September 8, 2002
Question from West Jordan, Utah, USA:
I am almost 64 years old, I've had type 1 diabetes since age seven, and about five years ago, I started to test and control my sugar levels closely. Over the years before, especially now, I've had many episodes of varying degrees of hypoglycemia (usually once or twice a day and too often at night during sleep), indicating usually that I don't eat enough for the insulin I take twice a day, and I am too often trying to regulate all that with my doctor. My concern is about the possible long-term effects of hypoglycemia on my brain functions (memory, language, electrochemical synapses, etc.). Are there serious consequences from prolonged episodes of hypoglycemia to worry about if they continue? I will retire this year, but will need to continue to work -- mostly with my brain! Hence the question.
This has been a point of interest in several large studies evaluating the benefits/side effects of intensive control. Remarkably, no severe intellectual deficits were noted with more frequent hypoglycemia. However, this is not the case for children where there is fear that hypoglycemia may have more permanent intellectual problems.
I would add that two insulin shots per day is not a very intensive regimen. I would suggest you speak to your physician about another regimen to avoid nocturnal hypoglycemia.