I had some wicked bad hypos in the early days as a kid growing growing up on Lente and/or NPH and Reg. Some of them left me unable to speak for 8-12 hours following. Don’t know how many billions of brain cells I destroyed back then …
I don’t think that’s true for everyone. I think in studies they’ve shown you can regain hypo awareness after 2 weeks of avoiding lows – but my guess is that’s not true for everyone.
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So sorry that happened. 
. I’m so thankful, as a parent, that technology exists today to help prevent these kinds of horrible scenarios. I don’t know what I would have done back in your childhood days, had I been your parent and not knowing what’s going on or how to help.
So much respect to the parents and kids… hell any Diabetic…Who have lived through the medieval days off diabetes and are still here to talk about it.
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Based on personal experience, I think hypo unawareness develops very gradually and over many years, I’d say I was probably around 8-10 years in when I noticed some changes in my usual low-symptoms, and then it took another 5-10 years to get to the point when I was occasionally unable to tell I was low. But, my early years were in dark ages, with lots of lows (and lots of highs), I honestly have no idea how I survived that unscathed. With increasingly better control over the past decade, I largely regained hypo awareness, but the symptoms remain relatively subtle, not even close to early-day shaking, sweating etc.
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I think there was a thread earlier where most people on here who have long-standing diabetes said they never fully regained the full shaking/sweating/super-noticeable type of hypo awareness. They could feel their lows but it wasn’t hitting them in the face, they had to pay attention to it.
It will be interesting to see if, with a new generation of kids who could conceivably have relatively few lows, if this will still occur. It’s not clear that all of this is down to overusing the hypo- physiological response. It’s possible some of the cells involved in triggering this response get sort of disconnected or atrophied over time, maybe…
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Or at least the kinds of lows referenced here where the lows resulted in some kind of major event occurring like losing speech, sight, hospitalization, blackouts and that kind of thing.
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well, a lot of kids run a lot higher than Liam and Samson do, and I know quite a few parents who have kids in what I would call “relatively well-controlled” range who avoid hypos like the plague so their kid has an A1C of 7.5 but a decently lowish SD. They might go a few weeks or a month with no time below 70 mg/DL. So I think there might even be some kids out there who just don’t have hypos hardly at all. Especially with the dual-hormone pumps coming out and closed-loop alogrithms eventually hitting the mainstream. Its very very possible.
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And that’s what we originally had strived for as well until I became, what I feel is, more educated about diabetes and the significant long term issues related to hyperglycemia. When I stopped accepting the common dogma everyone repeated and started really digging deeper I changed my mentality about lows vs highs. I see highs as a MUCH more serious issue to Liam in his lifetime.
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I’m in complete agreement with you on this, and say that from personal experience. The doctors that suggest otherwise - running “higher as it’s safe” - will not be the ones your T1D child is seeing as they begin to lose their vision, have cardiac and kidney issues, or suffer the agony of diabetic neuropathy or amputations.
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Everyone, please read Eric’s “For the Parents” one more time, this time slowly.
Then you can talk about the lows and highs and discuss how 1% of the time low, or 10% of the time high is going to cost your child millions of brain cells and make them a vegetable.
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I have much less awareness of my lows these days 13 years in…but I’ve also never ever been so low as to require help from another person. I’ve never passed out from a low either. And I’ve avoided lows for long periods of time and it’s still not really returned. 
So I guess to add my conclusion…we do our best, who knows why hypo unawareness happens, but at the end of the day whether it’s by feeling it, testing often, or using CGM, we do our best to stay in range and to heck with the rest of it. That’s my current mindset, but no judgment on any other opinions.
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This is me up until I get down into the 40s or low 50s. There’s no violent shaking or sweating at those numbers either though. I might shake a very small amount, but mostly I’m just ravenous and on edge, and I might have some weird jerking motions. I’m completely out of it any lower than that, and I do believe prolonged lows in the 40s and low 50s aren’t good for my body because when I’ve experienced them I felt weaker 1-2 days afterward. I try to avoid any numbers past the 60s because people without D don’t venture into that range (from the studies I’ve seen).
I think we just have to try our best, and that’s all we can do. I seem to be doing alright in life overall, and I’ve definitely experienced my fair share of bad lows in the last nearly 25 years.
A cgm has really helped me avoid the severe lows. I’m so grateful that I can use one, and that the kids today can have that as a resource to avoid them as well.
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Yep! I’m more concerned obviously about highs than lows, but I’m glad there are others doing things a little differently than me though so we can get that data. Who knows what the right answer is, but we’ll see I guess in 45 years, right??
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Below 100mg/dl the requirement is for 20mg/dl or, in Europe, 15 mg/dl, accuracy, so “54” means between 34 and 74. Sorry to be a pedant, but it is important; the actual number is meaningless to a physician (or an insurance company). What matters is that we diabetics do know what the real number is; it is inside us and tells us, but for Parents of Diabetics that essential information isn’t just there, which created a nightmare for my mother.
John Bowler, Diabetic
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I’ve always had some degree of hypoglycemic unawareness, unlike most it wasn’t something that developed gradually over years of diabetes. But I think a lot of that came from the fact that we were aiming for tight control (A1c at or below 7%) using just two shots a day of R and NPH and no downloadable data to analyze. Doing that meant that I experienced both highs and lows every day for years. The change to Humalog after about eight years of diabetes helped that a lot, but it wasn’t until I got off NPH at 13 years that I began to experience anything even remotely approaching stability. And it wasn’t until I got a CGM that I could go an entire day without experiencing an extreme high or low.
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Not necessarily. I lost my hypo awareness decades ago. I’d go from feeling just fine to suddenly sweating, shaking and confused. But after I started using a CGM a few years ago, and could head off lows long before I had those serious symptoms, I found I was again aware of early-warning symptoms – the slight vision changes, the feeling of “emptiness” that some call hunger. They’re subtle, and easily missed if I’m active, but they’re there. It could be a very individual thing, though.
I never lost the sweating/shaking symptoms when I went really low, just everything in between “normal” and “crisis.” Even now, if I’m not wearing a CGM, I can have those soak-the-bedsheets scary lows.
Exactly.
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I believe (i.e. not something I can prove) that this is why the docs want us to target >>80mg/dl. The fluctuations are a fixture; unless you go full keto the fluctuations will always be at least 20mg/dl and more like 50, so add whatever number you think the fluctuation is relative to let’s say 50 (i.e. when things start to get bad). We end up targeting a number which will reliably give us an HbA1c over 7%, “whatever”.
Watching that graph and seeing it heading down is a pain, but it works to a point; I can head off the 30’s before they hit 
Not where I want to be, but I can’t get there from here. I do need more than the CGM.
I still think we’re all hypo aware. I’m not an alcoholic; I drink, I fall over. I am a diabetic.
John Bowler
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I eat fairly low-carb in part because I want to minimize those fluctuations. But even without eating low-carb, the fluctuations i have today are nothing compared to R and NPH with no CGM. I would hit 2 mmol/L and 20 mmol/L (or lower, or higher) every single day, probably multiple times. It’s very rare that I’ll have a day hitting those extremes with today’s technology and actions taken to minimize highs and lows. It is a lot of work, though.
Low-carb by no means prevents all highs and lows, but it does in general keep my standard deviation at around 35 mg/dl or less. I’ve spent the past two days running high almost constantly due to (I’m guessing) hormones. This despite correcting every hour or two, running a +50% temporary basal rate, and upping my permanent basal rates. I’m still running at the very top of my target range, but am reluctant to be even more aggressive for fear this will all end as suddenly as it began.
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I have been on vacation and it took me a while to catch up on this discussion. Interesting comments here.
One thing I did not see mentioned - it is the rate that makes a big difference.
I mean, take a random number - say 50. All 50’s are not the same.
If I drop from 100 to 50 in 20 minutes, you better believe I can feel that! I feel that long before the CGM ever figures it out!
But if I drift from 70 to 50 over the course of 4 hours, I might not feel that.
The rate of drop is a huge factor!
So hypo-awareness maybe means that the slow drift is not as noticeable, but I can still feel the sharp drops. And I think that is the more important thing to be able to notice.
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That’s weird. I’m the reverse.
I can feel the slow drops, but not the fast ones.
Weird.
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