By: Doris Dickson for Diabetes1
According to Sheri R. Colbert PhD, author of the Diabetic Athlete’s Handbook, approximately 20 percent of long term insulin-dependent diabetics exhibit hypoglycemia unawareness. Essentially, hypoglycemia unawareness is the inability to recognize low blood sugar. The American Diabetes Association defines low blood sugar as levels <70 mg/dL.
Methods for Reducing Hypoglycemia Unawareness
Raise blood sugar targets for two to three weeks in order to avoid low blood sugar.
Test blood sugar more often, providing more data to make more rapid adjustments.
Increase protein intake and reduce carbohydrate intake, reducing insulin requirements.
Use the data from additional blood sugar tests to note the different symptoms experienced at specific blood sugar levels.
Many diabetics recognize hypoglycemia because they feel shaky. This shakiness is caused by a release of adrenalin – the fight or flight hormone – when blood sugar levels reach too low a level for the body to operate optimally. Once the low blood sugar is recognized, it is easily correctable with rapidly-digesting carbohydrates such as glucose tablets or juice.
However, over time some people release less adrenalin and symptoms such as shakiness diminish or disappear altogether. It is thought the cause of many cases of hypoglycemia unawareness is repeated bouts of low blood sugar. Therefore, the cure is thought to be reducing incidences of low blood sugar.
Some physicians and certified diabetes educators recommend raising blood sugar targets for two to three weeks in order to avoid low blood sugar. After a few weeks without lows, patients often find symptoms such as shakiness return.
Raising blood sugar targets isn’t the only way to avoid low blood sugar in order to restore symptoms. Patients can also test their blood sugar more often; some test as often as 12-15 times per day, thus, providing themselves more data to make more rapid adjustments. Patients can also increase protein intake and reduce carbohydrate intake, thereby reducing insulin requirements, which reduces the overall risk for low blood sugar.
In addition, patients can use the increased data from additional blood sugar tests in order to note symptoms at specific blood sugar levels, which may differ from those they are accustomed to (i.e. shakiness). For instance, some people notice that they begin to yawn when their blood sugar is in the process of dropping. Yawning alone is unremarkable but combined with a few quick blood sugar tests might reveal a new warning sign of low blood sugar. Keeping a log book with such notations might also assist with the process of identifying new symptoms in order to avoid lows and restore awareness.
Whichever method the patient chooses, it is important to restore awareness of low blood sugar in order to prevent major incidences of hypoglycemia. A major incidence is defined as one in which the patient requires assistance. For example when a patient loses consciousness or has a seizure. Although seizures are rare they are quite dangerous and can result in short-term or permanent cognitive damage as well as the loss of driving privileges in many states.