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January 30, 2005

Blood Tests and Insulin Injections, Hypoglycemia

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Question from Spokane, Washington, USA:

Last night, I was low while my boyfriend was with me and he sat down and went through the log book in my One Touch Ultra Smart meter and asked me how low my meter reads. So, I told him down it goes as low as 20 mg/dl [1.1 mmol/L]. After that, it reads “low” and he then turned and asked me about a reading like that in my meter. I am now concerned because it did indeed read “low” and I don’t even remember making that blood sugar check! I remember the two checks before it because one was kind of low, 75 mg/dl [4.2 mmol/L], then back up to 110 mg/dl [6.1 mmol/L]. But, I don’t remember making the other check. I should because I was definitely awake before that check and after that blood sugar check.

I am on Lantus insulin at night and NovoLog for corrections and meals. I’ve been working out at the gym at my college for a half-hour every day starting this week. No one else in my family is diabetic or hypoglycemic and no else has used my meter at all, so, it couldn’t be anyone else’s blood sugar except mine. Something I read once suggested memory loss in sever hypoglycemic cases. Anyway, I’m wondering if you could shed some light on this. My parents, boyfriend, and I are rather concerned because I don’t remember this blood sugar check at all. Should we be concerned? Could you tell me anything as to why I would not remember making this blood sugar check if I know I didn’t pass out because I was not home alone and I was definitely awake shortly after that check?

Answer:

From: DTeam Staff

If you have frequent lows, the brain will recognize it at a lower blood glucose level (threshold) and you will miss the bodily warning system, called hypoglycemia unawareness. You will subsequently not react in time to eat something and the hypoglycemia may proceed to severe hypoglycemia. Sometimes, you will not even remember afterwards that you had hypoglycemia and this is what’s happening to you. In your case, physical exercise at the gym at your college might have played a significant role towards the lower blood sugar levels. You should now aim for a slightly higher mean blood glucose and above all avoid levels below 65 to 75mg/dl [3.6 to 4.2 mmol/L]. In as little as a week’s time, you will recognize symptoms of hypoglycemia more easily. You may want to ask your doctor if reducing insulin doses before exercise or even glargine (Lantus) for a while may ameliorate your tendency towards low blood sugar levels over the day.

MS