The DNA damage response (DDR) of cells to low dose and low dose rate ionizing radiation is weak and remains a matter of controversy. The response can be studied by exposing cells to a low adapting dose (AD) and, subsequently to a high challenging dose (CD), where the response is strong. The aim of the present investigation was to analyse the DDR in cells exposed to very low dose rate AD and a high dose rate CD, with special focus on the role of the ATM kinase. U2OS cells (with wild type p53) were exposed to gamma radiation AD of 5.9 mGy at 31 µGy/h and of 10.5 mGy at 55 µGy/h. ATM was inhibited by addition of KU-55933. Adapted cells were exposed to a CD of 1 Gy photon radiation at 1 Gy/min. The studied endpoints included kinetics of 53BP1 foci formation and decay, cell cycle progression and gene expression. In some experiments, ATM was inhibited by KU-55933. AD alone led to a significant increase in 53BP1 foci, even in the presence of KU-55933, and it modulated the response to CD. KU-55933 failed to inhibit the induction of foci by AD and AD+CD, while foci induction by CD alone was inhibited. KU-55933 potentiated the G2 block in AD+CD-exposed cells. Gene expression was modulated by AD. In conclusion, AD differentially modulated the response of cells when given alone and after the CD, in absence and presence of KU-55933.