I have been waking up with extremely low blood sugars and, recently, I haven’t been feeling the symptoms at all when I have a low. So, I don’t know when I’m really low anymore. Can my low blood sugars be damaging my body?

Surely, hypoglycemia could be very harmful. As well, frequent readings in the lows are not good especially if you don’t feel any symptom during these nightly episodes. The possibility that you have some kind of hypoglycemia unawareness could be taken into consideration. I would discuss with your diabetes team a new insulin scheme in order to avoid so many hypoglycemic reactions. In fact, this is a serious problem as it can cause you to have changes in your mental status very rapidly and interfere with the ability to drive a car or operate machinery or even supervise children. When this occurs, the treatment is frequent monitoring of blood sugars, adjustment of target blood sugars to a higher level so as to prevent the lows, and frequent contacts with your provider. Previous research has shown that strict avoidance of hypoglycemia will allow for you to have a return of symptoms of hypoglycemia. They may not be as prominent as they once were, but they would be a help to you in avoiding serious reactions. We have even had patients receive pancreas transplantation for severe hypoglycemia unawareness. Obviously, medical management should be tried before consideration of transplantation. In some countries, you can lose your license for a hypoglycemic episode with loss of consciousness. Your physician has to be in on this and provide you direction. Frequent monitoring with strict adherence of glucose goals is mandatory.

MS