I'm 19 years into living with type 1 and up until this year have had consistent hypo symptoms. Sweat, thundering heart beat, confusion, tingling. I have got those symptoms at around 3.7 mostly. My hba1c has been between 42 at best and 80 at worst during that time. In the last 2 months my hypo signs have changed. Now at the same level I just find organisation difficult and am a bit chaotic but am not confused. My vision is also affected, I feel like i also have a screen separating me from what I see in front of me although technically I can still see fine. ive wondered if this is a sign of decreased hypo awareness. Does anyone recognise these changes as that? I started using a libre blood monitor a few months ago which is the only change I can think of. Since then I've had a lot more hypos but my bloods also consistently not going high as often or for as long. Thoughts?
Hypo symptom change
- Thread starter scaryblueberry
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kitedoc
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Hi @scaryblueberry, Going on my experience as a diabetic on insulin for 52 years (beginning of October 1966), not as professional advice or opinion.
As I understand it and experienced it, the usual early signs such as you described of sweating, rapid heart beat, and maybe shakes (caused by adrenaline) are the first signs of a hypo which are lessened or absent once hypo unawareness is happening.
Then the first signs noted are instead those affecting brain function such as the confusion, more pronounced tingling and sometimes a part of the body (lips, one side of the face, or a one arm or leg feel distorted/swollen out of proportion with the rest of the body and numb like after a local anaesthetic at the dentist. Vision goes fuzzy or like the window in front, garbled speech, recurring actions, stumbling etc. So your observations seem to fit that pattern.
Please check with your doctor or DN though to be sure.
My hypo awareness improved somewhat once I switched for MDI to an insulin pump at the 45 years on insulin mark. Maybe the change you note now is a left-over effect of less good control earlier.
But hopefully better BSLs now will lead to a return of your hypo awareness in full or in part after sometime ? weeks ? months??
Even so I make sure my BSL is 5 mmol/l or more before I start to drive and check in 2 hours or sooner if I don't feel right.
I hope your situation improves quickly but please stay vigilant for whatever is your first sign of warning.
For me, slight sweats and tremour and an isolated numbness just in my left front thigh!! Who said we are all the same ???
As I understand it and experienced it, the usual early signs such as you described of sweating, rapid heart beat, and maybe shakes (caused by adrenaline) are the first signs of a hypo which are lessened or absent once hypo unawareness is happening.
Then the first signs noted are instead those affecting brain function such as the confusion, more pronounced tingling and sometimes a part of the body (lips, one side of the face, or a one arm or leg feel distorted/swollen out of proportion with the rest of the body and numb like after a local anaesthetic at the dentist. Vision goes fuzzy or like the window in front, garbled speech, recurring actions, stumbling etc. So your observations seem to fit that pattern.
Please check with your doctor or DN though to be sure.
My hypo awareness improved somewhat once I switched for MDI to an insulin pump at the 45 years on insulin mark. Maybe the change you note now is a left-over effect of less good control earlier.
But hopefully better BSLs now will lead to a return of your hypo awareness in full or in part after sometime ? weeks ? months??
Even so I make sure my BSL is 5 mmol/l or more before I start to drive and check in 2 hours or sooner if I don't feel right.
I hope your situation improves quickly but please stay vigilant for whatever is your first sign of warning.
For me, slight sweats and tremour and an isolated numbness just in my left front thigh!! Who said we are all the same ???
kitedoc
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Hi @tim2000s, I would argue that loss of awareness or lack of presence of early symptoms means that potentially more disabling symptoms appear first. A change in hypo symptoms whatever the reason has the potential to affect timing of to recognition and treatment.
I would define hypo awareness as being able to recognise hypo symptoms in time to have the ability to do something about them and prevent/avert harm with a margin of safety build in.
Awareness is a continuum, which on the description given by @scaryblueberry , sounds like a shift towards a different awareness, one which is closer to potentially harmful situations. So I would call that a shift in awareness a loss of early, non-debilitating symptoms, and an increase in potential difficulty, particularly if driving oneself, swimming, crossing the road, using power tools, a sewing machine or being up a ladder etc.
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@kitedoc - the OP mentioned that they were seeing different symptoms at the same glucose level, which doesn't constitute loss of hypo awareness.
Equally though, having more hypos may lead to loss of awareness, especially if they are particularly low (loss of awareness is linked to levels below 3.0 mmol/l).
Equally though, having more hypos may lead to loss of awareness, especially if they are particularly low (loss of awareness is linked to levels below 3.0 mmol/l).
Thanks all. I'll look up more info on loss of awareness being linked to levels below 3.0 mmol/l and keep a better diary of when I'm having these different hypo symptoms. Thanks for pointing out that the first signs of a hypo are lessened or absent once hypo unawareness is happening. This does fit what I'm experiencing and probably due to the more frequent hypos I'm having. I guess its just the same old boring enigma to get blood sugar better under control. The freestyle libre has helped me reduce my HBA1C but it hasn't helped me predict bloods so I'm still chasing them and its still often not in the range id like. My insulin requirements and reaction to foods are different every day which makes matching insulin to food a nightmare. My only thought left that i haven't tried is to try and regulate hormones so i can predict insulin requirements better. Has anyone got any experience on this? Any other thoughts? I appreciate the time you've all taken to reply. C
There's a couple of books I found useful when I first started out with libre a couple of years ago, both on kindle:
Sugar Surfing by Stephen Ponder
Beyond Fingersticks by William Lee Dubois
In the first few weeks with libre, I was just really using it to watch out for hypos coming, but I was still making mistakes like, hypo coming, so I'd then head it off by eating way too much and, oops, end up hyper instead.
So, over time, I started paying a lot more attention to how little I needed just to level out the dropping arrow - sometimes just one dextrotab or a small biscuit. So, I'd not go hypo and not go hyper either.
Then there was things like realising I needed a 2u pin as soon as I got up to avoid a rise even without breakfast.
Then experimenting with pre-bolus timing.
And not being shy of doing a 1 or 2 u correction if it looked like I was starting to head towards 7 or 8.
Sugar Surfing goes into all that sort of stuff in detail. It means paying a fair bit of attention to what libre is saying, but I've found it time well spent as it makes it easier to keep in range instead of all the grief of sorting out a major hypo/hyper.
