I understand this now… Eric, a couple of months ago you told me to try to think about what my blood sugar was before testing or looking at a CGM. A couple of days later I reported back to you that I had been “guessing at my BG” with mixed success. You corrected me by saying you had never meant for me to guess but for me to use context, knowledge, experience, etc. to try to see if I could figure out where I was. I’ve been thinking that way since. It’s not that I always know the difference between an 80 and 110, but sometimes I do, and even when I don’t, I still know I’m not a 200– or even a 150. If I’m not thinking about it throughout the day, then it’s absolutely a guess, but I’m thinking about it. I also use the CGM to an extent, but it’s for a vague bigger picture. I know when it’s wrong, and it’s “wrong” quite often. Between finger sticks, CGM, and my own understanding, I’ve got a great team.
@T1Allison My Endo had me do an experiment last summer based on some research she had been following on hypo-unawareness. The research purported that the triggers or signs for a hypo while individual for everyone could be partially “re-calibrated” . The theory was based on what many of us have gone through when we run much higher numbers for a time period, followed by in-range bgs . The in range bgs “feel” like a low even though aren’t because your body is basing the feedback on the range and not the actual bg.
The test she had me run last summer was:
2-3 weeks of +200 bg (continuous, with no bg below 200)
followed by 2 weeks of 85-140 bgs with no bg over 160.
The last 2 weeks were insanely hard as we were vacationing back home in the South (think grits, Boudin, johnnycake, sweet tea, etc…) After a minor struggle to get to the lower threshhold the end result is that I do now have some hypo triggers that have long been absent.
So to answer your original question, yes I think the hypo triggers can be “reset”, but that it also requires that our awareness of the trigger also gets “reset”. While the trigger (sweating, confusion, etc. ) may work again to a limited or full degree, can we still recognize it as such and utilize it as actionable information?
I could be totally wrong about this…but after having a better run lately with time in range, and getting super reconnected to what my blood sugar is doing and why, and feeling like I know the significance of each trend change or fingerstick value like I used to before I got so disconnected from my own bg awareness…here’s my current theory for my body and brain:
When I know what my blood sugar is doing and why, and I know I’ll see a dip here and that it will correct itself or at least it will level soon or I have a pretty good idea of how many carbs I’ll need and how long it will take to correct the situation, and I feel in control of the situation, I can feel my low symptoms in the upper 60’s. That’s when the front of my brain feels itchy.
When I am out of sync in my day and things just aren’t quite working out and I don’t really know why my blood sugar is dropping or how intense the drop will be, and my Dexcom and my meter aren’t matching great and I don’t know if it’s lag or poor performance, that’s when my mental “unsettledness” takes over and crowds out the physical symptoms. Essentially, if I don’t feel in control of a situation, those thoughts/feelings/etc take over and I can’t feel my low symptoms even if they are probably there.
Just thought this was interesting. I’ve seen it enough times in myself in the last several weeks that I feel fine reporting it.
I don’t think I’ve ever seen that verbalized before, but it makes complete sense. Myself, I haven’t thought about it in terms of thoughts/feelings crowding out physical symptoms – that’s interesting. The way I think of it, when I’m sailing along in smooth water, I can be attuned to the tiny shift in wind, the tiny increase in wave strength or direction, that I wouldn’t notice at all in rougher, windier conditions. (Talk about a botched metaphor! LOL) Regardless how we see it, isn’t it a great feeling?
Love this. Makes total sense putting it that way!!
This bothers me. I keep reading it and wanting to know how an endo could suggest someone purposefully run over 200 like that.
@Eric I had read a study that suggested a similar approach prior to my Endo suggesting it. I gained some (limited) sense of high/low after, but don’t know that I would ever use such an unorthodox approach again. My fight for a lower A1c just doesn’t support such high bgs anymore. However, prior to a cgm and pump, I lived in the 180+ all day /every day club. I was desperately afraid of a serious hypo event and did everything possible to never go south of 150 - ever.
It just seems to fly in the face of the primum non nocere - “first, do no harm” thing.
Also want to mention - this is not a judgment on anyone who struggles with their BG and has a hard time with it, or has extended periods of high BG. I understand there are struggles with it.
My comment is just that I am shocked an endo would advise someone to do that for 2 weeks on purpose. That’s what I think is crazy.
Some research studies suggest that avoiding lows (less than 55) for several weeks helps restore hypo awareness. In my mind, that means running a little higher than usual…which makes a lot more sense than deliberately staging extended high BGs.
@Eric I’m not offended - I see your point, and on some level i definitely agree with you. Nature is sort of weird sometimes though. My Endo is at times “progressive”, especially when i am super engaged. I get a lot of leeway, probably more than I am due from my Endo, as long as I am focused. As an aside, given where my BGs where less than 2 years prior, +200 isn’t too bad and I enjoyed the break. The break came at a time we were travelling and I got to eat like a gluco-normal with all my favorite down home foods which I would never even look twice at if I was trying to control my bgs.