Hi Dani @dani1977 and welcome to TypeOneNation and welcome to “the club” of losing hypo awareness as your years with diabetes and insulin use take on long duration - I’ve been living with my diabetes for 60 years.
I’m NOT a medical doctor but I can offer you some insights for your diabetes management based on my experience and from what I’ve learned over the years. Like you, I’ve blacked out a couple of times where I needed assistance from EMS to wake up - but not until the last 5 years.
You haven’t said how you manage your diabetes, but I gather from what you have written here and on your other posts, I’m assuming that you are using a lon-acting background insulin supplemented with fast or rapid acting insulin for meals and corrections and that you monitor your glucose levels by using a meter; do I have that correct? One observation I’ve made that unlike with the older forms of insulin [from pigs and cows] the awareness of a dropping blood sugar is less apparent with the lispro and aspart insulin formulations [Humalog and Novolog].
When you mentioned in another post that you are now trying to manage your diabetes more aggressively [a really good move on your part] I immediately suspected that you might be “stacking” your fast-insulin - and this might also be piling up in you at times when your background insulin is at one of its peaks. Just a hunch. Another of my observations with myself, the “rapid-acting” insulins I’ve used do not affect me as quickly as they previously did; I switched to Humalog in 1996 the month it was approved by FDA and it began acting in me within 5 or 10 minutes and it was out of my body within three hours - now it stays acting in me for six hours and really doesn’t begin lowering my BG for at least an hour. I changed to Novolog in 2005 and that acted faster than Humalog for a while and beginning two years ago I’m back on Humalog.
I use a pump in which I have nine basal [background] rates of flow programmed in my “standard” pattern - the validity of which I periodically check by long term fasting, checking BG frequently, to make certain that I stay “in range” without needing to eat for lows or correct for highs. You said a pump is in the works for you - you may be able to speed up approvals with a little of this information.
Sorry that my response was so long - we can talk more if you’d like.