I am 12 years old and have had diabetes for seven years. I can usually tell when I am low or high, but lately, my symptoms have been either backwards or none at all. Is this normal? What’s making it that way?

It is common that the longer you have diabetes, the less accurate you are in guessing your blood sugar from symptoms. There are a few possible reasons. One is as you have diabetes longer, you may have more swings in blood sugar. If your blood sugar drops quickly from say the 300 mg/dl [16.7 mmol/L] or 400s mg/dl [22.2 mmol/L] to the 200s [11.1 mmol/L], you may have some symptoms of low blood sugar. These are actually the warning symptoms of a falling blood sugar caused by the body making a hormone called epinephrine which protects you from dropping dangerously low by pulling stored sugar from the liver into the blood. These symptoms often include sweating, nervousness, hunger, and shaking.

On the other hand, if you are having a lot of lows, your body may actually get used to these lows and not always make epinephrine to give you the early warning symptoms telling you to eat before your blood sugar drops dangerously low.

These problems are real and why blood sugar testing is so helpful. Hopefully, soon, we will have the GlucoWatch which will be able to automatically check your blood sugar every 20 minutes and warn you if you start to go dangerously high or low.

TGL