cut down on test strip use, I take 5 shots a day, and 4 tests really isn’t enough for that, but they don’t get it! very frustrating. it’s making me have one or two lows a day. not fun!

I would be finding a new doctor. THey shouldn’t limit you on your test strips. Insurance companies will pay for more if you prove to them you use them, like keeping a log of your sugars so that they can see you are testing that often. That is all I had to do to get more. Heck I went through almost 25 test strips today already just becasue I was low.