My 36 year old husband got diabetes when he was ten and now cannot feel the onset of a reaction. His blood sugar goes low, and he has no clue. He recently got into a car accident because of this. Is there something he can wear to alert him is blood sugar it getting low? What can we do so that I can feel safe with him driving our children in the car?

This is a very important question. When individuals with type�1 diabetes develop hypoglycemia unawareness, it means they do not have the appropriate signals from their body that a low blood sugar is present. Since glucose is required by the brain for normal function, it is no wonder that people behave strangely, pass out, or even have seizures. If your husband is at this point, it is time to do more drastic things.

First, I would say he cannot get into a car and drive unless he checks his blood sugar and obtains a blood sugar reading which allows him to drive (where he is not low or soon will be low). Second, he needs to see his diabetes care providers and get more help. There is some evidence to suggest that individuals who work at preventing frequent episodes of hypoglycemia may get some return of their ability to sense low blood sugars. This usually requires frequent checks with the physician, nurse, or diabetes care team. It may require lifestyle changes and changes in insulin, but it is worth it to do so. Finally, if lifestyle and safety deteriorates so dramatically, patients have been referred for pancreas transplantation for this type of problem. However, the latter solution is not the immediate first step. It should be done only if nothing else works.

JTL