Overview

Hypoglycemic unawareness means not being able to recognize low blood sugar until the symptoms are serious. Most people have symptoms if their blood sugar drops below 4.0 mmol/L. But if you have hypoglycemic unawareness, the only symptom you may have is confusion. Or you may become unconscious before anyone realizes you have low blood sugar.

You may have hypoglycemic unawareness if you:

• Can't feel when your blood sugar is low.
• Have had low blood sugar many times.
• Have had diabetes for a long time.

There is no cure for hypoglycemic unawareness. Sometimes you can regain some ability to feel that your blood sugar is low.

To do this, you need to avoid having low blood sugar levels for a few weeks. This helps teach your body how to react to low blood sugar again with warning signs like sweating, feeling shaky or weak, being very hungry, and feeling dizzy.

Your doctor may raise your target blood sugar level during this time to help keep it from dropping too low. Do not change your target blood sugar levels on your own. Talk to your doctor first.

How to stay safe when you have hypoglycemic unawareness

If you have hypoglycemic unawareness, you can't tell by your symptoms when your blood sugar is low. You may become unconscious before anyone realizes you have low blood sugar, so take steps to protect yourself.

• If possible, use a continuous glucose monitor (CGM).

  This is a useful tool to help predict when your blood sugar is getting too low.

• Test your blood sugar often.

  This is especially important before activities like driving a car.

• Keep quick-sugar foods with you at all times.

  At home, have something close at hand, such as glucose tablets (preferred choice), table sugar, or fruit juice. Carry glucose tablets or some hard candy when you're away from home.

• Teach friends and family how to treat low blood sugar.

  This is important for times when you are too weak or confused to treat low blood sugar on your own.

• If you take insulin or have hypoglycemic unawareness, always carry glucagon with you.

  Be sure your family, friends, and co-workers know how to give glucagon.