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<blockquote data-quote="EllieM" data-source="post: 2404418" data-attributes="member: 372717"><p>The problem with having too many hypos is that just as people who maintain high blood sugars for a while can get used to them and get false hypos at normal levels, if you maintain low bgs for too long and have too many hypos, you can start to lose hypo awareness. And loss of hypo awareness for a person on insulin is a big big deal. </p><p></p><p>Anecdotally, it seems that loss of hypo awareness is more of an issue for long term T1s (and some T3cs who may have their glucagon production reduced : glucagon is produced by the pancreas to tell the liver to pump out sugar), but it can happen to anyone. The problem with going too low is that you judgement goes, and it can seem like too much effort to get up and take some sugar (particularly at night), so you really need to treat a hypo before your judgement is compromised, and for that you need hypo awareness.</p><p></p><p>The reason that some DNs take issue with T1s with hba1cs in the 5s is that those levels are often accompanied by lots of hypos (it's a measure of average glucose, so you can compensate for the highs with lows). I've lost hypo awareness 3 times : all when I was keeping my bgs relatively low and I had too many hypo. I literally had to have a friend over to watch me with my toddler when I was pregnant with my second child, because I couldn't trust my hypo awareness. Luckily I could get it back (my current endo recommended a bg of 6-12 for a couple of months) but life without hypo awareness can be terrifying.</p><p></p><p>The good news is that as cgms become more available it becomes easier to avoid hypos and also to maintain hypo awareness so I am lucky enough to be able to self fund a dexcom.</p><p></p><p>Anyway, I don't want to discourage you, you sound like you are doing really well with your control.</p></blockquote><p></p>
[QUOTE="EllieM, post: 2404418, member: 372717"] The problem with having too many hypos is that just as people who maintain high blood sugars for a while can get used to them and get false hypos at normal levels, if you maintain low bgs for too long and have too many hypos, you can start to lose hypo awareness. And loss of hypo awareness for a person on insulin is a big big deal. Anecdotally, it seems that loss of hypo awareness is more of an issue for long term T1s (and some T3cs who may have their glucagon production reduced : glucagon is produced by the pancreas to tell the liver to pump out sugar), but it can happen to anyone. The problem with going too low is that you judgement goes, and it can seem like too much effort to get up and take some sugar (particularly at night), so you really need to treat a hypo before your judgement is compromised, and for that you need hypo awareness. The reason that some DNs take issue with T1s with hba1cs in the 5s is that those levels are often accompanied by lots of hypos (it's a measure of average glucose, so you can compensate for the highs with lows). I've lost hypo awareness 3 times : all when I was keeping my bgs relatively low and I had too many hypo. I literally had to have a friend over to watch me with my toddler when I was pregnant with my second child, because I couldn't trust my hypo awareness. Luckily I could get it back (my current endo recommended a bg of 6-12 for a couple of months) but life without hypo awareness can be terrifying. The good news is that as cgms become more available it becomes easier to avoid hypos and also to maintain hypo awareness so I am lucky enough to be able to self fund a dexcom. Anyway, I don't want to discourage you, you sound like you are doing really well with your control. [/QUOTE]
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