Common Health Issues

Hypoglycemia Unawareness

• By Rich Health Editorial Team
• November 01, 2021

HYPOGLYCEMIA UNAWARENESS

An important aspect of dealing with hypoglycemia is to recognize an episode and take immediate steps to prevent it from becoming severe. But for many people, hypoglycemia occurs without apparent symptoms. This phenomenon, called hypoglycemia unawareness, seems to be much more common than previously realized. In the Diabetes Control and Complications Trial, a study of the effects of intensive therapy, one-third of all episodes of severe hypoglycemia occurred in patients who had no evident symptoms

 

HYPOGLYCEMIA UNAWARENESS SYMPTOMS

If you have hypoglycemia unawareness, you are experiencing hypoglycemia without symptoms. The first sign may in fact be impaired thinking, which makes it even more difficult to know when you are having a low blood glucose reaction. You may find yourself in the middle of a severe episode without any warning at all.

 

HYPOGLYCEMIA UNAWARENESS RISKS

Hypoglycemia is fairly common in people who tightly control their blood glucose levels. It is also common in pregnant women and in people who have been recently diagnosed with diabetes. People who have repeated episodes of hypoglycemia are also at risk of hypoglycemia unawareness

 

WHAT YOU SHOULD DO

If you have blood glucose reading below 55mg/dl without any symptoms, either on occasion or frequently, talk to your doctor or health care team right away. You and your doctor should devise a plan for changing your blood glucose goals to prevent hypoglycemia.

 

If you are in the middle of an episode without warning, make sure those around you know what to do. If you are able, test your blood glucose level. If it is below 50-60mg/dl, take 10-15 grams of fast-acting carbohydrate. 

If you are unable to test, eat a fast-acting carbohydrate snack anyhow. Wait 15 minutes, then test again. You will probably need a second dose of carbohydrate. If you are having a severe hypoglycemic reaction, which is often the case with hypoglycemic unawareness, you will require assistance or emergency treatment.

 

If you have hypoglycemia unawareness, make sure those around you know the signs. Carry a supply of pocket carbohydrate and a glucagon kit with you at all times and make sure your helpers know how to use it.

 

HYPOGLYCEMIA UNAWARENESS TREATMENT

If you fail to respond to eating fast-acting carbohydrates or if you have become unresponsive, are having convulsions, or have lost consciousness, then you will need emergency assistance. Those around you should call for help immediately. If possible, you should be given an injection of glucagon. If medical help arrives and glucagon has not been administered, you will be given intravenous glucose.

 

HYPOGLYCEMIA UNAWARENESS PREVENTION

If you have hypoglycemia unawareness, talk to your health care team about what you can do to prevent it. By preventing even mild hypoglycemia, you may be able to restore at least some of your ability to detect the symptoms of hypoglycemia. You may want to change your blood glucose goals.

 

 For example, if you had been aiming for a between-meal blood glucose level of 120mg/dl, then 140mg/dl may be a more appropriate target. You may also be advised to monitor your blood glucose levels more frequently. 

 

This is especially important before you drive and after strenuous exercise. Also monitor any time that you do something that in the past has triggered hypoglycemia. If you seem to develop hypoglycemia every time you clean the house or argue with your boss before lunch, then test your blood glucose level whenever this occurs. Also, make sure those around you know how to detect hypoglycemia and know what to do if you are having an episode.

 

Sources and References

• The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

 

• The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview by David M. Nathan et al for the DCCT/EDIC Research Group

 

• Hypoglycemia Unawareness in IDDM by P. E Cryer