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February 1, 2001

Hypoglycemia

Question from Ottawa, Ontario, Canada:

I am 40 years old, and I have had type 1 diabetes since I was 10. I've heard that having many severe insulin reactions can cause memory loss over a long period of time. Is this true? My memory is terrible as I get older, and I know many of my reactions growing up ended with hospitalization on IVs.

Answer:

The long-term consequences of hypoglycemia are a major concern to patients with diabetes and their caregivers. The short answer to your question is that there has not been long-term deterioration in cognitive function seen in large studies of patients with type 1 diabetes. These studies included individuals 13 years of age and older. There have been studies which have shown deterioration in cognitive function in younger children with type 1 diabetes who have frequent hypoglycemia. This serves as the warning against aggressive/intensive control of blood sugars in very young children.

An additional point should be added. Note that frequent hypoglycemic reactions are more common when you lose your early warning symptoms. In addition, hypoglycemia unawareness tends to be more frequent the older you are and the longer you have diabetes. It is helpful to monitor for hypoglycemia which causes no symptoms so that you can prevent major reactions and adjust your regimen appropriately. The good news is that avoidance of hypoglycemia appears to offer some protection.

JTL