Has anybody ever had loss of hypo awareness?

[thewestiesmum]

And what did you do about it?

I've been Type 1 for 30 odd years and in the last several months have lost a lot of my hypo awareness.

On Wednesday I decided to change my target range from 5-8mmol to 6-10mmol.
Is this an ok thing to do and how long would you leave it until I change it back again?

Also if my BG level drops to 5 ish I have half a dextrose tablet then a quarter of a rich tea biscuit just to put me back hopefully to 6 again.

 

[Deleted member 527103]

Increasing target range is the way to improve hypo awareness. It may take a number of weeks to get awareness back, depending how long you have had no hypo awareness.

 

[ert]

I lost my hypo awareness the first time I travelled back to Australia due to the hot climate. I hypoed every day until I managed to cut my basal back enough. My hypo awareness took a couple of weeks to return. It returned after I kept my blood sugars above 4 mmol/l for a couple of weeks.

 

[EllieM]

I lost hypo awareness during T1 pregnancies (too many hypos from keeping my bgs too low) and a few years ago when over enthusiastic avoidance of highs (detected with a cgm) meant that I had too many hypos. (See a trend here? ). The loss wasn't complete but after the more recent one (trip to A&E after I collapsed at a shopping centre) my consultant told me to aim to keep my bgs between 6-12 mmol/L till awareness returned, which it did (took a few weeks as I remember).

My personal takeaway from this is that an hba1c below 50ish is unsustainable for me without a cgm. Now I self fund a dexcom (alarm set at 4.4) I'm a lot more relaxed, and I do have hypo awareness at 4ish.

But honestly, for me anyway, it's the hypos that cause it. Having a cgm makes a massive difference to my ability to maintain hypo awareness, though I must admit that the symptoms (particularly in the high 3s) aren't nearly as strong as they were twenty, thirty, forty or fifty years ago.

 

[EllieM]

Is this an ok thing to do and how long would you leave it until I change it back again?

My consultant didn't actually tell me when to change my target range back down from 6-12, I just did it on my own after I'd regained awareness (and then I had a cgm to back up my levels and my hypo awareness). I think she was a lot more worried about the loss of hypo awareness than possible long term complications from running my bgs a little higher.

Good luck. I personally find hypos the worst thing about T1, and I love my cgm and its hypo warnings. (Even though I can't count on it 100%, particularly during a hypo, it allows me to avoid a huge number of hypos that would otherwise erode away my hypo awareness.)

And, as always, we are all slightly different, this is just my personal experience, not medical advice.

 

[JMK1954]

A matter of two or three weeks might be enough to restore your hypo awareness, but depending on how low and how frequent your hypos have been recently, it could take longer than this. My advice would be to aim at dropping no lower than 8 mml at all costs. It can be tricky to avoid hypos consistently over several weeks.

 

[Antje77]

And what did you do about it?

I've been Type 1 for 30 odd years and in the last several months have lost a lot of my hypo awareness.

On Wednesday I decided to change my target range from 5-8mmol to 6-10mmol.
Is this an ok thing to do and how long would you leave it until I change it back again?

Also if my BG level drops to 5 ish I have half a dextrose tablet then a quarter of a rich tea biscuit just to put me back hopefully to 6 again.

How low do you go before noticing? And is this on a fingerprick or on a gluclose sensor?
For some of us, glucose sensors tend to read lower than blood, so always worth double checking with a finger prick.

 

[himtoo]

I had a really bad hypo quite a few years ago (unconscious for 2.5 hours ) and my endo signed me off work for 8 weeks and reduced my insulin by approx 25% and gave me a target of 8 to 12 mmols ....... this did the trick for me

 

[EllieM]

For some of us, glucose sensors tend to read lower than blood, so always worth double checking with a finger prick.

Indeed, I had a rare sensor malfunction a few months ago and was surprised that my bg kept going low all evening, despite the quantity of carbs I was knocking back. When I eventually double checked I was in the high teens and it took me all night to get my levels back into order.

I also find that if I go below 4 I have to use a glucometer to tell when my bg stops dropping, as the lag is sufficient to make me panic and have more sugar (a little goes a long way for me) if I rely on the sensor.