Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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When you are beginning to experience hypoglycemia, do you consistently have a particular symptom or set of symptoms that signal the start of a low to you? (This is part 1 of a 3-day understanding hypoglycemia series – check back tomorrow and Monday for days 2 and 3!) Cancel reply
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Early after diagnosis, hand tremors were a consistent early sign, but with frequent lows I lost this symptom quickly. Now I don’t often experience symptoms unless I’m very low and/or dropping fast. At that point, the most common symptom I notice is a racing heart panicky feeling. Occasionally preceded by hunger and irritability. If I could look back at myself with a clear head and normal glucose, I’m guessing I might notice some slower mental capacity before these, but it’s not something I pick up on in the moment.
Acute I-can-eat-the-Rock-of-Gibraltar hunger. Also sweating and grumpiness. I’d make Oscar the Grouch proud. 🙈 ʕ ͡눈 ͜ʖ ͡눈ʔ
I have that feeling too. I was very hard to stop and ended up over eating. With CGM I can see if I have turned the corner and am going back up hill.
Sounds silly, buy my nose starts to run and I feel chilled.
It varies – I usually experience a “sinking sensation” and my CGM alarms. I may notice lightheadedness, then confusion and a headache if I don’t pay attention to treat it right away. If my attention is involved in doing something to complete a task I may ignore those early body sensation alerts and then risk sinking into that sweating ravenous state where I want to eat the contents of the refrigerator. However, it is rare these days because of Dexcom and Baqsimi.
Sometimes I notice nothing, but when I do notice, the primary thing is a sense of weakness.
The very first symptoms include light headedness, weakness, exhaustion, tired. Then it usually goes to extreme and insatiable hunger. Deeper in, extreme sweat. Even deeper extreme resistance to help, loss of consciousness (but still standing). Deeper, not standing.
While it notice the same 2-3 symptoms, it is too late to be proactive. By the time I notice the symptoms, I often need help resolving them, e.g., to get some juice. I do have glucose tabs on me pretty much at all times, but often need the juice.
I see flashing spots and less coordination and confusion.
I feel weak, exhausted mentally and physically. My Freestyle Libre reassures me with a number as to what to do and I head to the kitchen or candy jar or goodies in my purse and car. Before the CGM, I tried to test, but that delayed the treatment for sure.
I said I didn’t notice. I keep a pretty sharp eye on my Dexcom to avoid lows. But if I’m working with loud machinery it may sneak upon me. Ijust get a desperate need to sit down and rest.
For me it depends on the onset speed and depth of the low or maybe the depth is the determining factor. It doesn’t happen too often since switching to CGM and pump. In the past I’ve had it where my only symptom was the mental fog while I was at work. I’m a computer programmer and was struggling to do some task and thought “what’s wrong with me?”, then in spite of my mental confusion I had the clarity to check my BG which was in the 50’s. I’ve also had a low hit hard and fast with the hunger, sweating, irritability and confusion all while my Dexcom alarm is blasting and not helping. Also in the past (I hope they stay there) episodes where I was combative with my wife trying to get me to drink some juice. That paranoia and confusion followed by guilt as your BG finally recovers is the worst.
For me it is weird. There are like 4 possible symptoms that I can get to tell me I am low. The first is inappropriate yawning. It isn’t a constant thing. This typically happens when my blood glucose is dropping. The next is getting cold. Sometimes I’ll get cold, sometimes I’ll start yawning. The last is inappropriate sweating. I’ve had days where my coat is soaked, and not because I am hot inside of it.
My normal first symptom is best described as uncomfortable. I want to get rid of that “uncomfortable” feeling. However, I don’t usually notice that till I’m much lower than I want to be (in the 50’s) and many times don’t notice that symptom at all.
My most consistent symptom is the “alert” function on my pump. I have that set so that I get the alert from my CGM at 80, well before my body tells me anything else.
My pump is usually the first alert to my getting low. I don’t notice anything physically until I am in the 50’s. Then it’s a feeling of my thinking going a bit sluggish, and a general feeling of something’s not right.
My symptoms vary based on how fast I’m dropping usually. And sometimes if it’s slow and gradual I won’t notice until much later. But, the 2 that trigger most often yet interchangeably are hunger and sleepiness.
During childhood and into adulthood, I had the shaking hands mentioned above. I would cup my hands and let the fingers touch to test: if I could see or feel them shaking against each other, I’d know my blood sugar was low. As I got older, nausea became a warning.
Now, after almost 67 years of diabetes, I’d only been getting blind spots in vision in certain lights. And, with the beta blocker metoprolol after bypass surgery, not sure even that. Yay for dexcom sensor!
very similar to the changes I have had through the years.
Hypoglycemia’s most often first symptom for me is acute hunger, famished. This is soon followed by a feeling of “dizziness” which will progress to various physical un coordination.
That’s changed with time… I used to almost always notice it with first symptom being my lips and tongue feeling like the were quivering and going to sleep. But since sometime around 2013 it’s gotten to where now, if I have hypoglycemia, I will feel pretty much the same whether my BG is in the 40s, the 140s, or over 250. It now takes my BG dropping to around 25 – 30 before I start feeling any symptoms.
I see flashing lights but that has to be dropping very fast into the 40s which is very rare since I used a CGM.
I said symptom, singular not plural, because the set of symptoms associated with lows no longer “feel” like separate symptoms to me. I just think “I feel like I’m dropping low”- my brain alarm goes off. If you asked I could enumerate the common elements of that experience but I do not experience them singly (I’m not thinking, :”Shaky”, “clammy”, “cranky”, “panicky”. I’m thinking “low”) I’ve been experiencing these for 59 plus years, after all. Since these are similar to the fight or flight response (or identical?) I experience them the same way I would experience “fear”- as a single reaction.
PS- someone else mentioned sleepiness. I will get that when my sugar is dropping somewhat rapidly- starting anywhere- and it does not usually signal an impending low, it recedes as my glucose stabilizes
In the 70s, I’m exhausted.
In the 60,s sleepy.
In the 50’s weepy and depressed.
By 42-43 I have flashing lights and semi blindness in my right eye; on the laser surgery area there are pools of brilliant light.
By 32 the situation requires professional. I pass out.
I’ve totally lost the ability to sense highs or lows. With lows, Dexcom is blasting an urgent low alarm long before I’m aware of any symptoms. I realize that’s not what the question is asking. When I was still aware of symptoms the first that I felt was a tingling around my mouth and spots in my vision.
In the early days, visual changes were never mentioned as symptoms of hypoglycemia. Recently, I have found that bright light in the middle of my vision is often the first sign I have of a low. (It is as if an alert switch has been activated.) Today, I am learning that a number of us experience this. Do you think that duration of being t1 is part of this?
My hypo event’s symptoms or lack of symptoms depend greatly on the rate of fall and the amount of insulin pushing it and the amount and type of food digesting, as well as, the amount and type of exercise. There are so many variables that affect what I feel and at what point on the number scale I feel it. I have some hypo unawares sometimes but definitely feel it other times. One problem I have is habitual unawares of the alarms built in to the CGM, phone, and pump. The alarm will go off, my husband will hear it, but I will not. It is kind of like living next to the train tracks where one’s brain goes numb to the noise of the train as it goes by.
My first sign is the feeling of losing focus on getting a job done and being too bull headed to quit.
To add to my first sign is definitely my
vision, gets blurry.
Although I selected “I do not notice any symptoms of hypoglycemia”, this is not strictly true. Very occasionally, just before I lose consciousness, I get a sudden feeling that something is happening, but it’s very often too late for me to do anything about it. i.e. I don’t get chance to check my blood glucose level, and I sometimes fall flat on my face.
If I’m awake, it’s a feeling that something is off. If asleep, I wake up hot. I might have what I call “Pac-Man” vision where it looks like one is running across my eyes. I don’t get sleepy. I get very sleepy with highs. I may get very lovey-dovey and my husband is like – go eat something. I may get weepy if I go into the 40s. Sometimes I get cranky but that is rare. I’ve never passed out and I’ve been as low as 19 (I know – I need a CGM). My warranty is out on my 630 and they want me to get a 770 with the option to move to a 780 with no extra cost. I was thinking of going TSlim and Dexcom but it is very hard for me to take the connection with Medtronic.
Break the connection.
I loved my Medtronic when I had one. I became very disenchanted with their CGM. I went to the TSlim and Dexcom CGM combo. I was going to suggest a Medtronic/Dexcom GCG combo. But, I don’t think the Dexcom CGM will communicate with the Medtronic pump.
Lawrence, actually I think my educator said I use a dexcom CGM. Thanks for the suggestion.
I am diabetic plus epileptic and when the tslim/dex was suggested to me I found it hard to break the connection with Medtronic beings theirs was the only pump I’d ever used. But, I chose it and I am in love with their system!
Since going on the insulin pump, and getting more consistently ‘normal’ readings, my ‘old’ symptoms went the way of the dodo bird – Often a low sneaks up on me and I don’t know about it until I use my cgm. At times I get an ‘off’ feeling, which sometimes means it’s going lower, but not yet low. Sometimes I feel like it’s getting lower, to find it’s already low. Sometimes I start to get hot all over, to find my BG has gone low, but not always. Nothing is ‘consistent’ any more.
I notice the symptoms some time, but I do have the Dexcom G6 which gives an alarm at 70mg/dl. Then I eat glucose tablets.
My first symptom is hunger. I want to eat something now!
Lots of the time I have to remind myself that I need to eat.
If I feel anything at all it’s usually just feeling off, nothing specific.
I generally do not feel any symptoms until I am quite low. First symptom is shakiness and sweating