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August 15, 2000


Question from Maryland, USA:

I am 41, type 1. Within the past two days I had readings of 45 mg/dl (2.5 mmol/L) and 50 mg/dl (2.8 mmol/L). They came from different monitors and both tests had ample blood. Both times, I had no hypoglycemic symptoms. In the past, I have had symptoms(mostly trembling) that began whenever my sugars were around 60 mg/dl (3.3 mmol/L). What is happening?


What you’re experiencing is called hypoglycemia unawareness. It’s defined as a hypoglycemic episode without having had warning symptoms associated normally with decreasing blood sugar levels. If you have frequent hypoglycemic episodes, the threshold for symptom recognition will occur at lower level. If the threshold for secreting counter-regulatory hormones falls below the blood sugar level where the brain reacts, you’ll not have any bodily warnings symptoms. You’ll subsequently not react in time and the hypoglycemia can easily proceed to a severe hypoglycemia. You should aim for a slight higher mean blood sugar levels and above all avoid hypoglycemia below 60-50mg/dl (3.3-2.7 mmol/L). In as little as one to two weeks time, you will recognize symptoms of hypoglycemia more easily again.