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September 26, 2000


Question from Marion, Indiana, USA:

I was diagnosed with low blood sugar about five months ago. My doctor did not say anything about a sugar tester. Should I ask him about it again? I can tell when my sugar is bad, but should I ask him about a sugar tester?


Hypoglycemia can usually be managed very successfully with frequent, small meals and snacks, and you may not need blood glucose monitoring to be well controlled. If you are concerned that you need further management of your condition, feel free to discuss it with your physician.

Additional comments from Stephanie Schwartz, diabetes nurse specialist:

It may be a good idea to have a blood glucose meter. Just because you seem to be able to “tell” when your sugar is low, does not mean that you intuition is reliable. There are lots of other things that can have symptoms similar to those of low blood sugar. In addition, where someone has low blood sugars for a long period of time, he or she may develop hypoglycemia unawareness and will not be able to recognize symptoms at all.


[Editor’s comment: The reader will note that the two answers above are entirely opposite: yes vs. no about the appropriateness of a meter.

I think that the decision whether to recommend using a meter is highly dependent on what the diagnosis of hypoglycemia entailed. Was the diagnosis merely a casual comment by a next-door neighbor that “your symptoms sound a lot like my brother’s niece’s problems”, or was it a diagnosis by an endocrinologist who did very detailed testing? (It was probably somewhere in between!)

In a situation where the diagnosis is perfectly clear, the instruction in the use of a meter by a Certified Diabetes Educator can add a lot of insight into what situations provoke low sugars and identify situations where the perception of low sugar isn’t matched by the reality of a low number; but buying a meter off-the-shelf in a pharmacy without appropriate instruction can sometimes just reinforce a misdiagnosis in a casually-diagnosed case.

If you haven’t been referred to an endocrinologist, and a dietitian who is familiar with diabetes and hypoglycemia, it would be worth requesting consultation with both.