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July 27, 2005

Hypoglycemia

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.

Answer:

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.

JTL