Do we know how long it generally takes for Unawareness to develop? I have been diagnosed for 6 years and have lots of lows, nothing so scary as mike’s, but I keep my candy near by at all times.
It’s more dependent how often a person goes low than the number of years that results in not being sensitive to lows.
So I’ve had a lot of severe lows over the 20 or so years I’ve been diabetic, and I still don’t have hypo unawareness. That really doesn’t answer your question. I would guess that it just depends on the person.
You ask a great question. They’ve crunched those numbers and I think the latest information suggests typically 10-15 years is a likely time frame when it happens to most, I think???
However, the issue normally is whether we are truly not able to detect them?
If so, could the cause be we are like an airplane flying too low to the ground? Meaning, are we pushing our sugar too hard, keeping it too artifically low and then have no room to get any warning signals, because we crashed and burned before those alarms “went off” ?
Dr. Cox, B.G.A.T (Blood Glucose Awareness Training) out of U. VA. originally I believe. They have done some fascinating work contenting (c. 1997) that if we let up (let our sugars be higher) just for 72 hours without having a single low during that time… these symptoms reset themselves.
Unsure what modifications have been done since then…
Do you believe your symptoms have disappeared, OR when you were first diagnosed they were like BIG BEN, merely now 20 years later, they are much subtler?
Stuart .
Your body will start to make certain adaptations and become used to lower blood sugars after just a few days of exposure. Over time, with severe lows, accumulated damage results in much of the standard “counterregulatory” stuff just being permanently out of commission. The work by Dr. Cox showed that even for long-term diabetics with extreme hypo unawareness, normalization of blood sugars can restore “some” level of awareness, but for may it can’t do much. Further work also showed that even when that did not work, you could learn additional techniques to become “aware.” His BGAT work trains patients to become concious and sensitive to other indicators of low blood sugar and that proper application of those techniques can result in you become markedly hypo aware, although your awareness is not longer based on having those wonderful feelings of being clamming, sweaty and wanting to blow chunks.
That makes sense, Gerri, Thanks.
Glad to hear you are still aware, Anna! It probably does depend on the person and a lot of other factors.
Stuart, that is scary…the lower we keep our #'s, the less play room we have. I am worried that my frequent lows will trigger the unawareness before my time. I have felt low blood sugars my whole life. The symptoms were different pre D, but I always had the tendency.
bcs…I am glad to know that studies are being done in that areana. I wonder what the new symptoms would be…
The BGAT approach depends on identifying your unique symptoms of hypo and hyperglcemia. Individual symoptoms may include things like nervousness,mood changes or twitching. The scientists found that hunger or feelings of a counterregulatory response are actually poor indicators and that by recording the repeated and recurring feelings, moods and other things during hypo and hyperglycemic events, a patient could identify a range of symptoms that when taken together are “pretty darn good” predictors. If you learned to see that a twitching indicated a hypo, you could become “hypo aware.” Hope that helps.
I’ve had unawareness from the VERY beginning… I would be fully functioning in the 40’s… not really have anything more than mild symptoms into the low 30’s.
I remember once testing in college, in class, and being something like 32. Instead of asking someone for a soda they may already have, or asking for a dollar to buy one from the machine down the hall (I didn’t have any cash on me) I got up, left class, and walked all the way across campus to a corner store to buy one. I have ZERO idea how much lower I had been by the time I got there, I’m just amazed that I DID get there. I drank half the soda before I paid for it. Clearly being that low does impair your judgment, even if it doesn’t physically effect you… I was apparently walking and talking just fine, I even got yelled at by the clerk for downing the soda before buying it.
I had a 38 the other night and didn’t feel a darn thing other than VERY sleepy (dexcom woke my husband up, who woke me up). I treated that and it was literally all I could do to stay awake long enough to know I was going to be fine. I ended up with a wicked horrible rebound high on top of it too… but somehow managed to get back down to about 120 by the time I woke up in the morning… all caught on the dexcom, and I was blissfully unaware of that when it was happening… without the dexcom I wouldn’t even know it had happened. I had scaled back my basal rate on my pump too, but I don’t think that contributed to the rebound since I was able to drop nearly 200pts after the high without any extra insulin… something weird was going on.
As far as maintaining normal levels to ‘reset’ the ability to feel lows… I’ve been having great #'s lately… that low the other night was literally the first one in months, and I still can’t really figure out why it happened other than blaming my period, even though I haven’t been running low this cycle. So it really isn’t a question of lots of severe lows happening often that impairs my ability to feel them - I just plain can’t, no matter what the circumstances are. I don’t really know why, and no one has really been able to tell me, but I do have to tell you it’s quite scary to not be able to rely on “feeling” a low until you are like 30. It’s not safe, either. It’s part of why I test often… and I ALWAYS test before driving, even if it’s only been 20 minutes… because 20 minutes is enough time for a lot to change. It’s why I don’t rely 100% on my dexcom to show me if I am going low… because by the time it alerts low I am often already much much lower… but it is useful if I am asleep 
Wow…
It helps to know that if/when it becomes an issue for PWD, we are not without resources.
This is more common than is commonly assumed, the reality is that the counterregulatory response in all patients with type 1 is compromised, but each hypo can kind of “reset” the autonomic response to those lows even lower. Some patients can restore symptoms by avoiding lows completely for a short time, others cannot. As with anything else with this disease, your experience may differ.
I’m 37 have had D since the age of 2, and find that only sometimes am I hypo unaware. Sometimes I can even tell before they fall or maybe while theyre falling. I have also noticed the more lows I have, the less I can feel them.
It all depends on the person and the low. I am generally always hypo aware, and able to self-treat ; but one week ago Satrurday I had a 36 low upon awakening: I needed to have help from neighbor and friend. I could not do anything for myself except grin and say " I am low" and then slump to a chair. Three weeks ago I had a 42 after mopping the floor and moving the furniture ( did not lower my basal prior, silly Brunetta). I felt a little clammy, and nervous, but was able to pop some glucose tabs and keep on a going, with relatively minor adverse effects… I guess it just depends… Our reactions to insulin induced low blood sugars are usually predictable in the WHY that they occurred, but their intensity is not always predictable by the number on the meter. For me it varies…
God BLess,
Brunetta
I agree with Antonia, the more lows I have the less I feel them. When I get up in the AM with a low, 40-50 I really feel fine. But if I have a low during the day, 50 or less I usually feel tired, sweaty, and sometimes confused ( if it’s in the 30 or less.) If I have a number of lows in just a couple of days, then I don’t feel anything. I have been a T-1 for 11 years.
Mine didn’t start til I was a diabetic for like 20 years. Does that help. I think Gerri would be right about this though.
Elaine,
Through hockey, David met the T1 Dad of one of his teammates. This Dad introduced himself to David after David’s first time playing with the team and running into a low following his first shift off the ice. He was quicker to react to get a gatorade than me as he was on the team side of the ice, behind the bench, and recognized a problem right away, while I was across the rink and didn’t notice the coach trying to get my attention.
That Dad talked to David, and us, a lot about his experiences over the few summers that our boys played hockey together and strongly encouraged David to let his teammates know about his diabetes. He explained to David that you never know when you might have to count on one of your friends to help you out. That Dad had been T1 from a young age and so had his twin brother. While he was always aware of lows, his twin brother had always been hypo unaware. As adults, they were both involved in farming, and I assume working the same family farm, so they basically put a call system into place for his brother and any time that he missed calling in, they’d head out to find him unconscious in a field, or elsewhere.
I think sometimes, kids like David, try to ignore the signs and that can lead to a dangerous situation. The other night heading to hockey, David was talking and a few moments later he asked me if he had been mumbling, and what does that mean exactly anyways? I explained the word mumbling and he said I feel like maybe I was slurring my words. I suggested he check his blood sugar, and he replied, well I know I’m low… but was I mumbling? I told him at that point, if you know you are low, check your blood sugar, and fix it. Sure enough his reading was 3.1 or approx 56 in the U.S. so he drank some gatorade, but I can’t understand for the life of me, what he was waiting for, or even why he would wait. I think he figured that since he had just eaten in the past 30 minutes, that the low might go away, on its own.
Cheryl
Hello Sarah:
Have you considered or factored in the potential for any of those readings to be in error by potentially as much as 30 percent? Meaning a reading of 100 could actually be 70 or it could be 130!
Readings are not veinous readings and are definately rarely “right”. They are hints only…
Why can’t our ()@#@#@ symptoms be something EASY, say like the irresistable urge to TAP DANCE for example! See Stuart tap dancing and everyone (including me) would know I was low… why do they have to be subtle or obscenely vague symptoms???
Just one chorus of ~…Don’t Cry for Me Argentina…~ excaping my lips would let me know I was in trouble easily ! Come on, I just want a BIG symptom, lets skip these worthless ones… swaeting, fatigue… baaaah!Like to re-wire them all to become BROADWAY symptoms rather than the puny ones I possess…
Broadway symptoms and there would be NO doubts “trouble” was brewing…
Stuart
I had tons of hypos/seizures while I was young and a lot of lows through the years including occasionals in recent years. I’ve only had Hypounawareness(not totally) about the last 4 years. There are about 5 reasons that I’ve seen for Hypounawareness.
Call me weird but I’m relieved that I have a degree of Hypounawareness. At least I am not freaking out and stressing worrying if a sweat and a dizziness is a low and being able to get enough glucose in time. I always hated those heart racing events. I was always afraid that my heart was going to explode.
I did develop some time ago which are new minor symptoms of hypo which aren’t scary. Like my temples and cheeks buzzing sometimes when I have a low. My eyes getting Really moist and hazy. When I’m deeply involved in something my brain just grabs my attention and demands me to test. That alerts me. I normally do test about 7-9 times a day. Sometimes more. Learn your body and sensations and what affects it including new symptoms of whatever.