Symptoms

First of all I want to say I'm new to this board and I think it's a great resource. The more who participate, the better.

My question:

I've had DM (type 1) for almost twenty years. I'm 42 now and got the juvenile type in my early twenties. For the most part after I was diagnosed I had no problems for almost 15 years. I just took my shots as prescribed and everything was fine.
The past 5 or so years have been different. I'm having problems with ketoacidosis and low (hypo) sugar levels.
The first problems I had were with high levels (keto), but now I keep having probs with low (hypo).
I used to be able feel when I was low or high, but now it seems to happen more suddenly.
I've been told that recently I passed out and yelled out at the time and I am sore and have evidence I may have fell down.
Also once before I woke up with a dislocated shoulder and don't know how it happened. Could this be a Hypo reaction?

Again, thanks for the resource.

[JDRF-Team-LRS]

BScott,
I'm glad you found us.  I've had DM for about 32 years and am now 48.  What you describe certainly sounds like it could have resulted from getting hypo and not realizing it.  It's frightening, indeed, ... losing hypo awareness puts not only *us* in danger, but those around us, too.

I'm not sure if you're being followed by an endocrinologist now or not, but it sounds as if it's time to visit one again.  For many of us "long timers," who've learned a lot by experience thru the years, it's easy to forget that the docs are keeping up with the science & have more info available to them than we do.

I have read that hypo unawareness can increase with the time we've had DM and that it also increases in the short term based on how many hypos we have.  Once we have & treat a hypo, for example, we might have more trouble within the next few days to detect the early onset of another one.  That, of course, adds to the dangers we face .. both from injury and from long term damage to our brain and other organs.

Living alone add plenty of added concern and it leads me to encourage you even more strongly to check in with an endo.  If you live anywhere near a Joslin clinic or satellite, you might be able to take one of their "regaining hypo awareness" training seminars ... other endos may offer something similar.

Some subtle early warnings of going hypo include ... difficulty "finding the right words," having a single thought repetitively and not being able to get out of the cycle of that thought, confusion in an otherwise familiar setting.  Some folks experience a numbness in their lips or hands.  Some develop a slight headache.  

If you're willing to test quite often initially, you might well be able to match up "odd" feelings with bg numbers.

Finally, do avoid drinking alcohol wihtout food.  Alcohol in our system thwarts our liver's ability to respond with glycogen to a low (cuz it's busy workin' the toxin alcohol out of our system) and thus we can't even count on our built-in counter-regulatory function to help us out.  

Bottom lines ... see an endocrinologist or a diabetes specialist or a certified diabetes educator for a check up & a tune up of your management routine.  Test often and try to find patterns or at least specific questions to ask your health care team about.  Do it for yourself and for your family & pals who care about you.

The episodes of passing out and injuring yourself are very very dangerous.  Hope you'll check in again as you work thru this.  You are certainly not alone in facing the situation.