My first hypos


#1

I’m still new to this diabetes thing. I had my first real lows (61, 57, and 42). I know that is not super low, but the weird thing is, I didn’t feel it. I have symptoms when it there is a sudden drop, and at those times I’m not even low…it is just that I went from 130 to 90 in a few minutes.
I’m not on a CGM nor a pump. I retested as well.

As being a relative newbie at this (dx 05-2018) I’m not sure what happened. I only added a wee bit of resistance training and that’s it. I know to reduce my insulin intake, but it still kinda freaks me out and I don’t want to discuss this with my dear husband, because he’s already freaking out a bit both by knowing my numbers and heck, the diagnosis as well.

I’m not sure what symptoms to watch for in a gradual decline of BS. I didn’t have the sweats or shaking. I was just tired and a bit dizzy…and only dizzy when I stood up or made sudden movement.

So I guess I’m asking for thoughts on how to tell if you are going low when there is no shaking or sweating? What is your experience with exercise and how do I fix insulin dosing? Funny thing, I’m still having a hard time keeping my morning fasting numbers under 110 (TBH, I’d prefer morning fasting numbers in 85-105).
Thank you in advance.


#2

I have been T1 for 50 years. Originally I got sweaty and could just tell I was feeling off. Now the only sign I am off is vision. My vision improves when I am 80-100. Better than when I am higher. When it get into the 60s I can tell my vision is off. A little blurry and less clear. That is my only signal.


#3

Because I’m active and also because I have dawn phenomenon, I need to pump for the best bg results. MDI just doesn’t cut it for me.

Hypos can present themselves in many ways, including (dangerously) having no noticeable symptom, right up to passing out. Getting low when sleeping is especially dangerous (hence, I wear a CGM and have four electronics for monitoring the numbers, the Dexcom receiver, my phone (and watch during the day–I shut it off at bedtime), as well as my wife periodically monitoring me from my old phone.

Sometimes the first sign I’m low is my vision will get “speckles”. When I’m quite low I get temporary central-vision blindness. As soon as I come up a bit, it returns to 20/20.

Some will shake, get confused, become weak, agitated, belligerant, sweat. The list goes on and on. My symptoms have changed over the years, AAMOF. And not all of my lows present themselves similarly.


#4

Speak with your doc about a pump and CGM and see if they think that would benefit you (I can’t imagine either one won’t benefit a T1)


#5

Well that could be the only warning you’ll get. The real test for if I’m thinking I could be low besides you know actually testing my BG is trying to read something. I’m usually reading something anyway so if I see spots in my vision or any blurriness and what I would describe as slow blinking I know I need to do something. If I’m not reading anything I won’t usually notice my BG is low until I get to the shaking disoriented stage.


#6

If I’m having a hard time expressing myself verbally and am just slow with language, that often means I’m low. Certain kinds of background noise, like kitchen noise in a restaurant, can seem more irritating than usual when I’m low. My eyes are more sensitive to bright sunlight when I’m low. If I wake up low, I’ll often see spots in my field of vision, kind of like the spots you see from flash photography. When I’m low, I have a hard time composing and writing. If I’m reading while low, I’ll often read the same sentence or paragraph multiple times since I’m not comprehending the content.

People who share your daily life can often observe your behavior and sense that something is off. I often was irritated with my former wife when she asked if I was low. She was usually right.

I think you should give serious consideration trying out a continuous glucose monitor. It can provide invaluable feedback about your food and exercise but most importantly, it will enhance your safety, a lot.


#7

A great explanation of feelings going low, thanks.
To my best friends I just tell them I am in my stupid mode, things just don’t register.
I just sort of sit there. I maybe at 70 or 50 just varies. But always when I am pushing exercise.


#8

Hi Jenn. 42 is pretty darn low. It is amazing what a little exercise can do. I don’t sweat or shake either, but I just feel off when I am really low. If I drop while exercising I find it much harder to ride my bike. I am very fortunate that I have always woken up when low at night. A low prevents me from sleeping.

Because I don’t mind testing a lot and always wake up, I don’t use a CGM, but I think that they can be a very good idea. That way you would be alerted to a low so that you can treat it right away. It might ease your husband’s mind a bit.


#9

I’d really recommend using a CGM, at least temporarily. You will be able to see what’s happening very clearly and get a handle on what input is causing what result. I really wish I had access to one when I was first diagnosed. Would have sped up the learning curve.

They are expensive which is frustrating. And therefore, use of them is highly dependent on insurance, good insurance (or a great income.)

But, if you’re able, consider using one, if only for a month or two.


#10

Oh, and I would let your husband know.

Oftentimes I when I don’t notice my lows, I start acting a little stupid. But even though I don’t really realize it, those around me notice. It’s super helpful for someone to interrupt the moment and say, “Hey, stop for a second and check your blood sugar.”

About half the time I’m low, and about half the time I’m just stupid. :grinning:


#11

One theory is the more lows you have the less you feel it. Sometimes if I’m busy I don’t notice and I’ll be a little low, say 70’s. But much below that I usually get a slight anxious feeling, maybe a slight headache, sometimes ravenous hunger, not being able to concentrate or focus well, if I hit say low or under 60’s I’ll see bright flashes of colored spots when I close my eyes.

But in bed I can go a lot lower without feeling a thing, sometimes it’s just waking up and not being able to go back to sleep. I always thought I woke up when I was low, but when I got my CGM it showed I slept hours low before I woke. I am getting a Dexcom CGM so it has the alarm.

Get a CGM, it tells you all sorts of stories about what your BG’s are doing. It can be eye opening.


#12

Same here and similarly when I’d ride a bike, sometimes when I wouldn’t feel too bad, but when I’d stop the bike to test on a meter, I might be as low as the high 40’s or 50’s.

And it’s not just a theory that repeated lows cause folks to have more hypo unawareness.


#13

Its Dexcom time. Your not SUCH a newbie that you couldn’t use it. Might be reassuring for your husband to be able to look at the number on the device, as well. It would help him get acquainted with your symptoms and recognizing how you react to lows. My type III checked my Dexcom all the time - just subtly pulled it from my purse and glanced at it if he felt uncomfortable.


#14

Not a lot to add to what everyone else has said, just to emphasize that what “low” feels like is one of those things that seem objective in the D literature but are actually heavily subjective and dependent on your past personal experience and other factors. Lots of people with not-so-great control will report feeling low at much higher BGs—like above-normal ones, 120s, whatever—than the same people will experience later on after getting their BGs in better control. My knees used to lock up when I’d get in the 70s, but now I hardly feel any low symptoms at all at that level. As you say, rapidity of onset seems to have a lot to do with it. And age, how long you’ve had T1, lots of stuff. In short, this is something everyone has to learn for themselves to a large extent, and re-learn, because it doesn’t remain stable over time.

My one consistent symptom, the one that acts as an emergency warning for a rapid, severe hypo coming on, is the “flashbulb in the eyes” effect. Center of vision goes, and when I blink rapidly there’s a big flashbulb-after-image floating in front of my eyes. Comes on before before sweating or anything else, and means I’m under 60 and going down rapidly. Exercise is definitely one of the commoner causes for those.


#15

I guess we have the same symptom, but use different terms: I refer to it as central-vision blindness but I like your description!


#16

I’ve definitely experienced it that way too, just going blank without noticing the flashbulb thing. In a restaurant I suddenly discovered I couldn’t read the menu, and recently had it happen taking my grandkid to the playground—just couldn’t see her as she ran to the teeter-totter (fortunately my daughter was there to help out). I was in the low 40s both times. Lesson learned: Fiasp can hit too soon when you’re bolusing for pizza.


#17

I call this the sun blind effect, looks like I have stared at the sun for a short bit.

I also get numbness in my lips and tongue, that’s my earliest signal.


#18

My eyes aren’t affected, but at least when trying to sleep, my heart starts to beat
much faster like it does when exercising.

I have been a type one for 60 yrs.


#19

After 4 years of Type 1, I usually don’t feel anything until about 50ish, sometimes lower. I can’t even imagine going to bed without a CGM. My endo says more people die from low blood sugar than you think. Extreme low blood sugars can cause brain damage. I am curious if low blood sugars in the 30-60 range do any slight brain damage over time? My lowest has been 30 when Dexcom screwed up on my order and I was without the transmittor for 2 weeks. I need to ask my endo this at my next visit.


#20

My first sign of a low is that I’m hungry. Almost always… unless I just ate an enormous meal and am low because I dose too aggressively.

If the low isn’t treated at that point, I’ve noticed that I start to feel a little more anxious or on edge. It’s hard to describe. It’s almost like I’ve had too much coffee.

Sometimes that doesn’t happen though… because nothing is consistent with this disease :slight_smile:

Another symptom is, as many others described, spots in my vision. This usually only happens for a fairly severe low, and if it’s severe enough to cause that, I can also count on my tongue feeling tingly and going numb. If the tongue thing happens, then that usually lasts a little while after my bg levels have come up.

Those last two symptoms haven’t happened to me for awhile. Getting a cgm was the best thing to ever happen to me since I was diagnosed with diabetes (though Lantus and Humalog were pretty awesome too). A cgm can really help you prevent severe lows.