You have a very different definition of moderate low that the rest of the world.
I’m no saint myself, I’ve done lots of things I shouldn’t have when my bg was too low. But I would never be surprised if I passed out and they told me I had a bg of 40. That’s the sort of bg where bad stuff happens for me and everyone else. I have also had a wide spectrum of other symptoms (eyes not pointing correctly… arm and leg spasms… etc.) in the ballpark of 40 so I don’t expect it to be the same every time.
This study may also provide some helpful insight, though I’m not sure it’s a perfect parallel to your situation. Note that the study is actually performed on rats, not humans, so the results may not necessarily translate.
"Episodes of both moderate and severe hypoglycemia have long-term clinical consequences. Recurrent moderate hypoglycemia induces a maladaptive response that limits symptoms of hypoglycemia (hypoglycemia unawareness), limits the counterregulatory response to subsequent hypoglycemia (hypoglycemia-associated autonomic failure), and thus jeopardizes patient safety…
Patients with the highest incidence of severe hypoglycemia are most often those who maintain intensive glycemic control and, hence, are likely to have had recurrent bouts of moderate hypoglycemia. In this study, recurrent moderate hypoglycemia preconditioned the brain and protected it against brain damage and cognitive dysfunction induced by severe hypoglycemia."
I assume you are using a CGM with the alarms properly set. I had years of hypoglycemic unawares and this has been easily and completely eliminated by a Dexcom CGM. I no longer need to worry about being alone or travel. I know that if there is no alarm sounding I am fine.
The title of this post drew my attention, but I have a completely different issue, or issues as it were. With increased control and stability I seem to have been seeing more or worsening complications. Though I do also have some decreased hypo awareness too.
I would carry glucose tablets. Every time you start feeling low take one and see if that relieves the symptoms. One thing I’ve found in 26+ years of diabetes is if my BG isn’t very low 60’s or 70’s one tablet is usually all I need and I often feel lower than I am but only if I am dropping quickly so take that into account. You might want to do an experiment in a safe environment next time you go low see if you’re still dropping or you’re just stable. It’ll at least give you some clues. Honestly though overcoming that feeling of Ahh I’m dying when you’re not really might just be mind over matter. I’d rather feel low at 70 than 30 anyway, it’s a lot easier to treat and takes less time to recover so more time skiing and less time having a panic attack 
This also happened to me and it came on quite suddenly. I was switched to Tresiba and given a dexcom and now all is well, again…
Is it possible that those complications were there before your control got better, and since you’re feeling better BG wise that issues that were in the background are just more noticeable?
OK, maybe I over reacted. I’m hitting a lot of 60’s. I am able to detect them and am not loosing my facilities. perhaps that 40 BG was just a fluke or maybe there was something out of the ordinary at play that day. I’ve been riding my bike an hour a day, and while it has cause some lows, I haven’t gone blind or had super severe symptoms associated with moderate lows of late.
A perfectly ‘normal’ dude (with no chronic medical conditions) lost consciousness at my feet the other day on the train. It reminded me that fluke situations just happen sometimes.
So, the system is back to ‘my normal’, my typical standard deviation. Severe symptoms associated with lows have disappeared. I’m not getting complaints from people who are close to me. I’m able to power through normal activities with lows.
I think my physiology adapted very quickly to that increased system stability and made me almost like a normo-glycemic, who might run around naked and screaming at a BG = 60 (although not quite that bad). I suppose if my physiology adapts quickly to changes in BG, that might be expected. Its something to watch out for in the future.
That was honestly the strangest, most unexpected blood sugar effect that I have ever encountered. I would definitely rather have a resilient system than a perfectly ‘flatline’ one. If thats what happened, but its awful coincidental - suddenly running the best numbers of my life and simultaneously shaking at the knees and barley able to think straight at 70. So bizarre.
I hope you are still treating lows and disengaging from dangerous activities (like driving) when low. I don’t think “powering through” is always the best option.
I’ve seen frequent posts from newly-diagnosed people who feel terrible with a BG of 70. So my guess is that you’re right, and your body just got used to in-range BGs and so everything outside that range felt worse than it had before.
I personally think I’d find increased stability and increased symptom awareness a good thing. But I’m glad you’ve resolved the issues you were having.
Yes, your right Jen. I spoke with a Doc about it today and he found it reasonable that increased stability caused increased symptomatology.
That level of stability was a fluke for me. I kinda doubt that it will pop up again in the next twenty years, but if it does, I will know to exercise caution. Its already passed and my numbers returned to more typical (less stable) behavior. I’m fine with that. I feel ‘normal’ again.
It is super confusing. I, too, would have expected to feel ‘better’ with increased stability. But, I also can recognize situations where that is not the case. So, I appreciate you guys talking about it with me. I know it sounds counter intuitive and strange.
I talked about this with the Doc today. He brought it up because I rode my bike an hour to my appointment and my blood pressure and sugars were high (300). But, I felt physically great. It was a beautiful ride and I felt physically strong. I wanted to bike another hour. He suggested that I might be pumping adrenaline (which might make me feel physically good and strong, but might also be bumping my numbers high). That happens a lot when I ski. When I am really skiing at my best, I tend to run high. I cannot say, for sure, why this happens. But, maybe my body is ‘helping’ me by kicking out sugar. I also see this effect on days where I wake up feeling great - full of energy and super productive. I tend to be ‘kicking energy’ in some way that causes huge BG spikes.
These things have long puzzled me. I think I will choose to think of them as the invisible, magical diabetes forces that help me do things, but also screw with BG stability.
Thanks for checking in. Let me know if you ever encounter something similar and we’ll put some additional thought into it.
Check your BG constantly. I never drive without first testing my BG and will pull over to test every hour of driving to give me peace of mind. I had one experience when I drove and it had been about 90 minutes without testing. My BG bottomed out, and I can still hear my son shouting “I don’t want to die” as I began driving on the wrong side of a busy road. That shout snapped me back into clear thinking and I was able to navigate us out of trouble.
I also worried about skiing alone with good reason. It’s a pain to have to carry testing supplies and stop on the side of a slope to test, but that was the only way I stayed safe. The same concern and solution for swimming.
CGM has made my life easier and my loved ones less worried. You should consider using it. Good luck.