A new study has found that 21 per cent of adults with type 1 diabetes in Australia have a low awareness of hypoglycemia and are more vulnerable to repeated hypos.
According to researchers, people with impaired awareness of symptoms are four times more likely to have severe hypos catching them without warning than those who manage to react in time.
People with type 1 diabetes who were found to have impaired awareness of hypoglycemia perceived warning symptoms of hypo at much lower glucose levels than those with intact awareness.
For example, participants reported missing some of the early signs of a shortage of glucose in the brain (neuroglycopenia), which manifests with sweating, shakiness, tachycardia and anxiety.
Surprisingly, being very perceptive to hypo symptoms did not correlate with diabetes duration. Those reporting impaired awareness of hypo had lived with type 1 diabetes for a mean of seven years longer than those who did not report it.
Researchers believe that impaired hypo awareness is worsened by not enough self-monitoring. Those with impaired awareness who check their blood sugars four times a day still reported many instances of hypoglycemia during a seven-day period.
In contrast, those who performed extra checks of their blood sugars were more likely to treat hypoglycemia at a higher glucose level (3.5 mmol/l).
This highlights the importance of frequent self-monitoring of blood glucose, for example, through technologies like continuous glucose monitoring (CGM), to avoid losing the ability to sense symptoms of hypoglycemia and facing increased risks.
Impaired hypo awareness seemed to be more prevalent among middle-aged people in this study. Stanford University School of Medicine recently published a study showing that nearly half of older people with type 1 diabetes can have a negative attitude toward diabetes technology.
Yet, as researchers point out, hypo-unawareness tends to increase with age, and the benefits of CGM devices can help older people with type 1 diabetes achieve greater glucose control and limit events that could land them in the hospital.

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