Hypoglycemia Unawareness
Hypoglycemia unawareness means that you have little or no warning signs when your blood sugar is low. As a result, your blood sugar may drop to a very low level (less than 40 mg/dl) without symptoms. This may occur in people who:
- Have had diabetes for many years.
- Maintain lower A1C levels.
- Have frequent low blood sugars.
The hormone, epinephrine or adrenaline, is normally released when the blood sugar falls below 70 mg/dl. When this release happens, symptoms like shaking and sweating occur. If you have hypoglycemia unawareness, adrenaline is not released and the usual symptoms of low blood sugar do not occur.
Symptoms or warning signs of low blood sugar can change over time. Symptoms may be more subtle or you may have no symptoms at all. Your first warning may be feelings of fatigue or confusion caused by low blood sugar to the brain. When in doubt, check your blood sugar.
Special Precautions
You will need to take special precautions if you start to lose symptoms of low blood sugar.
1. Check your blood sugar more often.
2. Always check your blood sugar level before driving. If blood sugar is less than 150 mg/dl and you have not eaten in the last two hours, you should have a snack before driving.
3. Carry some form of sugar with you at all times. It is a good idea to keep sugar in the car as well (glucose tablets, glucose gel, fruit juice, soda pop, candy).
4. If you live alone you may want to set your alarm and get up during the night to check your blood sugar. Your blood sugar will be lowest between 2:00 am and 5:00 am. You may want to have a family member or friend call you in the morning to be sure you are up at the normal time.
5. A glucagon kit should be available in the event that you are not able to safely swallow sugar. Family, friends, and co-workers must know how to give this rescue medication. Please see Health Facts #4306 about the use of glucagon.
Informing Others
Tell family, friends and co-workers that you do not always sense your low blood sugars. They should know how to help if you become confused or do not respond. Always wear identification that is easily seen by others such as a Medic-Alert bracelet or necklace. Carry a wallet card that states that you have diabetes.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 10/24/2008
Copyright © 10/24/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4508
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