[trekky1700]

Just curious, how old are you and how long have you had it? I've had it for 11 years this February, and while my A1C is pretty terrible (high), the idea that I might not be able to detect lows eventually is pretty terrifying.

[MrFoof]

About 13 years. My big tipoff is feeling tired. I'm a night owl and stream on Twitch after a long day of consulting -- I'm NEVER tired before 1 or 2AM.

The most severe problems were the result of a new doctor in their residency changing my long-acting insulin to an intermediate that was also a 30% mix of fast acting, in an attempt to drive my A1C to under 6. This created a serious problem of wanting to give myself insulin for a meal, my blood sugar only being around 90-100 mg/dL, and then being unable to decouple the fast-acting from the intermediate since it was pre-mixed. I hemmed and hawed, but the attending stood by the decision to change to 70/30. I had to change 10 years of regimen instantly, which was fraught with peril.

Two serious episodes later, and a waiting room at a prestigious teaching hospital hearing someone scream, "Your stupid decision has nearly killed me twice", and I'm now back on the long-acting with insulin reactions being rather infrequent (twice a month), and nowhere as severe (catching it around 65-70 mg/dL). My A1C has trended up slightly (6.1-6.2 to 6.3-6.4), but I'd rather that than death by overdose.

[bigtunacan]

Not speaking for the parent, but I'm a 35 year old T1D who has been diagnosed for only about 7 years and I am already nearly asymptomatic when I have low blood sugars. The risk of becoming asymptomatic for low blood sugars increases over time, but it is completely inconsistent. Some diabetics have always been asymptomatic for low blood sugars, others will go their whole lives and always have easy to detect symptoms. I have a friend who is in his mid forties and is also a T1D; he was diagnosed about 30 years ago and he still consistently gets the shakes when he is any lower than 70.

[coldpie]

I was diagnosed when I was 12, about 13 years ago, and I can usually still detect when I'm under 60 or 70. I'm one of the tight-control types that the OP mentioned (6.4 A1c), so this happens a few times a week. I usually notice it when I can't think, and instead wander over the same two thoughts back and forth. Suddenly I realize I'm thinking in the tiniest of circles and go have some yogurt or something.

The first thing my endocrinologist asks when I see him (literally, before he even asks how I'm doing today) is if I can still feel lows. I think he'd get me on a CGM pretty quick if I reported I couldn't.

I'm super interested in this contact lense solution.

[RA_Fisher]

In my experience (Type 1 partner), it's repeated and severe lows, say like 4 or 5 in a week, that will give you hypo-unawareness. It's definitely possible to experience that and still have a high A1C, but I don't see it causing hypo-unawareness. I'd highly recommend a pump to get more control.

[bigtunacan]

That is simply misinformation. The problem is you can not extrapolate your personal experience out to the rest of the population. I'm virtually hypo-unaware and I have low blood sugars maybe 2 or 3 times in a month.

[RA_Fisher]

I didn't say it was the only way to get hypo-unawareness, it's my experience.