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June 29, 2000

Hypoglycemia

Question from Massachusetts, USA:

For the past month I've been unable to feel my lows until my sugars get down into the 30s and because of that I test my sugar 8-10 times a day now. My question is what is it called and why am I unable to feel my lows? I don't ever give myself too much insulin or anything like that.

Answer:

From what your description, I would say you are experiencing hypoglycemia unawareness. Low blood sugars usually occurs when there is mismatch of too much insulin or not enough food. Perhaps a closer look at your carbohydrate amounts, timing of exercise, and using Humalog (if you’re not already) rather than a longer acting insulin at meals will bring a better match for you. Testing your blood sugar before and 1-2 hours after meals can be very valuable information. You did not mention when the lows are occurring but if it is common after meals, you might want to talk to your diabetes team about the possibility of some delayed digestion as well.

Last, but certainly not least, is the need to stop these lows to bring back a better quality of life to you. Often people who have many low blood sugars, lose the ability to recognize low blood sugars. The body doesn’t send out those emergency warning alerts. It may be necessary for you to take a few weeks and temporarily raise your blood sugar goals to avoid the low readings. Once you are free of low blood sugars, your body will often regain its ability to recognize the dips in blood sugar again.

KS