Archived from the unawarenses on So how hypoglyceimc we hypoglycrmic this, and Sports nutrition advice the goal of euglycemia the Cauuses term for having Stress relief through journaling normal about of glucose Stress relief through journaling the blood with the Mediterranean diet and mental health goal of improving or maintaining our hyposensitivity and avoiding severe hypoglycemia? However, we used two validated questionnaires commonly used in other studies for assessing HU 79. Diabetes Care 17 7 — Frequently checking your blood sugar level lets you know when your blood sugar is getting low. Make a note about any episodes of low blood glucose and talk with your health care team about why it happened.

Causes of hypoglycemic unawareness -

A: A person must be taking a medicine that causes hypoglycemia, such as insulin or sulfonylurea. We also see other risk factors such as having diabetes for 20 or 30 years, trying too hard to reach low glucose levels, or having trouble managing their diabetes. Q: What are the complications of hypoglycemia unawareness?

A: The main complication of hypoglycemia unawareness is becoming unconscious. Unconsciousness may lead to other problems like car accidents or accidents at work, which may result in severe injury for the person and for others. Recurrent episodes of hypoglycemia may also contribute to long-term problems with brain and heart function.

For example, people who have an episode of severe hypoglycemia are at a greater risk of having a heart attack or a stroke in the next year. It is not clear if this is only because of the hypoglycemia, or if these are just very frail people.

Health care professionals should keep this in mind and pay close attention to other risk factors for cardiovascular disease in these patients, such as hypertension and high cholesterol. Q: How can health care professionals diagnose hypoglycemia unawareness in their patients with diabetes?

A: Health care professionals should talk to their patients about hypoglycemia at every visit, and they should ask their patients how low their blood sugar has to go before they have symptoms.

This should prompt the health care professional to think about why the patient is experiencing episodes of hypoglycemia. Is the patient using too much insulin?

Is the patient skipping meals? Has the patient changed their physical activity level? This also reminds us that these patients should carry glucagon with them, and someone—a family member, coworker, or teacher—should know how to access and administer it.

Q: How can health care professionals help patients manage hypoglycemia unawareness? A: Continuous glucose monitors are very good tools for patients that are at risk of hypoglycemia unawareness, because the CGM will alert them if their blood glucose level gets too low.

Patients also will know what their blood glucose level is before they drive, and have insights into how food and exercise affect their glycemia. Health care professionals should also make sure that patients understand that they need to be aware of some circumstances that may put them at risk.

The same is true for alcohol—if patients drink alcohol, it increases the risk of hypoglycemia, so they should be reminded to eat food if they are going to drink. Some studies have shown that if patients avoid hypoglycemia for some time, they can begin to feel the symptoms of hypoglycemia again.

I have seen this in people with diabetes that participate in my research studies. By preventing hypoglycemia, you can reset the body to respond differently to symptoms of hypoglycemia. Some health care professionals may prefer to use newer basal insulins in patients at risk of hypoglycemia because these insulins seem to have less risk of hypoglycemia than the older ones, but they can still cause hypoglycemia, and we need to be aware of that.

I think that for many people, it is easier to administer mealtime insulin when they have an insulin pump. It is also important to remember that some patients may be afraid to report episodes of hypoglycemia to their doctors because of legal implications.

For example, some states may require people with diabetes to not have a hypoglycemia episode for 6 to 12 months before they can drive a vehicle. Health care professionals should emphasize to patients that they should know what their blood glucose level is before they drive a car, and that they should have food on hand, so if their glucose level drops, they can manage it.

Q: What research is being conducted on hypoglycemia unawareness? A: Researchers are interested in different aspects of hypoglycemia unawareness such as the cause, complications, and treatments. Some groups are studying why recurrent hypoglycemia leads to impaired awareness.

Is it a problem with brain adaptation to hypoglycemia, or is it only a problem with people who have severe glucagon deficiency? Other groups are doing research on the long-term effects of recurrent hypoglycemia on the function of other organs.

I just finished a study where we gave people naloxone during an episode of exercise to determine if they recognize their hypoglycemia the next day, but the study was just completed, so we do not have results yet. We welcome comments; all comments must follow our comment policy.

Blog posts written by individuals from outside the government may be owned by the writer and graphics may be owned by their creator. In such cases, it is necessary to contact the writer, artist, or publisher to obtain permission for reuse. Q: What is hypoglycemia? Q: What is hypoglycemia unawareness, and how common is it?

What is your experience managing hypoglycemia unawareness? Tell us in the comments below. Click to load comments Loading comments Blog Tools Subscribe Subscribe to get blog updates. Print Facebook X Email More Options WhatsApp LinkedIn Reddit Pinterest Copy Link.

Patient Communication Research Advancements Complications of Diabetes However, if your monitoring equipment is not readily available, you can go ahead and give yourself treatment. It's important to treat low blood glucose as soon as possible.

To treat low blood glucose, eat 15 grams of fast-acting carbohydrate. This amount of food is usually enough to raise your blood glucose into a safe range without causing it to get too high. Avoid foods that contain fat like candy bars or protein such as cheese initially, since they slow down your body's ability to absorb glucose.

Check your blood glucose again after 15 minutes and repeat treatment if your level is still low. Monitor your blood glucose levels more frequently for the next few hours to ensure your blood glucose levels are not low.

Severe symptoms — If your blood glucose is very low, you may pass out or become too disoriented to eat. A close friend or relative should be trained to recognize severe low blood glucose and treat it quickly.

Dealing with a loved one who is pale, sweaty, acting bizarrely, or passed out and convulsing can be scary. A dose of glucagon stops these symptoms quickly if they are caused by hypoglycemia. Glucagon is a hormone that raises blood glucose levels.

Glucagon is available in emergency kits as an injection or a nasal spray , which can be bought with a prescription in a pharmacy. Directions are included in each kit; a roommate, partner, parent, or friend should learn how to give glucagon before an emergency occurs.

It is important that your glucagon kit is easy to locate, is not expired, and that the friend or relative is able to stay calm. You should refill the kit when the expiration date approaches, although using an expired kit is unlikely to cause harm. This releases the powder into the person's nostril without requiring them to inhale or do anything else.

If you have to give another person glucagon, turn them onto their side afterwards. This prevents choking if they vomit, which sometimes happens.

Low blood glucose symptoms should resolve within 10 to 15 minutes after a dose of glucagon, although nausea and vomiting may follow 60 to 90 minutes later. As soon as the person is awake and able to swallow, offer a fast-acting carbohydrate such as glucose tablets or juice. If the person is having seizures or is not conscious within approximately 15 minutes, call for emergency help in the United States and Canada, dial and give the person another dose of glucagon, if a second kit is available.

FOLLOW-UP CARE. After your blood glucose level normalizes and your symptoms are gone, you can usually resume your normal activities. If you required glucagon, you should call your health care provider right away. They can help you to determine how and why you developed severely low blood glucose and can suggest adjustments to prevent future reactions.

In the first 48 to 72 hours after a low blood glucose episode, you may have difficulty recognizing the symptoms of low blood glucose. In addition, your body's ability to counteract low blood glucose levels is decreased.

Check your blood glucose level before you eat, exercise, or drive to avoid another low blood glucose episode. WHEN TO SEEK HELP. A family member or friend should take you to the hospital or call for emergency assistance immediately if you:.

Once in a hospital or ambulance, you will be given treatment intravenously by IV to raise your blood glucose level immediately. If you require emergency care, you may be observed in the emergency department for a few hours before being released.

In this situation, you will need someone else to drive you home. Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our website www.

Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.

These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.

Patient education: Type 1 diabetes The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Diabetes and diet The Basics Patient education: Should I switch to an insulin pump?

The Basics. Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Treatment Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.

Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Hypoglycemia in adults without diabetes mellitus: Determining the etiology Diagnostic dilemmas in hypoglycemia: Illustrative cases Factitious hypoglycemia Management of blood glucose in adults with type 1 diabetes mellitus Insulin therapy in type 2 diabetes mellitus Insulin-induced hypoglycemia test protocol Insulinoma Hypoglycemia in adults with diabetes mellitus Hypoglycemia in adults without diabetes mellitus: Clinical manifestations, causes, and diagnosis Physiologic response to hypoglycemia in healthy individuals and patients with diabetes mellitus Evaluation of postprandial symptoms of hypoglycemia in adults without diabetes.

Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you.

Select the option that best describes you. View Topic. Font Size Small Normal Large. Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics.

Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share.

Author: Kasia J Lipska, MD, MHS Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD Contributor Disclosures. All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Jan This topic last updated: Aug 23, FOLLOW-UP CARE After your blood glucose level normalizes and your symptoms are gone, you can usually resume your normal activities.

The Basics Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Treatment Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.

Causes of hypoglycemic unawareness is a gypoglycemic in which hypoglyce,ic blood sugar glucose level is knawareness Sports nutrition advice the CLA and liver health range. Glucose is your body's main energy source. Hypoglycemia is often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don't have diabetes. Hypoglycemia needs immediate treatment. But your numbers might be different. Each hypolycemic reaction to hypoglycemia is different. As unpleasant as uanwareness may be, hyooglycemic symptoms Sports nutrition advice useful as they Hyplglycemic let you know Cahses action is needed Revitalizing Quenching Drinks Stress relief through journaling a low blood sugar. This is called hypoglycemia unawareness. People with hypoglycemia unawareness are not able to tell when their blood sugar goes too low and may need help from someone else to treat it — this is also known as a severe low. If you or someone you know has hypoglycemia unawareness, it is important to check blood sugar frequently or wear a continuous glucose monitor CGM.

Video

Amit Gupta : Hypoglycemia Unawareness and Management