July 18, 2011

Have You Experienced Hypoglycemia Unawareness?

An article by Elizabeth Woolley at About dot com appeared on my computer on July 7 and sort of shocked me. I guess I should not be surprised any more with all the new information coming out every day on diabetes. But this one gave me a funny feeling and made me wonder why I had missed this before. Hypoglycemic unawareness is known to affect people with Type 1 diabetes, but there is significant evidence that Type 2 people also have this problem.

The evidence presently that hypoglycemia unawareness affects those Type 2 people on insulin, or on oral medications that can cause low blood glucose. Hypoglycemia is defined as a blood sugar reading of below 70 mg/dl. If a person does not experience the symptoms of hypoglycemia, they need to take action. The more common symptoms include trembling or weakness, lack of coordination, drowsiness or confusion, headache, dizziness, double vision, excessive sweating, and convulsions or unconsciousness.

If you get to the last symptom, you are in already in trouble and a glucagon kit should also be kept available, in case the person is unable to take in sugar orally. Early in the symptoms, a juice box, candy (but not chocolate because of the fat), or glucose tablets will normally bring blood glucose levels back to normal fast.

The risk of hypoglycemia unawareness increase the longer the person has had diabetes. In a study done with people with type 2 diabetes on insulin, those who had severe hypoglycemia in the prior year were at a 17-fold higher risk of having severe hypoglycemia the next year.

Hypoglycemia can make management and treatment more difficult, but the following ways may help reduce the risk. The first suggestion is difficult with the insurance restrictions on test strips they will pay for, but you still should consider frequent testing and let your doctor know if you find your blood glucose levels are low and you do not feel any of the symptoms.

Next, if possible get self management education which most insurance will cover with a doctors order. Then work with your doctor for individualized blood glucose level goals. Also ask about flexible treatment regimens. All of these can greatly assist in your management to prevent hypoglycemia.

If you develop a history of hypoglycemia unawareness, ask your doctor about hypoglycemia avoidance for a period of 2 to 3 weeks to possibly increase sensitivity. This means allowing your blood glucose levels to be higher for this period in an effort to increase your sensitivity to the symptoms of hypoglycemia.

Read the blog here by Elizabeth Woolley, and the ADA article here. The abstract for reading is here.  This last link may not work if you browser does not accept cookies.

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