
April 5, 2004
Hypoglycemia, Other
Question from Bogota, Colombia, South America:
For the past three years, I have been unable to recognize low blood sugar symptoms. My last A1c was 7.9 percent. I take lispro (Humalog) and Lantus. I have been having hypoglycemic seizures and my endocrinologist is very worried about possible brain damage. He recommended a positron scan, but there is no one in Colombia who can perform this exam. Where are the nearest places in the United States do get this brain scan? Do you know if any of the countries that are near Colombia, such as Panama, Ecuador, Venezuela, Brazil or Argentina, have hospitals that can perform the scan?
Answer:
What you are experiencing is hypoglycemic unawareness, which is a result of several factors:
poor glucose control in the past
long standing diabetes
the body’s counter regulatory system is disrupted and you do not produce enough epinephrine, glucagon to sustain a response.
I do not know of any area in Central or South America which can provide you with this scan but you can check it out. In the United States, I would concentrate at the major university centers such as Miami, Los Angeles, San Diego, etc. In the meantime, I would definitely improve your control. In some instances, if your A1c improves and your control improves, the ability to detect hypoglycemia can be restored.
ABS