I do get warning signs before a hypo event though.... So I'm not "unaware" and get enough warning signs to be able to bring my vehicle to a controlled stop, safely. How do you know I'm not Fat Adapted? I would be crazy to give up my driving licence when I feel absolutely fine and have no detrimental effects. I am a chartered member of the Institute of Occupational Health & Safety so I am sure I am qualified to assess risk and I wouldn't drive if I felt I was risking my life let alone someone else. I am not concerned by hypo unawareness as like I've stated, before any symptoms I have always got notice that they are coming.
What do you call a hypo event and what signs do you get?
Clearly you have had quite a few dips into the red in the last 3 weeks let alone 7 weeks when you say above that you have had no hypos, apart from this one, so your understanding of hypos may well vary from ours and perhaps your understanding of hypo awareness also differs. I have not found a very clear definition of what it means and there are very odd occasions when my levels have surprised me with a low 3 and I haven't felt it until after I tested but at least 95% of the time I feel them at low 4s or high 3s.... bearing in mind the limited accuracy of our measuring devices. Certainly during the night when we are asleep, we are much less likely to detect it early because our senses are not so effective... ie. eyes closed in the dark so no vision disruption/impairment, lying down so no wobbly legs etc.
I think the terminology around hypos and hypo awareness is a bit flakey. A hypo is generally considered a reading below 4 for us insulin dependent diabetics, even though non diabetics can drop below 4. That is not to say we can't function perfectly well a bit below 4 but we need to be aware of it so that we can take action before it drops lower and does affect our mental capacity.
Ideally you want to be getting your first warning signs in the low 4s or high 3s, but this is the minor signs, not the real hypo symptoms. One of my first signs is my peripheral vision going slightly blurry even though my main vision is good. When I am out walking, even though I have Libre, this is something I consciously assess quite regularly. I usually walk/run on my own in rural areas at odd times of the day and night, so keeping my wits about me is important, because if anything happened, it would be a long time before anyone found me, so I semi consciously self assess every now and then. I also scan regularly so I have an idea of where my levels are and where they are headed. I am not at all anxious about it and it doesn't spoil or interfere with my enjoyment or stop me from going out alone but I just pay a little attention to my peripheral vision for a second or two every 10 -15 mins or I scan. Another sign is sometimes a tiny suggestion of indigestion. A sort of little tummy butterfly/flip maybe just once or sometimes a feeling like I am wrapped in cotton wool and sort of a bit wooly headed/isolated from my surroundings. More obvious is the lip or tongue tingle but I don't get all these signs every time. Usually at least one of them and the peripheral vision burryness is the most consistent early sign for me and these signs happen probably 5 mins or more before the adrenaline pumping, heart pounding, cold sweat, jelly legs of a full hypo, so if I treat at this level, I can prevent the full hypo and carry on doing what I am doing.
These early warning signs are different for different people. If your levels are dropping fast then you can drop through these early warning signs before you notice or experience them and just reach the adrenaline surge which should trigger your liver to kick in and release glucose to bring you back up if your levels aren't dropping too quickly which is how you can recover from night time hypos without waking up, but don't ever rely on that mechanism.
I don't think being fat adapted is all that relevant. From my understanding being fat adapted just means that your body has a steady stream of glucose being released rather than a spike from carbs and then tailing off, but if your insulin dose is dropping you faster than your glucose release from fat and protein, then you will still hypo.
I see your signature shows you as being on fixed doses of NR. Is that still the case or are you carb counting now? With fixed doses, you are going to be at greater risk of more dramatic hypos, particularly when exercising, so perhaps this is why you are not experiencing the early hypo signs until you get too low and have a full hypo. I also see that you are on Toujeo which is not very flexible for adjusting for exercise. I would hypo regularly during the night if I used Toujeo because my levels drop during the night after exercise and I need to reduce my evening Levemir dose to try to prevent that. That is just me and my body, but these are all things to discuss with your nurse or consultant and push for a DAFNE course or whatever your local equivalent is to help you understand it all better and improve your carb counting and dose adjustment.
I would also ask where your low Libre alarm is set? It needs to be above 4 to enable you to prevent yourself dropping below 4. I have very fast digestion and I follow a low carb way of eating and adjust my bolus insulin accordingly so my levels rarely drop fast and therefore a jelly baby or two at 4.2 can prevent me dropping into the red but if you get fast drops in BG perhaps due to fixed doses and exercise, then 5 might be a better level for your low alarm until you get better at managing your levels.
As mentioned, you will also be in your honeymoon period which means your own pancreas may throw a spanner in the works with some of your own insulin which will also contribute to dropping your levels fast.
I would encourage you to be more conscious of your levels when you are exercising particularly and try to correlate how you are feeling, seeing, hearing with your levels, so that you develop a better sensitivity to when your levels are getting close to the red line or crossing it. We are so lucky to have the convenience of Libre (and other CGM) to enable us to scan whenever we like and see what our levels are doing all the time, but it is important to learn to listen to our bodies too and be able to detect small changes that tip us off to low and indeed high levels rather than just rely on the alarms.
I do wonder if this will become an increasing problem for people who have Libre from the start and stop "looking out" for the sometimes subtle signals their body gives them that levels are dropping low or going high.
