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Can you tell when your blood sugar is low?
Hypoglycemia Unawareness (HU) develops mostly with some people who have Type 1 diabetes. Normally, when blood sugar "drops below about 60-80 mg/dl, the body releases a hormone called epinephrine. It signals the liver to produce more glucose. It also produces the early symptoms of hypoglycemia, which let you know it's time to eat or drink." (website www.bddiabetes.com/us/understanding/hypo.asp). With hypoglycemia unawareness, the body no longer produces the epinephrine response, and therefore the person with diabetes does not experience the warning signs of hypoglycemia. However, their blood glucose may continue to drop to dangerously low levels, and they "may become weak, disoriented, or lose consciousness." (quoted from www.bddiabetes.com/us/understanding/hypo.asp)
If you have this condition, it is important to let your doctor know, so that you can get some help. Find out what blood sugar ranges s/he wants you to aim for. They may be higher than for those who have all the physical warning signs of low blood sugar.
This is a good time to review ALL of the symptoms of hypoglycemia yourself and with the people with whom you live and work:
Perhaps you can learn to detect one or more symptoms yourself, or that a co-worker or family member may notice -- for example, you may sit "funny" when you blood sugar gets low. Or, your face may look slightly different - maybe you look "older" when you get low.
If you work on the computer a lot, you may be able to notice yourself making more typing mistakes!
Use ALL of your resources if you have this problem, which include your doctor and diabetes educator, your own ability to study the symptom list and learn, and your co-workers and friends and family.
Some people with HU are absolutely terrified of having high blood sugars, but they think that very low blood sugars are okay.
REALITY:
Getting stopped by the police for having low blood sugar, or having a car accident because of low blood sugar can cause you to lose your driver's license.
You could fall down the stairs, hit your head or break a limb.
You could have a serious car accident, or heaven forbid, kill someone, including yourself.
People can die from very severe hypoglycemia.
LEARN FROM YOUR EXPERIENCE.
Once your blood sugar comes back to normal, you may want to forget about what happened, and resolve not to have a problem again. You may be embarrassed or angry with yourself for having "screwed up" or for having the paramedics called. But, "forgetting about it" will not help you to learn from your experience! Write down what happened and see if you can figure it out. If you can't, talk it over with your diabetes healthcare professional.
I have worked in psychotherapy with people with Hypoglycemia Unawareness. Why?
Sometimes, we are able to identify symptoms that the person does have. We work together to identify any little "inklings" you may have that something is different. Getting attuned to those inklings can be really useful.
Sometimes severe low blood sugar episodes have things in common -- they may seem to occur when person is visiting certain family members, or in the late morning when a person is at work. comfortable. In therapy, we work together to try to figure out why the low blood sugars are occuring at these odd times.
We also take a look at how it happens. Forgetting to test or ignoring blood sugar "inklings" is a natural human tendency -- who wants to interrupt their day? But, ignoring those inklings can have some pretty disastrous results, too, which hurt you in the long run.
Perhaps your fear of complications makes you think that even very low blood sugars are safe.
For example,
- Did you think you could "make it home" before eating something?
- Did you not want to stop what you were doing to test and then eat? Doing "one more thing" may result in a drop in your blood sugar that is so severe that you won't be functioning "on all cyllinders" and could result in a nasty fall, passing out, or the paramedics having to be called...if there is someone who checks on you.
- Do your most severe episodes tend to occur when you are with the same group of people? What is it about your interactions with those people that results in your having these problems?
- Do you enjoy the hypoglycemic episodes because then you get to eat something that you like?
People with hypoglycemia unawareness have usually had diabetes a long time. You may think that you know everything there is about diabetes. But, in my experience, this is a very good time to take a new look at your management of your diabetes. Find a diabetes educator who is a CDE, a Certified Diabetes Educator, and go over everything! Be sure to go over your target blood sugar levels, what you should take to raise your blood sugar, when you should take it, what you eat, when you take your insulin, how much and what type of insulin, etc. Keep a record of your hypoglycemia episodes - exactly when they occur. Good diabetes educators are worth their weight in gold - find one you like and get some help.
And, know that I am also here to help.
Hypoglycemia Main Page
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