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Hypoglycemic Unawareness? How do you identify it and how do you deal with it?

I was one of those who said..."I am so fortunate, I still FEEL my low blood sugars." Well, I decided to buy (read, out of pocket) a box of sensors to make sure what was happening, especially at night. Of course, wearing the sensor made me test, I have gotten a pretty good sense of what my blood sugars are doing round the clock. Little did I know...I am dropping into the 50's WITHOUT any indication that my blood sugar is low. I woke up this a.m. at 49mg/dl (per meter) and felt totally normal. I proceed to check w/ both of my meters...yes, I am low! I was scared to death...I think I have been sleeping through these! I was under the false impression that I still had dawn phenomenon! I do not..but, my pump settings were set for increase before rising. My dawn seems to be after I get up...through breakfast. I had this low AFTER reducing my 3 a.m. to breakfast basal rates! The diluted point I wanted to make, was that I wonder how many of us experience these types of lows, that never get noticed? How did you find out that you had hypoglycemic unawareness (HU)? What do you do to identify when you are having one? When did your doctor identify that you had it?

Tags: CGMS, hypoglycemia, unawareness

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My doc realized how bad my hypo unawareness was when I started testing 10-12 times a day, including waking up every AM at 3 or 4 to test. I knew I had a problem when I started testing 6 times a day which is why I started testing more. My doc wanted me on a CGMS right away so I got on the DexCom and now I know what times of the day and the month I am more prone to lows. I also am figuring out what foods set me up for lows later so I can improve my eating. I still don't feel my lows at all but the Dex catches them if I don't.
You know what is terrible...I tested that much too, and never caught these! With the CGMS trial I found myself checking almost hourly:) and that is when I caught them. Still learning how to use the MM CGMS, but hopeful it will alert me to them. I have heard great things about the Dex and hope to try it soon. I currently have such limited insurance coverage, that it is all out of pocket. I am sure if I had better coverage I would have been started much earlier. Again...thanks for sharing your experiences Suzanne:)
I am aware of lows during the day but I sleep through them. I must have slept through thousands of them. I remember the many nights when I woke up drenched in sweat. Eventually I figured out that my bg was too high in the morning because I used too much insulin at night, not too little. These days my DexCom wakes me up when I am low at night. This is annoying because I know that nothing bad will happen if I sleep through it. There is no way to switch off the 55 alarm. The upside of treating the low is that my liver does not go into glucose overdrive which would give me an early morning high. I am planning to switch from shots to pump to improve my bg control.
Using the MM system...I have not always noticed the alarm in the middle of the night. What is the DexCom like? Have you ever slept through it? I also made the mistake of setting the alarm threshold (mg/dl) too high. Fist night it went off constantly! I would think a loud alarm for night may be a good option so, we can set the alarm threshold at a reasonable number to catch dropping blood sugars vs. just "excellent" blood sugars...hoping Dex or Nav are addressing this. Thanks Helmut, for sharing your experiences.
A Type 1 for 64 years I am acutely aware of my hypoglycemia unawareness, and have had far too many visits to my home by the ambulance and trips to the ER. The Dexcom Seven Plus has been an enormous help to me. It wakes me up if I dip too low, and the software that comes with it lets me analyze exactly what I need to do to avoid the overnight lows. The error rate of +/- 20 percent of today's glucometers is way to high for anyone trying to keep a tight control.
64 years:) I hope to follow in your steps. Sounds like I need to try the Dex!
What is the Dex? It sound like I desparetly need to have it. I sometimes have the urge to test when I get home from diving. O.K. why am I not feeling it when I'm a 49 and driving. This has happened more than once. I experience unawarence often and hope when I get on the pump I'll have less lows. Been a Type 1 for 33 years and unfortunately I have limited insurance.
Dex is a Continuous Glucose Monitor made by DexCom.
The 7+ vibrates first and most of the time I wake up from that. If I don't press a button to acknowledge the alarm the 7+ will beep after 5 minutes. There is no way that I don't wake up from this beep. This is what the 7+ user's guide has to say:

The Receiver also has an automatic Low Glucose ALARM set at 55 mg/dL. This ALARM is a feature in addition to your personal glucose alerts. You cannot change or turn off this ALARM or its re-Alert settings.
• When your SEVEN PLUS glucose reading is at or below 55mg/dL the Receiver will notify you with 4 low beeps and vibration in this order:
- 1st 5-minute ALARM: “Vibrate”
- 2nd 5-minute ALARM: “Vibrate” “Beep” “Beep” “Beep” “Beep”
- 3rd 5-minute ALARM: “Vibrate” “Beep” “Beep” “Beep” “Beep” (louder)
• The Receiver will vibrate and beep every 5 minutes after the 3rd ALARM if your readings are still at or below 55 mg/dL until you press the C button.
wow! that would work:) Thanks for the specifics...always appreciate your help:)
Good point:)
Actually, this is (pardon my language) complete bull$#!t ... avoiding lows does not restore lost counterregulatory function, although it may work for some people, there is little scientific evidence that it works for all patients.




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