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December 21, 1999

Hypoglycemia

Question from Sweden:

I am a 43 year old female with type 1 for 30 years. I am on Insulatard and Humalog and have an A1c of 5.5%. I have a question concerning rebounding. Often when I expect my sugar to be somewhat low I find at testing that it is 10-12 mmol/l [180-216 mg/dl]. Also when it has been steady in the lower range (4-6mmol/l) for a length of time I find that it suddenly jumps up to 10-12mmol/l. When up there it is very difficult to bring it down with Humalog. At those occasions I never feel any symptoms of hypos before running high. I easily recognize hypos when I am around 3mmol/l. Could those "highs" be some form of rebounding or what is else causing them?

Answer:

You probably developed hypoglycemia unawareness due to having too tight blood sugar control (I notice your HbA1c is 5.5% ): in fact, the closer to normal you keep your blood sugar, the lower your sugars get before you have any symptoms. In your case, in order to better understand those ‘highs’, it may be wise to ease off on the control a bit to allow the body to readjust to give you the right clues at higher blood sugar levels.

MS