I am a 34 year old female and have had type�1 diabetes for 15 years. I have noticed that I can have two different sets of symptoms for a hypo. I have recently seen a short article that calls these two different hypos ‘Adrenergic’ and ‘Neuroglycopenic’. Can you give me any information on what decides which type of hypo I will get and is the ‘Adrenergic’ type related to heat?

I think that you are differentiating between different degrees of hypoglycaemia. Mild hypos are manifest by symptoms caused by excess activity of the sympathetic nervous system resulting in so-called autonomic symptoms such as palpitations, nausea, dizziness and pallor. If nothing is done about these ‘warning signs’, then the level of glucose in the brain falls further leading to neuroglycopaenia (reduced brain glucose levels) and confusion and uncontrolled behaviour can eventually lead to unconsciousness and collapse. This model implies that hypoglycaemic unawareness is a consequence of the neuroglycopaenic symptoms coming before the autonomic symptoms, rather than the other way around.

KJR