How to recognize hypoglycemia with type 1 diabetes?

Hello doctor,

I’m reaching out because I’m having ongoing concerns about my diabetes management and overall care.

My previous doctor, who had been managing my condition for many years, recently discontinued her practice. I’m now seeing a new physician, but there have been some issues and inconsistencies I’d like to clarify.

I was first diagnosed with diabetes 24 years ago, at age 39. Initially, I was prescribed a few different types and dosages of oral medications (though I can’t recall the names), but I was eventually switched to insulin. I’m currently on Lantus and NovoLog. When I asked my previous doctor about my diabetes type, she told me it was type 1. She managed my diabetes through a pregnancy at age 39, and about five years ago, I was hospitalized with diabetic ketoacidosis (DKA). I was also diagnosed with Graves’ disease shortly after my pregnancy and have been on Synthroid since.

However, my new doctor disagrees with my diagnosis. He believes I can’t possibly have Type 1 diabetes because I was diagnosed at 39 and says I have Type 2. He wanted me to stop insulin and try Metformin instead. I declined to stop insulin but agreed to try Metformin alongside it. Unfortunately, I had severe gastrointestinal side effects and had to discontinue it after one month.

My most recent A1c was 7.2, taken a month ago. Honestly, I expected it to be higher due to the significant stress I’ve been under—helping my mother with Alzheimer’s and placing her in a nursing home, and recently losing my father while also dealing with Medicaid-related issues. The A1c six months prior was 6.7. Now that things are settling down, I’m focusing on my own health again.

While reviewing my electronic medical record, I noticed my kidney function tests and became concerned. My GFR was 57.51, and six months later, it was 59.41. A previous doctor told me that this indicated early chronic kidney disease (CKD) stage 3, and prescribed Enalapril Maleate not for hypertension, but to help protect my kidneys.

My current doctor wants to stop the Enalapril because my blood pressure is consistently low (around 90/60), though it has always been in that range for as long as I can remember. He has not mentioned anything about my kidney function since.

Additionally, I’ve been experiencing hypoglycemia unawareness—my blood sugar sometimes drops as low as 35 mg/dL before I notice symptoms. I brought this up with my doctor, but he didn’t seem concerned. This worries me greatly, especially since I live alone.

I’ve tried looking for another internal medicine specialist, but there are very few available in my area.

Can you please advise:

1. Could I still have Type 1 diabetes, despite being diagnosed at 39?
2. Should I be concerned about my GFR levels and the possible stage 3 CKD?
3. Is it safe to continue Enalapril with my low blood pressure?
4. How should I manage my hypoglycemia unawareness?

Thank you for your time and help.