For many years I managed my diabetes by over-infusing insulin. Hyperglycemia was my main focus. I knew, of course, about the dangers of hypoglycemia but I became proficient at catching my lows before they turned into real world trouble. I did have some close calls and one time ended up in the ER due to taking short acting instead of long acting insulin at bedtime.
I also remember, during the pre-CGM days, sticking my finger and seeing BGs in the 40’s and 30’s yet I felt cognitively aware and acting socially appropriate. I even could carry on conversations about technical matters. I had become hypoglycemia unaware, a condition medically know as Hypoglycemia-Associated Autonomic Failure or HAAF.
I was aware of my unawareness but I considered it the cost of my “more normal” blood sugar levels. I discovered, however, that my normal behavior in the face of lows was not 100% dependable. Since I had subdued my body’s natural response to hypoglycemia, I was left with no bright line that could warn me of coming incapacity. I suffered a few severe hypoglycemia incidents where I slipped from acting apparently “normal” into a walking unconscious state before I passed out. During this walking unconscious state I lost any awareness of my diabetes and that I needed immediate hypo-treatment. Unfortunately I ended up in an incident that could have killed someone, but did not.
I was responsible, to some extant, for this. That realization shook me to the core. I thought I could handle whatever hypoglycemia threw at me. And I could, 99.9% of the time! But dealing with six, seven, or eight hypo incidents every day meant, it was only a matter of time before I stumbled into the 0.1% circumstance that I could not handle. I had to accept the fact that I was culpable for that small fraction of the time where I could not only hurt myself but I could also injure or even kill someone else.
I finally figured out that better control could only safely come if I reduced BG variability first. Low carb eating while using and paying attention to a CGM proved to be the ticket for me – that and daily exercise.
What I’m trying to say is that suppressing the body’s natural alert system for hypoglycemia can be dangerous. I do not recommend it to anyone. For me, I now get reliable low blood glucose signals of a faster heart rate and sweating when I reach 65 mg/dL. Even though I wear a CGM sensor and live with a hypo-alert dog, restoring my body’s natural low BG alert makes me feel safer.