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Does age or number of years with D help with self-awareness?

Discussion in 'Parents of Children with Type 1' started by momandwifeoftype1s, Feb 3, 2011.

  1. momandwifeoftype1s

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    I am noticing that as Connor gets older and has had diabetes for more years (4 years), he is becoming more self-aware of his body and feelings of low blood sugars. One of the newer changes that I've noticed is that he will be unable to fall asleep if he feels his blood sugar dropping. He'll stay awake and want to talk, and he inevitably ends up with a low blood sugar at 11:30 p.m. It would not have been a low that I would have caught myself (scary). He is not yet waking up during the night when he's low. When will that start to happen? Is is a chronological age? Number of years with diabetes? Brian (DH) has had type-1 diabetes since he was 15, and he said he woke up during the night when he was low since the time he was diagnosed. It seems to be a gradual progression of self-awareness with Connor. I wonder if it's because he's younger (age 9) or that he hasn't had diabetes long enough to know to wake up from a low?

    Connor didn't used to shake when he was low, but now he visibly trembles. It seems that diabetes keeps changing on us, but maybe it's just Connor changing and growing? Will this trend of self-awareness and new automatic self-preservation keep kicking in for Connor? I like to see that I'm not alone in being responsible for catching lows now. He plays just as much of a role; if not more, than me.

    I'd like to know what to expect next? Could any of you with children who have been diagnosed around age 5 whose kids have gone through these self-awareness steps forward tell me what I can look forward to next?

    Thank you!
     
  2. TheFormerLantusFiend

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    Changes in my symptoms have happened to me over the past five years. On studies of strength of counter regulatory response to hypoglycemia, all have showed that the body's internal response gets weaker and weaker over the first few years. My impression is that it then sort of stabilizes but if there's any neuropathy, especially autonomic neuroapthy, that weakens it again.

    I woke up because of hypogylcemia in the first year and had a hard time sleeping when under 80, maybe the second year. I have hypoglycemia awareness.

    I have a friend who's had diabetes 16 years and has never been able to fall asleep when she's on the low side although lows don't wake her up.
     
  3. momandwifeoftype1s

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    Could you please explain this ^^^^ in simpler terms? I'm sorry, but I don't understand. Maybe I need more coffee?

    If I'm reading correctly, are you saying that it's completely variable? That there is no steady progression towards self-preservation at night for lows? Each person responds differently? Or not?

    Thank you for your insight. I really appreciate it.
     
  4. StillMamamia

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    Amy, just wanted to share that Ian has always felt when something was off in his body. At first he couldn't pinpoint it, like he'd say he felt weird or sick, then BG was low or high. Now he'll say he's low or hungry, since he's told me both feel the same. He sometimes, but not as often, will say he doesn't feel good, that maybe his number needs to be checked, and usually it's high. He's very much in tune with his body, which is a good thing, but I suspect it may weaken with time. Who knows?

    Not a helpful post, I know.;)
     
  5. TheFormerLantusFiend

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    The hormones that the body is supposed to release because of hypoglycemia- the hormones that are supposed to help by both alerting the person to their hypoglycemia and by raising blood sugar themselves- are affected by a number of factors but overall are released less the longer a person has had hypoglycemia.

    Although come to think of it, I remember reading something about prepubertal children having a different hormonal response to hypoglycemia as opposed to children in puberty or after. If you want I'll go look for it.

    Anyways, the hormone most responsible for hypoglycemia awareness is adrenaline. How strong of an adrenaline response there is depends on how many lows the person has had recently, how low they are etc. Typically exposure to lows over the years makes the body release less and less adrenaline for lows, because adrenaline is a stressful hormone that the body doesn't want to release without a good reason. Later on in the course of diabetes (like where your husband is at) if there is any damage to the nerves that help the body sense hypoglycemia (and typically there is) this will also cause a drop in the levels of adrenaline.

    What I assume is happening for your son is that his brain is maturing and making the connections (in a literal and metaphoric way) so that he is more aware of the adrenaline rushes when they come.
     
  6. momandwifeoftype1s

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    Of course it's helpful, Paula! I like to hear how things progress with other kids besides my own. I have very limited exposure to what is the "norm" because I only have one child with diabetes (thankfully).

    Connor rarely notices when he's high, but he will see a high number when I check and say "See, that's why I was being so naughty." Nice, huh?

    It seems to me that the opposite is true about being in tune with his body being weakened over time. I see his self-awareness increasing through the years. Also, Brian (DH) bolts up out of bed in the middle of the night to go eat when he's low. When will that happen with Connor? Will it happen? Or is Brian just lucky? Hmm... Maybe we'll just have to wait and see.
     
  7. momandwifeoftype1s

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    So, are you saying that having lows for many years makes it less likely that the body will respond with adrenaline? It will be less likely that his body will know when he's low the older he gets? Connor has had a lot of lows throughout the past 4 years (unfortunately), but yet his ability to know when he's getting low is much more obvious now (or at least he's verbalizing it more now). Will that go away at some point? I wonder why Brian can feel himself getting low, and he's spot on? He's had diabetes for 22 years, and he responds to a low day or night. I wonder why he's been able to preserve his body's ability to respond to a low? Where are the nerves that help the body sense hypoglycemia? What would preserve this function? I'm really glad he wakes up during the night, but sometimes he scares the crap out of me doing so :eek:.

    Do you find that you are unable to feel your lows as well as you've gotten older? I was not expecting that response at all, so I'm very interested to know what you've found to be true for you. Thanks!
     
  8. Tigerlilly's mom

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    I am looking forward to the responses to your post. ... With Tyler he tends to go through "spurts" when he is totally unaware of his highs or lows and then other times he knows if he is slightly high or low. I have tried to pay attention and notice if there are any trends, and this being diabetes, of course there is no trend:rolleyes:

    I definately think that on a whole he is more aware of his body and where his bgs are. He definately notices a difference on how he plays sports dependant on his bg. (Which is great - cause I know he will also check and take measures to ensure good (safe) bgs before playing sports)

    He does wake up if he is high at night, but not when he is low. I hope that the day will come when he wakes up when he is low. (the peace of mind that would bring me when he does sleepovers would be much welcome)

    Over the past 5 1/2 years Tylers low symptoms have changed many many times. For about the past year or so, he describes it as "just being off", and has no specific symptoms when he is low.
     
  9. TheFormerLantusFiend

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    At four years post diagnosis, I would expect that the adrenaline response over the following fifteen years will depend mostly on how often a person is hypo. So the more he avoids hypos, the better he'll be able to feel them when they do happen, and the higher the blood sugars he'll feel them at.

    Autonomic neuropathy is a complication of diabetes, one of the less preventable and more common ones, but keeping lower A1cs may help. Where are autonomic nerves? To be honest, I just realized that I don't know. :confused:

    I think overall for me in the last few years, my low symptoms have been less dramatic but I've been getting better (and the CGMS has helped) at feeling them- at knowing when a very subtle change in how I feel is a hypo. I still have hypos that I don't feel and feel hypo even when I'm not, but I'm getting a lot better at it.
    I've had other things make hypo detection harder for me though- I've been sick with other things, I have sensory processing dysfunction, I seem to have neuropathy, and so forth.
     
  10. MHoskins2179

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    Not sure.

    When I was a kid, my parents tell me that my Lows ("reactions") came on very quickly and without warning, but that seemed to improve and become less the case as my childhood progressed into adolescence. In my later teen years and early 20s I kept my BGs higher to avoid Lows, and was more used to feeling that way and did notice the Lows more often. But in my later 20s when I began pushing for tighter control, I had them hit unexpectedly at times.

    Most of the time now, I can tell when I'm Low and feeling off. Only rarely does it happen that I am unaware of a hypo or impending one. Mostly that comes at night when I'm sleeping, and that's a key reason why I am so eager to continue using a CGM to better track that. But, I've read that many experience hypo unawareness the longer they have diabetes -my mother, who's been a Type 1 diabetic for about 53 years, in fact says she more often has unawareness. Just haven't really experienced it as a trend, at this point in my life.

    I tend to think that Your Diabetes May Vary on this front, but don't really know if there's research or science proving otherwise.

    All I know, is that a Low is frightening enough whether you know or don't know - to be caught off guard just adds to that feeling that we aren't in control.
     
  11. DsMom

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    Don't know if this will help at all--but I find it fascinating that my niece, who has had T1 since 2 years old and is now in her late 20s, says she has different types of DREAMS at night depending on whether she is high or low, and she'll wake up knowing even before she checks BG! Don't know at what age that started--but that's really being in tune with your body, no? Hope my son gains that awareness one day. He was diagnosed at 4, and is now 6 1/2, but has come a long way in the last year with recognizing lows. He's almost always right--but never wakes himself up if he's low. He never mentions anything when he's high yet, though.
     
  12. Christopher

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    I don't fit exactly into the category of responders that you are looking for so I hope it is OK that I respond. :cwds:

    Unfortunately with this disease I have found that there are no "rules". I believe what you said above is correct, there is no automatic self preservation at night and that each person will experience diabetes differently. Danielle has had this over 3 years and while she usually feels her lows while awake, she does not wake from them while asleep. That is one of the main reasons that I have checked her multiple times through the night since she was dx and I will continue to do so as long as she is living in the house.

    When discussing lows and awareness of lows with her endo, she said that the more lows that Danielle experiences the more likely it will be that she will not feel them in the future. I have no idea if this is true or not. Endo's say many things and not all of them are correct. I hope this is not the case with her and I feel very much for those people with diabetes who are not aware of their lows, it just makes this journey that much harder.
     
  13. Tiff's mom

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    I too heard that having a lot of lows leads to unawareness, it may be just a coincidence with us but I noticed that after about 6 months wearing CGMS ds can feel his lows again. If the sensor is off and he has a hypo he lets me know and it's usually around 60-70, whereas before he wouldnt feel it until it was in the 40s, or sometimes not feel it at all! The only explanation i can find is that with the CGMS all the lows are mild and caught and treated fast.

    Its similar with highs, before 300 and over wouldn't bother him at all, but now he complains if he's over 250. He can't sleep at all at night if BG is over 200.
     
  14. TheFormerLantusFiend

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    I can tell you exactly what the endo is referring to- the more lows she has, the less of a hormonal response her body will have to them. That has been shown over and over in studies. In a sense, the less your respond to your body's hypo alarms, the quieter they get. Usually doctors assume that lab tests like this translate into actual symptoms and experience.

    BUT if her brain or her awareness or whatever gets better because of more hypos, if her brain makes the connection between the feeling more efficiently, it's plausible that a smaller hormonal response could STILL cause as much or more awareness.
     
  15. Traci

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    Ds9 has had d since 23 months. He feels not only his highs and lows, but can often tell his bg number--or rather, can guess it pretty close. I know that sound crazy, but he will say, "I feel 167" and will be 170 or "I feel 80" and will be 90. He doesn't do this all the time, but it's often enough that if he feels low and the meter reads a normal number I will recheck him in ten or fifteen minutes and sure enough, he's dropped. Lows will wake him, highs cause lots of thrashing and restless sleep.
     
  16. Dmama24/7/365

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    I believe it varies from person to person, child to child as said.

    Justice has been able to feel his lows since a few weeks post dx. And he knows when hes high cause of his attitude change.

    He doesnt wake from a low either but cannot fall asleep if dropping.

    Everyone is so different.
     

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