What is hypoglycaemia unawareness and why does it occur?

Hypoglycaemia unawareness also known as impaired awareness of hypoglycaemia, is a term used to describe a situation where the person with diabetes does not notice symptoms of low blood sugar until they lose consciousness.

Condition is common in those who experience frequent episodes of hypoglycaemia. With each episode, glucose level at which an individual starts to experience symptoms is reset to a lower level.

An individual who experienced symptoms when their blood sugar dropped to 3.3 mmol/L during their last episode of hypoglycaemia, may experience symptoms only when the level drops to 3.0 mmol/L the next time they have an episode. Whilst level at which symptoms develop continue to drop, glucose level that triggers unconsciousness remains the same.

Researchers estimate that 25% of individuals with Type 1 diabetes and 10-15% of those with Type 2 diabetes experience this condition. Individuals with diabetes for over 10 years , and those who suffer from mental health conditions that affect learning and memory are at higher risk of developing the condition, as they may have challenges taking care of themselves. Diabetics living with depression are also at risk.

Individuals with uncontrolled diabetes undergoing intensive treatment to achieve a specific range in order to prevent complications, are at increased risk of developing the condition. Beta blockers commonly used in the treatment of hypertension , have been shown to increase risk, as they can potentially disguise early symptoms of hypoglycaemia.

Hypoglycaemia unawareness impacts the sufferer’s life in a negative way and may affect their ability to carry out simple day to day activities. Reducing the frequency of episodes has been proven beneficial , as it helps reset and restore sensitivity to drops in blood sugar levels. Use of technologies like the continuous glucose monitoring (CGM) device is recommended for individuals with hypoglycaemia unawareness.