I’ve had type 1 diabetes for about 15 years. I was just released from two days in the ICU with severe hypoglycemia. I have hypoglycemia unawareness. When my husband found me, my blood sugar was 11 mg/dl [0.6 mmol/L]. He called medics and they gave me a bolus of dextrose. In the hospital, I was told that I would have died in about 30 minutes from the hypoglycemia if I hadn’t been found or helped. Is this possible? Can hypoglycemia really kill? If so, why?

Unfortunately, hypoglycemia can kill. Glucose is the obligate fuel for the brain. Without it, you can have seizures, unconsciousness, and you can suffer accidents related to the compromised mental status. People can aspirate secretions into their lungs, have motor vehicle or machinery accidents, and suffer cardiac rhythm disturbances during the episodes of hypoglycemia. That being said, I am glad you are better. You need to work through a plan with your physician that helps you meticulously avoid hypoglycemia. This may have some of the same elements as tight control of glucose when you are going from high values to low values. However, you will be going from low to high values.

There is some evidence to suggest that avoiding hypoglycemia for a period of months may allow you to regain some of your symptoms of hypoglycemia, and this will help protect you. Elements of the program include new target goals for your blood sugar, frequent monitoring and reporting, potentially new insulin regimens, and nighttime glucose monitoring. New insulin regimens may utilize more frequent short-acting insulin or even an insulin pump, if you are not already doing that. You and your family need to be educated on the use of glucagon for home use. You need education to learn when you are most likely to be low. I hope you can receive this comprehensive education and intensive care. It will be very important to you.

JTL