My 20 year old daughter has had type�1 diabetes for 16 years, has had a remarkable ability to recognize low blood sugar reactions, and has never had a reaction that necessitated intervention by medical personnel (even though at one point she was 16 mg/dl [0.9 mmol/L]). However, today, she was incoherent and unaware, a friend called an ambulance, and she was tested (44 mg/dl [2.4 mmol/L]) and treated. She can’t understand why this reaction(not her worst by far in terms of blood sugar readings) created such an unusual response in her nor can she understand why she didn’t recognize she was low. Do you have any suggestions?

This is a common question and response for people who have chronically lived with diabetes. However, there are a lot of studies which have shown that individuals lose their ability to sense low sugars the longer they have diabetes and the more low sugars they have. [This is called hypoglycemia unawareness.]

The fact that the number was not the lowest it has been is not surprising, given the fact that glucose monitors are not the most accurate in the low range of sugars. In addition, the sugar level may have changed from the time she had the event until the sugar was measured. The most important thing to do now is monitor more frequently and prevent low sugars so that she may regain some of her ability to sense low sugars.

JTL
Additional comments from Dr. Philip Ledereich:

The result obtained for the glucose result may have been higher than her actual glucose level, depending on the technique of glucose testing and model of the glucose meter. See Glucose Measurements Using Blood Extracted from the Forearm and the Finger. [Note: This is a PDF file and requires Adobe Acrobat.]

PL