Low & not noticing - when to worry

Type 1 and LADA
#1

My son had his lowest low - 31 - yesterday while on a school field trip. He had no idea he was low and only caught it because he was testing before eating lunch. The backstory is that he woke up high, corrected, had a discussion with me about what he should eat for breakfast since he was high, then got busy getting ready for the field trip and forgot to eat. He said he didn’t realize he forgot (and I didn’t notice either) until he was trying to figure out later why he was so low.

How could he be that low and not feel anything when he routinely feels low if he is in the high 60s/low 70s? He hasn’t had a lot of lows lately, and has actually had about 3 days of running considerably higher than usual, so I wouldn’t think he would be desensitized to lows? I’m trying not to get freaked out about one episode, but when do I need to get worried?

Thanks.

#2

Please don't worry. Lows are exasperating because they present differently. I've felt wiped out & dopey at 60 & fine at 30. It changes. Slow declines aren't usually felt as acutely as rapid drops. Your son is fine.

#3

maybe he was distracted by the excitement of the field trip, all things considered i think he would of otherwise noticed esp where he hasnt had to many lows, my son has been less aware and can test for a meal and be in the 60's or 50's and not have a clue but he does feel it at other times he came running in from outside the other day low low low and he was 78 but he had been higher and he was probably dropping quick from activity. i suspect this was an isolated event, field trips always make me nervous another reason to, no really just kidding, they ussually do a lot of walking and need extra food on board so hopefully smoother sailing for a while now.. best of luck amy

#4

Can I suggest a CGM?
I have never had good hypo awareness. My CGM can tell if I'm low with much greater accuracy than I can, and I don't have to run high to try to avoid lows.

#5

for me it depends on how long I am low. Some times I don't feel it until it has been down low for a while.

#6

A CGM would be great. I am unaware most of the time when going low, so I started on a Dexcom. It has been a great experience for me. I'm even learning to notice different symptoms that appear when going low. Sounds like he had a lot going on and could of been very distracted.

#7

I am very unaware of lows, but that comes from two things: 50 years of T1 and A1Cs of 5.1 to 5.3. I am hyper about my control, due to my "youth" and years of D. I now have a cgm. It really helps, but can be a real pain in the neck, but I never ever go without it, as I feel so unprotected.

I will have absolutely no idea I am low, for several hours, so the cgm keeps me alert and makes me treat--it nags very well.

However, I as a former child D, I know that what is going on around your son is much more important than how he feels. Diabetes is low on the scale of concern for kids (parents want it to be #1, but let's be realistic: they are still young and have other things going on that will be more important...) The last thing he wants is to be identified with a problem in a group of his peers and may hold back as a result. He was undoubtedly having a great time and other things did not register. It happens.

I actually just did this with my grandkids. Whole fam went to a Nationals game. Mommy is such a worrywort about what they eat. I got low, had skittles to treat, but would not eat them. Afraid it would cause a scene--Grandma blantantly eating a banned substance... finally got up (Grandad was about to strangle me) and got a $6 coke from the concession and gulped about 1/2 on my way to the bathroom. Just an example of how others (peer or not)can influence your son's decisions.

I am sorry that he (and you) have this burden, but just teach him that he can be well, happy, successful and give him the knowledge and tools he needs. He will be OK.

#8

I agree w/ the suggestions that adrenaline from the field trip was likely to have masked the hypo. A lot of my more spectacular hypos have involved some sort of distracting situation. It might be good to try to arrange to toss granola bars into pockets for things like that although if he is similar to many teenagers, he will eat anything he runs into?

#9

You're a good parent to be worrying! You're justifiably worried. The time is now to try a CGM. His body is changing. He may find he loves it. With summer activities soon, a CGM could be used as a device to research his own body, his foods, and his summer activities and where they all converge to change his BG. Self knowledge wah-hoo!
It is not possible to feel low when thinking of other things. That is why we use devices and alarms.

#10

I have had lows as low at 27 that I didn't feel at all (my husband said "there's something wrong with you... test!") and then have routinely felt others in the 60s and 70s. This is one reason to test every time you get behind the wheel. I think in my case it's like a previous poster said, that my blood sugar was dropping so gradually that I didn't notice. I wonder the adrenaline response to a low is only triggered by a precipitous drop. When I had that low, my brain was clearly affected since hubby could see that I wasn't making sense, but I had none of the physical symptoms. That has happened to me a small handful of times, maybe 3 or 4 times in 19 years.

#11

I do notice it sometimes, if I have visual disturbances, but mostly I don't. It is one of those things that sneaks up on you. Anyone around me might notice me acting slow and stupid. One time someone thought I'd been drinking.

#12

Thank you for chiming in. Fortunately, this was the first time he didn’t feel a low and hopefully it won’t be a recurring experience. I’m going to check into a CGM. The Dexcom isn’t approved for pediatric patients - I don’t know what that means in terms of insurance coverage, but I’ll do some investigating. I keep waiting for the Ping/Dexcom integration, but that doesn’t seem to be happening with lightning speed.

Thanks again!

#13

What is a "CGM" ? I have terriable hypo awareness and thought I would just ask about this. Thanks for any help & have a great day.
Chuckles. :)

#14

CGM= Continuous Glucose Monitor, a device that keeps track of your BG every 5 minutes or so with occasional problems with accuracy and some what might be called "delicate" calibration issues? The two brands are the Medronic Paradigm, which is integrated with their pump and Dexcom, which is a standalone unit, with another unit you use to test BG that also serves as I remote I think? There's a plan that's been out there for a year or two to integrate the Dexcom with the Animas Ping pump I think but I have not seen a date. The device will give you a graph like this:


Despite the accuracy and sort of fussiness of the calibration process, I like mine a lot but a lot of people who've tried both (which I haven't...) swear the Dexcom is better?