What? Why? How?

[Lucie75]

Hi everyone,

I've been running my bg higher for the last 6 weeks or so with the aim of getting my hypo warnings back. A couple of weeks ago, after going back on my diet post Christmas, I started getting really obvious warnings when my bg went down to about 3.5mmol. I thought I'd cracked it and that the dsn did actually know what she was talking about. It hasn't lasted though, and although I'm still running on average at about 9mmol for most of the day, I've again had the odd reading of 2.2mmol or (shock horror) 1.6mmol with no warnings whatsoever. This is just in the last week or so. How can warnings come back with a vengence and then disappear again? I haven't changed anything, and don't want to be running higher than 9mmol if I can help it.

What's going on?

 

[Jen&Khaleb]

For me having a child that can't talk I would have to say that testing more often is a good way of avoiding hypos. Do you think you are having these hypos at a typical time? Khaleb's insulin overlaps a little about 10am and I am usually doing a test about 9.30am and making sure morning tea is on time. Are you testing and eating before driving a car or are you not driving because of the hypo unawareness? Have you been offered or asked for a CGM to see what is really going on? Maybe you think you are at 9 all the time but are still dropping to low levels at times. I met a man not long ago who was diagnosed as a child and lost all hypo awareness as an adult. He is now on an insulin pump and much happier. He described knowing he was hypo but another part of his brain was telling him he wasn't.

All the best

 

[SophiaW]

I don't have an answer to your question. My daughter became hypo unaware last year but we did as your nurse advised you to do and ran her levels a little high for a while and the awareness did return. She does occasionally still miss a hypo but that tends to be when she's heavily involved with something. I think she can be so involved with what she's doing that she becomes unaware of what's going on around her or how she's feeling. Have you noticed your hypos to occur during a time like this, perhaps you're distracted with other things and are missing the syptoms that you may otherwise notice when you're less busy? Although 1.6mmol is very low to get without noticing, I hope you can find a solution, it's no fun being hypo unaware.

 

[kegstore]

Unless you're testing every hour or so, or have access to CGM, there's no way of telling what your blood sugar is doing over a period of time. I have had zero hypo awareness for a while, but I still do very occasionally get a sensation that "something's wrong", then do a test to reveal a sub-4 reading. So no longer a reliable warning system sadly. I've also tried the "running high" method to see if that makes any difference, but nothing consistent unfortunately.

What I'm suggesting is the possibility of autonomic neuropathy. This can cause hypo unawareness (along with a few other unpleasant symptoms) and unfortunately there's not much you can do about it, other than stopping it get any worse by exercising really tight control. As with other complications, this tends to present in a longer-term diabetic who may not have had the best control over the years.

Have you thought about changing insulins? This can sometimes make a difference but again, no guarantee. I'm convinced my situation got markedly worse after changing to NovoRapid (with the pump), so I'm planning a swap over to Apidra in a few weeks to see if that helps.

 

[lilibet]

Hi

Agree with kegstore. Since changing insulin Ive been less aware and getting to the 2's (whilst driving :shock: ) without any real feeling though on other occasions getting to 4's can make me feel funny. To be honest though, its less that Im not aware and more like my symptoms now need re-interpreting. So what was shaky, jittery, woozy is now boiling hot, general feeling of 'something', hunger pangs, nausea. My clinic have been at great pains to tell me that since all my hba1c's have been in the 5's , barring diagnosis, that its inevitable. However, maybe a change back the way would help?

I feel quite strange across the day at various points (since dx in fact) which makes it harder cause sometimes you ignore it thinking its something else

Also, it depends on what you are doing (ie lying down its dead easy to miss), the speed of the drop and the reasons for it . Best way is to test at 'likely' points ie my novorapid hits hardest at 90 mins and I can tell at this point whether I'm going to be ok at the 4 hour point or whether I need to take a little something then. A pain, yes. Necessary, absolutely!

 

[DiabeticVeteran]

Hi,

I would go the advice of changing your insulin first.

I was on Human Insulin since 1991, used Lantus & Novorapid for the last 7 years & to my horror experiences over the last few years, I have found out that I had lost my awareness.
What screwed me up was that i never know that this symptom existed until it was too late!

From my previous posts, people have suggested raising your blood sugars & see if this helps in returning your awareness. You may have of already done this. There may be a high possiblity that you will have to change your insulin to Animal.
I have spoken to a lovely lady, Jenny from the IDDT & she has given some great advice for me.
Perhaps you could give her a ring & explain to her what you are going through.

I hope this helps,

Regards,

Steve :mrgreen:

 

[Lucie75]

Thanks all. Didn't consider for one minute that it might be the insulin. I have always blamed it on getting used to running low while pregnant, but come to think of it, that was when I switched insulins from actrapid to novorapid.

I have a review in Feb so I'll raise the question then.