Every time I see my endocrinologist, he asks questions like “Can you feel it when you’re 70?” “How low does your blood sugar have to get before you know?” You know, the typical questions used to figure out if, and by how much, Hypoglycemic Unawareness has set in.
I’ve been reading a lot about Hypo Unawareness lately. As I understand it, Hypo-Unawareness is when you are unable to tell that your BG is low without testing it. Its magnitude is defined by a threshold – some can’t feel it until they drop below 60 mg/dL, some not until 50, and some not until 40 or lower. Some people can’t tell when they’re hypoglycemic at all. Hence the question, how low before you feel it?
As for me, I don’t know my cutoff. Sometimes I “feel it” when I’m at 85. Other times, I test, and am shocked to see a 58 because I feel fine (but once I know, then I start to feel it, like it’s psychosomatic or something). Maybe I’m hypo-unaware, I’m not sure. I’ve got Hypo-Unawareness Unawareness.
But what does it mean to be able to “feel it” anyway? I always thought it was some form of impairment: confusion, trouble thinking straight, feeling really tired, that kind of stuff. That’s typical, right? If that’s the case, then I’m happy not to feel it when I’m 64. It means I’m not struggling to drive, or to attend to a crying baby, or to do whatever it is that I’m trying to do. So a lower threshold for “feeling it” just means a better tolerance for dealing with lows.
I’m sure that everything I just said in that paragraph is completely wrong. But I just don’t understand what hypo-unawareness is about, or even if I have it. I do feel hypos – usually (but not always) when my BG is dropping quickly, moreso than when it falls below an absolute number. And if I let it continue to drop, I continue to feel worse.
(Of course, sleeping is an exception. It’s hard to pay attention to this kind of stuff when in a deep slumber. I have slipped into dangerous lows during sleep — either because I didn’t feel it or was too tired to do anything about it. Fortunately, the last one of those was about ten years ago.)
Can someone with hypo-unawareness please explain it to me? I know it’s something serious and something real, but I can’t get a grip on how it feels or how it really happens. The textbook definitions just don’t make sense to me. If they did, I’d know if I’ve got it.
For now, though, I’m thankful that I know when lows are coming on. I do wear a CGM, and in many cases it warns me of lows ahead of time if I don’t know myself, though that’s not the reason I use it. And I generally can handle them, even If it means sitting quietly until that low blood sugar gets up to normal.
My wife has not had to bring me food or juice since that time ten years ago when I got low in my sleep. She’s offered, but I’ve already been a step ahead at that time and have eaten something. I hope I don’t need to rely on her, someday, to uphold a lyric that were sung when we were younger and shared a piece of wedding cake.
That lyric is in the caption of the picture at the top of this post; the context giving it a slightly different meaning.