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September 3, 2002

Hypoglycemia

Question from Atlanta. Georgia, USA:

My 33 year old girlfriend has had diabetes for nearly 26 years and is still fighting this disease. She is under a doctor's care, but her sugars now are extremely bad. She follows all of her doctor's instructions but to no avail since her sugars get really low (20-32 mg/dl [1.1-1.7mmol/L]). When this happens, she blacks out, and the EMTs are called. Are there any new cures or medications out there for her? I'm writing to you because I love dearly, and I want to help her in anyway that I can.

Answer:

First, I would recommend she see an endocrinologist as her diabetes-care provider. These frequent low sugars have to be stopped. She needs frequent and close follow-up with her diabetes care team.

With these kind of serious complications from diabetes, aggressive therapy with frequent injections designed to avoid large doses of long-acting insulin is appropriate. If this does not work, I would recommend discussions regarding the use of an insulin pump since it has been successful in preventing frequent severe hypoglycemia in this situation. Lastly, patients who have life-threatening hypoglycemia that does not respond to intensive intervention with the above mentioned strategies may be candidates for a pancreas or islet cell transplant.

JTL