A tale of 2 hypos

Sorry. This is long.

I guess the only thing I can say, as background to all of this is htat I am no novice. I’ve had T1 for 40 years and been in really great control for the last 19. I’ve been high, and I’ve been low. I know the drill. So I am travelling for work and in another country, not too far, just Canada, I am still out of my element and in a hotel that is a smidge more unfamiliar than Hilton.

Oh yeah one other bit of background: recently I have started working out. I am sick of feeling blah, and weak, and so I have been working out. I lift 1 to 2 times a week and run 5k 1 or 2 times a week. After the 2nd week I have had to reduce basal, first in the overnight and then in the afternoon. I have halved my bolus for breakfast and I am eating fruits (1 serving +/-) at each meal. My blood sugar has been great… if not a little low. So I’ve been gradually reducing my use of insulin. Sounds great, yea?

So here’s what happened. I traveled in the morning and was under a bit of pressure all day. The team parted in the lobby and agreed to meet in the bar in 30 minutes. I did my usual: cleaned up and FaceTime’d my son. All was good at home. Somehow, a brutal low came on very fast. No adrenaline reaction, no tingle in my lips, just sweat…everywhere and (here’s the good part) a complete loss of cognitive abilities. In a moment, I lost most of the information in my head and ability to solve any kind of problem.

To say I lost my s**t is an understatement. I was so confused, I couldn’t tell you what I was doing, what I was supposed to do next, why I was in this strange room, why I wasn’t home, who I was supposed to talk to or why. I remember getting angry, and saying out loud, over and over again “What is your mission”? as if this was a scene from a superhero movie. It wasn’t helping. Nothing was helping. I thought if I emptied my backpack I might find something useful. I started feeling anxious. I dumped out my backpack and was looking for some clue as to why I was here in this place. I was staring at each item, I didn’t recognize many items. What I did eventually find was my emergency backup “Milky Way” bar, partially mummified because it was in there for maybe 4 months. I didn’t stare at it, I just remember eating it. I sat in a chair and wondered what might happen next.

Of course, 15 minutes later, I was fine. I was up in my room for an hour and a half. My work buddy asked what happened… I said I was “tired”. Shaken up a little… It took me 24 hours to feel 100%.

Fast forward to last weekend. Playing cards with my brothers at my little nephew’s 11th birthday part, we were having a pretty good time. I skipped lunch but typically my basal settings would allow me to skip 3 meals and nothing happens. Same kind of low… fast onset, no symptoms except I couldn’t add card values. My brothers made my use my meter and I know I did, but I don’t remember doing it. 35 mg/dl. Totally confused… one brother put a glass of juice in front of me and without saying a word I drank it and sat there in a fog for about 15 minutes till my head cleared.

I guess a Dex is in my immediate future. It’d be OK if it were like the thousands of lows I’ve had before, but these lows have not been. Putting it out there because, like we all already know, just when you think you’ve got this figured out, T1 throws some new rules your way.

-Joe

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Been there, done that. I’d hit the 30s and completely zone out. Fortunately there’s always been someone nearby that knew what to do (i.e., get me some OJ). That’s the main reason my wife pushed me to get the Dexcom CGM to help catch any hypos before they happen. I’m only on month 3 of the Dexcom, but so far have easily been able to avoid any severe low blood glucose reactions. My wife and my daughter have the Dexcom Companion app so they can also track my BG levels at any time.

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This sounds like you’ve developed HypoGlycemia Unawareness (aka HGU). That happens when your body no longer notices the dropping levels so it (used to) give you symptoms to warn you to take care while you still could.

The only real answer that I’ve heard of is to get a CGM as soon as possible. That gives you a different way to get effective warnings, and sooner each time.

Long term I understand that a few people have regain hypoglycemia awareness through careful control, but it sounds like you were already doing that. Get a CGM and see if that lets you regain it sometime.

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Thanks @tedquick and thanks @Jonalan0323 John. Yes. CGM. I suppose it’s dumb luck that my MM warranty is up AND they quoted an obscene deductible. Thinking of going the way of many and getting the Tslim and DEX.

Wish me luck I am getting in an airplane to Ireland in an hour. I’ll just test more for now.

Welcome @Joe to TypeOneNation Forum; I hope you find here suggestions from folks who “have been there too”… :slight_smile:

I fully agree with @tedquick suggestion that a Dexcon CGM should be in your future 0 and sooner rather than later if you are experiencing hypo-unawareness. I’ve found that my G5 has alerted me in plenty of time so I can take preventive action thus saving EMS another trip.
As a side benefit, the DEX has helped to greatly increase my TIR (time-in-range); my Dexcom will not connect to my t-Slim for another 6 weeks when I upgrade, but I manually suspend basal and keep myself safe. Hopefully no more EMS readings of less than 10 mg/dl. Like @Jonalan0323, my wife has been feeling better since I’ve continuously used my CGM.

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I’m really sorry, @joe. That all must’ve been really frightening. Thank you for sharing.

I had an episode like that when I was in college, about 12 years ago. I woke up to my alarm clock like normal but my blood sugar was already low. I remember knowing something was wrong but not being able to figure out what. I left my apartment in my pj’s looking for the bathroom, then turned back when I couldn’t find it only to discover that I hadn’t brought my keys with me. Eventually one of my roommates woke up and let me back in. Sometime after that I noticed some chocolate in my bedroom and decided to eat it. I came to after that. It was just dumb luck that saved me. I don’t remember how low I was or how much time had passed.

One of my friends had seen me wandering the halls, so when I saw her in class later that afternoon I told her and another friend what had happened. They were really nice about it and told me that I could come to their apartments if that ever happened again. I didn’t know what to say. I wouldn’t be in the right frame of mind to think of asking for help, assuming I remembered I had friends in the building at all.

Nothing like that has happened since, but I worry about it all the time, especially since I live alone.
Normally I wake up drenched in sweat and feeling nauseous, but one day I won’t.

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One explanation for your sudden lows could be the newly introduced exercise. Exercise can effect your blood sugar for hours afterward. I’m talking 24 hours and even more for some people. Once your body gets used to the new routine you will know what it needs in order to workout for longer or shorter periods of time. It is definitely tricky to figure out. I totally agree that a Dexcom should be in your future. It makes it so much easier to catch those annoying lows when working out or any other time. I’m sure you already know all this, since you are not new to diabetes but sometimes we need reminders :smile:

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Hi @joe. While you’re waiting on approvals for your Dexcom you might try out the Freestyle Libre. Unfortunately it does not have alerts, and you do have to swipe to get your readings (it stores a few hours worth that you can see when you swipe) but I’ve found it more convenient than fingersticks on those occasions when I had an issue getting Dexcom supplies. Those issues have been very rare for me, by the way. An rX and training is required but it might be a quicker solution fur the short term.

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@wadawabbit thank you Dorie yes that’s also an option.

I agree. My sugar is more unpredictable because I have to find my new basal and ratios. I got into trouble because of a low due to too much basal AND because I didn’t sense it, oh and didn’t test. Bad triple play.

I have the same issues these days, Joe. I have been a type one for 59 years and for the past 10-15 years have hypoglycemic unawareness. My Freestyle Libre has been my lifesaver. BTW, at first I didn’t have insurance coverage for it and paid privately, approximately $200 a month. It was worth it. Now, it is covered as Durable Medical Equipment and costs me nothing out of pocket. Good luck getting things under control.

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Thank you @Ritabw Rita and welcome to TypeOneNation.

Hi Joe
Stress also can cause you to have either highs or lows. Sometimes with the right combination it can indeed be awful. I have been type 1 for the last 43 years and one of the worst hypoglycemic incidents I’ve had happened when I was having a rough day and running around more than usual at work. I remember walking out of my office then I remember getting in my car screaming because I wasn’t understanding anything for a few minutes. I actually drove erratically for a few miles (in rush hour traffic) before going off road and rolling my car over. I was so lucky that I didn’t hurt anyone and all I got were some bruises and poison ivy. (they actually dragged me out through poison ivy) Since then I carry sugar pills and snacks and if i feel at all odd i have some. good luck!

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Thanks @MikeW that’s a scary one and I’m sorry that happened to you but glad you were ok

@Joe Going very low (30’s) is horrifying, to say the least. While I’ve only been dealing with this chaos called T1d for 13 years (I’m LADA) I’ve ‘bottomed’ twice. They are life changers.

I think you’ve done the right/best thing with getting a CGM, but just a hint… they are just a fail safe. Take all other precautions also, make basal adjustments for exercise, keep sugar tabs readily available. Best of luck!!

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Thank you Jan. I agree and have been doing this long enough to know about the accuracy and reliability of CGM. I have owned 2 generations of Guardian (Medtronic version).

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Joe, been there too many times that is why I went to the Dexcom CGM, it has alarms, thank goodness. After 66 years I no longer can sense highs and lows, got to 23 the other night, not good. Hopefully my CGM will be here next week, had to give it up before due to Insurance coverage or non coverage, but I’m getting it back, for me it’s been a life saver and is much better than checking my BS every 2 hours from midnight to 6 am. Have a great day and enjoy your Dexcom. Bye Jan

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