No one with diabetes would want to have symptoms of low blood sugar. Sweating and feeling shaky, dizzy, moody and anxious are all symptoms of lowered blood sugar. It is important to deal with this condition as soon as it occurs.
But what to do if your body doesn’t send these warning signs? The inability to perceive hypoglycemia is called hypoglycemic disorder of consciousness, and patients can faint without knowing that their blood sugar is lowering.
Learn more about what increases the chances of this happening and how to prevent it below.
Who develops hypoglycemic dyscalculia?
People with diabetes, whether they use insulin or other medications to control their blood sugar, can develop hypoglycemia. People with type 1 diabetes are more likely to develop it. Once hypoglycemia occurs, it is more difficult for the patient to respond to hypoglycemia thereafter.
People with type 1 diabetes are also more likely to be unable to perceive hypoglycemia, although this can also happen in people with type 2 diabetes. The longer the duration of diabetes, the more common this is. The patient’s perception of hypoglycemia begins to fade after 5 years of disease. 20 years later, it may be so weak that the patient does not notice it at all, or the symptoms may only occur if the blood glucose is very low.
In addition, patients with the following conditions are more likely to have hypoglycemic dysfunction of consciousness.
- Have neuropathy, or damage to the part of the nervous system that triggers the response to hypoglycemia.
- Have tight glycemic control, are on intensive insulin therapy (3 or more injections of insulin per day), have a history of severe hypoglycemia requiring assistance from others, or have recently experienced hypoglycemia.
- Taking medications for heart disease or high blood pressure that mask the body’s response to hypoglycemia.
What causes hypoglycemic disorders of consciousness?
Normally, when blood sugar is too low, the body stops producing insulin and starts producing other hormones, including glucagon and epinephrine, which help keep blood sugar stable.
Adrenaline is also the hormone that works when the body has a “fight or flight” response. Adrenaline can trigger the symptoms that people with diabetes usually feel when their blood sugar starts to fall. However, if hypoglycemia is present all the time, the response to hypoglycemia will become blunted. If the symptoms of low blood sugar are not felt, it may not be possible to know that blood sugar levels are dropping. If blood sugar levels are too low, you may faint or have a seizure and need emergency treatment.
Response to hypoglycemic dyscalculia
If you are unable to feel the symptoms that should occur when hypoglycemia hits, you should see your doctor. It is possible that perception of hypoglycemia will return within a few weeks. The doctor will develop the best treatment plan.
The doctor may have the following recommendations.
- Set a higher than usual goal for blood glucose levels. This usually takes a few weeks to stick to.
- Increase the frequency of blood glucose testing. It may be necessary to test your blood glucose at bedtime, during exercise or meals, or more frequently when you are sick or stressed. Your doctor may also ask to test your blood glucose at other times.
- Use an ambulatory glucose monitor. It is still necessary to monitor blood glucose and tie your finger, and this monitor is more likely to detect patterns or trends in it. This helps manage diabetes better.
- Reduce the chances of hypoglycemia. Review the factors that are more likely to cause hypoglycemia and take steps to reduce the chances of hypoglycemia. For example, it may be necessary to adjust the amount of insulin to match your diet and exercise habits. Or the diet and the amount of carbohydrates consumed at each meal may need to be more regular.
Knowing the other symptoms of hypoglycemia
Even without the physical symptoms of hypoglycemia, there can be:
- Inability to concentrate;
- slowed speech;
- slow thinking;
- clumsiness.
These symptoms begin when blood glucose levels still allow patients to manage hypoglycemia on their own. These symptoms are more subtle than typical hypoglycemia symptoms, but can be observed at those times if one knows at which times of day one’s blood sugar often drops.
Preventing hypoglycemic disorders of consciousness
The best way to prevent hypoglycemic disorders of consciousness is to try to avoid hypoglycemia, including:
- Discussing your target blood glucose level with your doctor.
- Testing your blood glucose frequently and being aware of what factors can affect blood glucose levels.
- Even if you feel good, retest and treat low or declining blood sugar.
- Tell family and friends.
- Tell family and friends that you are at risk for hypoglycemic disorders of consciousness. Teach them the signs to look for and how to manage the disorder.