The Low Down(er)
I’ve had some shitty lows lately. Some no good, bottom out, ass-kicking, still-reeling-later lows. Like on Saturday morning, for example. I felt a little extra groggy when I woke up, but took a shower anyways. By the time I got out and realized this wasn’t just lack of sleep, I was 39mg/dL. Or the other day when I felt a litte “out of it” and found myself at an adorable 58mg/dL. And then there was Friday night when I went from 52 down to 42 juuuuust as I was getting ready for bed. Thanks a bunch, ‘betes.
I don’t like lows as much as the next person, but there’s a bigger concern creeping around my head like a little black raincloud: I’m getting more lows that I don’t feel until I’m way down in the depths of hypo-ness. That 39 crept up on me like it was nothing, and that freaks me out. I’ve heard from patients and providers alike that the longer you have this disease, the harder it can be to sense your lows, which is where big problems can start.
I’m really quite spoiled in being able to complain about this just now, because I’ve had diabetes for almost 19 years and have been truly blessed to have extremely good hypo-awareness. I wake up every time I have a low, and for a long time I started feeling symptoms at about 70 (and I still do that sometimes, I just have more of these creepers that I don’t feel at all). I know this awareness is a luxury that many people with diabetes don’t have. But this is new for me, and I have to say that its totally unnerving.
I talked to one of my endocrinologist customers about it yesterday, and he mentioned that my low A1c might have something to do with my no-warning lows too. Since my average BG is way down right now, it’s possible my “low threshold” has gone down too. Similarly, you may have heard that people who run their sugars high all the time might feel “low” at 150mg/dL because their body becomes used to the elevated state. Thinking about that being my problem is so frustrating though because why bother with a low A1c if it’s going to become dangerous? Once again diabetes, you don’t play fair.
I’m trying not to worry too much about this because I have my DexCom on my hip most of the time. It makes me feel good knowing I’ve got back up when it comes to low warnings (although that couldn’t have helped me in the shower that one morning, and often when I’m just at home roaming around, Le Dex gets left in other rooms…so there’s that problem) but still, this sucks. These are the kinds of diabetes issues that make me feel like its “catching up with me,” and I hate when I feel like diabetes has the upper hand.
Have any of you guys noticed that your hypo awareness has declined over time? Or if in your times of tight control?
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Comments
I didn’t have this problem until the past year. After having a lot of lows, now I don’t always feel them coming on. Yesterday I went to eat a late lunch, feeling fine, CGMS going and saying I’m around 100. But when I tested, I was 61. Not too, too low but I couldn’t feel it, at all. It gets scarey when you can’t feel them coming on or wake up from them. Thank goodness for the CGM but sometimes it’s slow in alerting for them…but at least it helps most of the time. Better than nothing.
Low A1c’s have made me almost completely unaware of lows. When I was around 6.5-7, I felt lows around 50.
Now that I’m 5.5-6, I don’t sense them at all. Recently had a terrifying 22 with insulin still on board that I didn’t sense at all - just a little tired. Only realized that something was wrong when I was reading a book and it wasn’t making any sense.
Need to decide if the trade-off between 5.5 and 6.5 is worth it. Diabetes certainly doesn’t play fair.
I’m always balancing my overall BG with the semi-infrequent lows. The real problem is the blindness to it. I was getting to bed late and felt a little weird: 29mg/dL. Maybe the answer is a slightly higher A1c, but relinquishing a little control is something I hate to do.
As a T2D I have noticed as my A1C has declined due to weight loss and exercise, my lows dia-radar has also decreased. Before I knew whenever I was going below 110 but as my A1C declined (improved) I only feel the fatigue, dry mouth, tremor or tunnel vision when I am below 75 - 80. I find I can tell when I’m 20 - 25 points below my average waking fasting which has dropped in the past year from 135 to 95.
I am SO glad that I’m not the only one dealing with this semi-unawareness! It’s so insidious. I am totally on the fence too about the A1c - do I come up a little so that I’m more hypo-aware and just live with a higher A1c? I don;t want to do that, as you said Tim - relenquishing a little control doesn’t appeal to me. Ug!
LADA here…..My honeymoon period was rather short. Was on insulin within 6 months. I developed this same problem with the hypo-unawareness. Talk about frustrating!! I too was told by my endo to shift my target slightly higher so the awareness would return. I still happens on occasion, but not as often. Recently got my insurance to approve my CGM, so I’m sure that helps me avoid the lows too.
I totally know where you’re coming from! My A1c has been below 6.5 for the better part of the past 15 years, and for almost all those years I’ve had what I’d like to call “partial hypo-unawareness”. Sometimes I feel a low coming on perfectly fine, but other times I don’t realize until I see a reading below 2.0 mmol/l (36 mg/dl). I’ve even had readings just saying “LO” a few times - and being able to see those results is plain scarry! I hope it doesn’t get that far for you