Signs of Hypoclycemia Unawareness?

Our 8-year old son was diagnosed on 5/13/09, and he has, up til this point, been pretty sensitive to lows.  I have been able to catch his drops before they get much under 80 because he displays symptoms, such as suddent intense hunger, edginess, dark circles under the eyes, and sitting on the floor wailing "I don't want to die".  Not too hard to miss for a mom who is in tune to her kids, or even for one who's not that in tune.

Well, we've been on vacation for the past several days, and William has had a couple of non-symptomatic lows.  Nothing severe, but tonight after a full day at an amusement park (during which I consistently under-dosed his meals) followed by 1/2 hour of swimming, he tested at 58 and barely registered a "yeah, I'm kinda hungry". 

So, I guess what I'm asking is, is this a sign that he will be someone who cannot tell when they are going low, or is this just because he's in a completely foreign environment and experiencing a different level of activity?  (I'm hoping for the latter)  I'll certainly be mentioning this at this next appointment (Oct 2nd), but would appreciating some ground-level input before that happens.  (P.S. We're on a practically new batch of test strips that I control-tested, which has also registered highs up to 328, so I'm pretty sure it's not the testing that's off).

So, any ideas, guys? 




I don't know if all of those lows happened while he was swimming, but I know that, for some reason, I can never tell I'm low when swimming. I have no idea why, but I just can't feel my lows when I'm swimming. I can usually feel them by the time I'm at 60 under normal circumstances, but I never do when I'm in the pool.

I almost always go low when I'm swimming, though, even if I'm not doing much in the pool. So I've learned to just test often when swimming, just in case I do go low.


Each time I have a low the symptoms are not always the same. In the case for your son, with vacation and all the fun he was having he may have just missed some of the more tell tale signs. Plus he was just very active and sometimes it takes a while for the symptoms to catch up for me. I have lost some of my more tell tale low feelings but some still exist. For your son right now I would write it off more as a vacation oriented low than anything else. If you start seeing this consistently than it might be a problem. Last week I was at mass serving and dropped and had yet realized that it had happened. We were at the sign of peace when my pastor came over to me and asked if I was okay. Apparently I suddenly just went as white as the alb I was wearing and my sensor had yet to catch the low and I was not paying complete attention to my own feelings as I was at mass.But the sheet white was a new symptom for me or at least a new one to be aware of since I was not aware of it.

Hi Mo

I am definitely one to be unaware of lows. Some of the hardest times for me are when I am really happy, excited, nervous, or scared. Sometimes it is hard for me to distinguish a low from whatever positive/negative excitement is going on at the time. It could be possible that your son is just really excited about being on  vacation and or nervous about being somewhere different.

I also agree with what Brian was saying about it sometimes takes a minute for symptoms to catch up to you. My husband will say that I am pale or that my skin feels electric, so I will check my sugar and sure enough I am low I just wasn't feeling it yet.

Mo - I am in the same boat as you as my 3 yr old son was diagnosed on 5/28/09.  I am beginning to wonder if testing after having hands submerged in water (eg. 'pruney' fingers) has any effect on BG readings. It is a hard one to figure out with swimming because then I anticipate that is a high calorie burning activity and so would cause a drop in BG. I have my pruney finger hypothesis because sometimes when we test right after a bath, he is low and then 15 min after treatment has gone pretty high - like was he really even low to begin with vs. a rebound. So it makes me wonder if the test comes out artificially low when the fingers are pruney? I could possibly imagine this to be the case, as your fingertips are one of the few areas of skin that swell with exposure to water and when the blood is coming out of the capillary it is then exposed to higher than normal amounts interstitial fluid and this could dilute it, causing the test to read low? (Do I even make sense?) I plan to ask about this at our appt coming up next week.

From my reading, and talking with a few other T1s that have had it for many years, they say there are times where they think they are low and end up being high or vice versa. So I would not tend to worry about 1 test, but only if it becomes a pattern.

Thanks, guys, for your responses.  It really helps to have input from the "pros".  We're just gonna go with it until we get home, and see how William does once we're back into our usual routine.  It's been a challenge keeping his numbers tight while on vacation, but we're managing, and he's having a great time, so it's worth a little extra stress :)


Brian makes sense. Not all lows are the same! And depending on where you are and what situations you're in it varies your signs and symptoms.

I've been at 45 and not known it before.

Welcome to my world. I wish that all people can avoid the hypoglycemia unawareness, it is not so much fun to one minute be sitting in class and the next minute be sitting in your room trying to figure out how you got there, how you lost two hours in the day, and if you talked or insulted anyone in that time period. Thank goodness for CGM's.

A quick update.  We're home (yay!) as of 10:00 pm tonight.  We've been really struggling with excessive highs the past two days, especially today with 11 hours of travel, and I'm REALLY looking forward to getting back into a "normal" routine ASAP, especially since William has an endo appt on 10/2 during which it will be determined whether or not he's ready for a pump (mama REALLY wants a pump after this vacation, and I think so does William after all of the "extra" doses required to control his spiking BS).   It'll probably take a few days for me to figure out whether or not William's insulin got too hot while we were travelling, or if he moved out of honeymoon phase, or if it was just the irratic activity that goofed up his BS.  BUT, we ALL had a GREAT vacation, so it's all worth it.

Quick side note.  Our home in Lawrenceville, GA suffered some water damage while we were away due to the extraordinarily heavy rains.  It's too late tonight to figure out exactly what needs to be done, but it's mostly confined to the basement, and our neighbors were VERY generous in trying to minimize the damage in our absence.  We've got a couple of very long days ahead to clean up and get everyone settle in (oh, yeah, and it's our eldest's birthday tomorrow). and our pets all seem to have picked up huge colonies of fleas during our absence, BUT we're HOME, and I'm sooooooo ready to sleep in my own bed :)



[quote user="Brian"]

Welcome to my world. I wish that all people can avoid the hypoglycemia unawareness, it is not so much fun to one minute be sitting in class and the next minute be sitting in your room trying to figure out how you got there, how you lost two hours in the day, and if you talked or insulted anyone in that time period. Thank goodness for CGM's.


I pass out a lot. At least once a week. I will be in the middle of a conversation, playing video games, cooking dinner and the next thing I know it is 2-4 hours later.

Welcome Home Mo! I hope that things get back to "normal" with your son's sugars soon. I am sorry to hear about the fleas and the water damage.


That really is not a great thing. Have you tried to pinpoint what causes these lows?

Yes I have. Half of the time it is because I have taken too much insulin and or under ate for a low The other half of the time I do not know what causes them. I have told both of my doctors and they basically said to keep a log of what goes on during the times I pass out. I just had another episode Saturday night. It was pretty scary and I am still a little light headed.

One of the reasons I am looking forward to getting the Ping is the smaller doses and it can give you a bolus over time, which my stone age insulin pump cannot do.

Lol, I hope you are able to work your way through this. The Ping is nice though, and there is no such thing as a Stone Age pump. They are all High Tech. Does your insurance cover CGMS or even the three day trial so you can pattern your sugars? My endocrinologist told me that most insurance companies even if they will not cover the CGM full time would once a year allow a CGM to track trends and such to help the patient. You may want to look into that.