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July 27, 2005


Question from Virginia, USA:

Do most people with long term type 1 diabetes eventually develop hypoglycemia unawareness? Is there a difference between what they get and transient hypoglycemia unawareness? I've had diabetes for seven years and, 99% of the time, feel my lows at about 70 mg/dl [3.9 mmol/L]. Will good control make it more likely, in the future, that I'll lose my ability to feel lows? From talking to other long timers with type 1, I got the impression that, in spite of testing their blood sugars frequently, they've never gotten back the ability to "feel" their lows. I hope this isn't an inevitable, unavoidable complication.


Hypoglycemia unawareness is not inevitable. However, as good control is the more expected and sought after outcome, there may be less vigilance for preventing lows. To avoid the problem, I would recommend intermittent monitoring of overnight blood sugars. This is the time that most are missed. Avoiding severe lows is helpful in avoiding hypoglycemia unawareness.