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Do you have hypoglycemic unawareness?

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February 10th, 2012
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Since I can remember, I've always had certain symptoms of being low. A funny feeling in my stomach, shaking, cold sweats, feeling tired, slow or incomplete thoughts. Depending on the low, sometimes certain symptoms would be worse than others. Almost every single time, I got this feeling in my stomach kind of like butterflies. Lately, I've been having some of these low symptoms when my blood sugar is not even close to a low. I get the feeling in my stomach, I feel shaky, I even start slurring my words. I check and I'm fine. 141. 126. Even 204. So why do I feel low? (READ MORE)


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I'm going to fight. I want a CGMS and even though the universe may have spoken, I'm still going to fight. (Perhaps I misunderstood what the universe was saying.)

 

I put a lot of emphasis on thinking that the primary benefit of using a CGMS is to detect lows. There was a time when I had some pretty serious hypoglycemia unawareness. I remember taking a walk with the family once and not feeling low until we returned. I was 35. I didn't feel it until I was 35. That's scary stuff.

 

More lately I've been thinking that one of the better benefits of using a CGMS is to ward off highs either between meals or before the two-hour post-prandial check.

 

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"I totaled my truck”  

 

I looked at my friend in shock. He did not look hurt or anything but his lower lip quivered enough to tell me it was bad.  

 

 

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The problem that I have with Lantus is that one dose just doesn't cut it for me. It claims a 24 hour lifespan, but honestly...it's probably more like 20 hours on a good day. Which means that my blood sugars start spiking towards the end of that injection.

 

That's exactly why I split my doses however many years ago. It worked, dropping my A1c like a lead balloon. And now that my schedule nearly forced me into either the insane asylum or a once-per-day dose, I'm struggling to find an appropriate time for my Lantus injection.

 

An evening shot wasn't working because I was having to take such a bulk of insulin that I was dropping way below my safety point by morning. And now I've switched to an early afternoon injection, but I'm afraid that looks like it's bombing as well.

 

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After my recent posts, I've gotten a lot of feedback from you guys. I'm very appreciative of it all! Some of it is common sense to me after 16 years with this disease, but you never know which piece you can overlook in the complexity of diabetes. So I decided to sit down with it all and figure out where I need to listen most.

 

I heard differing arguments as to if I'm doing the right things and if I'm just lost with this disease. I've chosen to believe the positive feedback with that. I know that I'm doing the right things. I aim for a low A1c, but I also aim for a safe level of numbers since I know that I'm prone to lows. But lately, maybe I have been aiming a little too low in too little of time.

 

(READ MORE)


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Someone should have taken a picture: my dad and I checking our sugar roughly two hours after we ate Thanksgiving. He: 114. Me: 86.

 

"You must have overestimated your insulin," Mom said.

 

"Yes, but I'll spike later," I said.

 

Sure enough, an hour later I was 206. Would have been nice to have had a CGMS on my side for Thanksgiving. Between the smooth mashed potatoes, stuffing, pumpkin pie and pumpkin cheesecake Thursday was not only a carb fest but a complex-carb fest leaving me hanging out in the upper 200s for most of the Thanksgiving evening no matter how much insulin I doled out (actually, I listened to my pump's recommendations in an effort to avoid a low).

 

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In most people with diabetes, lows occur either because we've overcalculated the amount of insulin we need, or because of an impaired, inhibited, or insufficient glycogen response. While this is obviously an oversimplification, I remember reading that either autoimmunity or modern insulins did weird things to the glycogen response in people with type 1 diabetes, and I know that at least one class of oral diabetes drugs works by inhibiting, if not completely blocking, that response. Then there's the issue of undereating, or not eating sufficiently, for there to be glycogen stores that can be easily converted to fuel our bodies — and, of course, drugs such as glipizide which work by stimulating additional insulin release.

 

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It seems like every time I meet a new diabetic, there is the normal discussion of management. The management of blood sugars, tricky situations, and the unexpected. We always hit the high points: A1c, what foods make things worse, number of lows/highs, and the rest of the "normal" diabetes lingo.

 

So every time I meet a new diabetic I'm usually thrown into the low blood sugar toss-up. As I talk about my diabetes, it is inevitable that I discuss lows. Because ever since I can remember, I've been prone to low blood sugars. And nearly every time, I get the normal response of "Your A1c must be great!" or "Oh, how lucky!"

 

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In my last post, I mentioned that I would be wearing some Continuous Glucose Monitoring Systems (CGMS) and deciding if any were right for me. 

 

I tried both the DexCom and the Navigator.  My decision was this: there is simply no way a separate device is going to work for me.  This was proven by the HOURS worth of dead zones - where I'd accidentally left the device behind.  Further evidence, the fact that I regularly leave my cellphone behind when I leave my house in the morning - and that since childhood I've been known as someone who "would lose their head if it weren't tied on."  Really, I think I'd lose my pump if that weren't tied on!  

 

So, I am starting the process of trying to get a Minimed Real-Time System.  I've got new insurance with my new job- so the pump part shouldn't be too great a struggle.  But the CGM to go along with it is a different story. 

 

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It's been a little over three weeks since I started tapering off the medications I've been on for the past 18 months. If you're new to my health world, I was on bio-identical hormones for a multitude of health conditions (PCOS, hypothyroidism, adrenal fatigue). Quite a few of my major symptoms disappeared or eased while I was on them (joint pain, mood swings, more regular periods, fatigue, and so on), but a few in particular were only making my life worse. Much worse.

 

My acne (one of the main symptoms I'd originally gone in with) had not only persisted but gotten 100x worse going from moderate to severe. And even though my periods were much more regular, I was still experiencing terrible headaches and cramping several weeks out of the month.

 

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Carey Potash
Carey PotashCarey is a full-time hater of diabetes. The benefits stink. His 7-year-old son, Charlie, has been giving he and his wife the finger since November of 2003. Carey's parenting humor has appeared in various websites and print magazines. He resides in the suburbs of Philadelphia with his wife and three children. (Read More)
Lindsey Guerin
Lindsey GuerinLindsey is a typical, yet unique, Texas girl who loves shopping, movies and reading. She loves to travel and take risks. She dreams of diabetes cures, never-ending cheesecake and her own airplane. The rest you can discover in her blog! (Read More)
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