Joslin Answers Your Questions

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Topic: Blood Glucose
Question: One day at work last week, I apparently was acting and talking strangely. A coworker who knows I have diabetes made me sit down and drink some orange juice. Was I possibly having a case of "hypoglycemia unawareness"?

Answer: Hypoglycemia unawareness is the absence of physical symptoms of hypoglycemia. And the longer you have diabetes, the more likely hypoglycemia awareness may become an issue for you.

Normally, when blood glucose drops, hormones such as glucagon and epinephrine are released, and they signal the liver to release glucose to help raise blood glucose levels. These hormones also cause the more typical symptoms of hypoglycemia-or low blood glucose-such as sweating, shakiness, and feeling anxious.

If you are experiencing hypoglycemia unawareness, though, the hormones may not be released, which means you may not have symptoms of low blood glucose. Because you can't feel symptoms, your blood glucose may drop even further before you actually have symptoms-and this may cause you to delay treatment. If you think you might have hypoglycemia unawareness, work with your healthcare team. They can help you design a treatment program that limits hypoglycemia as much as possible. (And bravo to your coworker for being so alert.)

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