
- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
read biographyclose windowBiography of
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
Latest entries
- Diabetes: Why sticking to your goals matters
June 4, 2013
- Still pricking your finger for blood glucose monitoring?
May 24, 2013
- Diabetes etiquette: When you don't have diabetes
May 2, 2013
- Coping with diabetes: Helping your loved one
April 24, 2013
- Types of diabetes
March 16, 2013
Living with diabetes blog
-
Aug. 19, 2011
Avoiding hypoglycemia unawareness
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Hi fellow bloggers,
Last week I shared with you a patient story about "hypoglycemia unawareness" — a condition in which a person with diabetes doesn't experience the usual warning symptoms of hypoglycemia. This week I'd like to share some risk factors and possible treatment strategies for such hypoglycemia unawareness.
Risk factors
Long-standing type 1 diabetes. Reduced awareness of hypoglycemia is common among people who have long-standing insulin-dependent diabetes. Many of those who've had diagnosed diabetes for 15 to 20 years report having lost their ability to perceive low blood glucoses and to often failing to treat and prevent severe hypoglycemia.
Severe hypoglycemia is an episode in which the person with diabetes is unable to treat him or herself and needs the assistance of another person. This includes prompting by a relative or friend to drink juice or eat.
Being an older adult and having type 2 diabetes. There also have been an increasing number of hypoglycemia unawareness episodes in those with type 2 diabetes; adults older than 65 seem to be most at risk.
Treatment options
Strict avoidance of hypoglycemia. Strict avoidance of hypoglycemia for several weeks to months can restore at least partial awareness of warning symptoms. Strategies for avoiding hypoglycemia when you have hypoglycemia unawareness or don't experience the warning symptoms include:
- Aim for a higher blood glucose target
- Try to more accurately count carbohydrates
- Avoid overcorrection or stacking of insulin doses
- Test your blood glucose and adjust your insulin dose more frequently
- Consider blood glucose awareness training education programs to help you learn to identify new symptoms and improve recognition
- Consider a personal continuous glucose monitor (CGM) that sounds an alarm when your glucose gets too low
- Consider a service dog that can recognize low blood glucose
Glucagon for emergencies. Glucagon is the treatment of choice if someone with diabetes is unconscious or unable to swallow. The length of time a person is unconscious, is more of a concern than how low the blood glucose number is.
Ask your health care provider for a prescription for Glucagon or GlucaGen and for instructions on how to use it. Instruct your family members or friends on how to use this in an emergency and on how to access the emergency response team, such as calling "911."
Have you lost any awareness of symptoms of low blood glucose? How have you coped?
Regards, and have a good week.
Nancy
10 comments posted
April 23, 2013 10:08 a.m.
The symptoms of hypoglycemia can be caused by other things besides being on diabetes medications. Not eating enough or fasting can bring on symptoms of low blood glucose; eating a healthy balance of protein, fat, and carbohydrates at each meal will help give you fuel or energy lasting 4-5 hours.
- Nancy and Peggy
April 20, 2013 2:40 p.m.
As far as I know I do not have diabetes, however this shakiness, sweating a d feeling I must eat something very quickly seems to on me when I have carbs for breakfast. So therefore I thought I should be eating more protein. I don'tknow exactly what I should eat to avoid this
- bonnie
March 22, 2013 3:50 p.m.
i have hypoglcemic unawareness that is why i always check my blood suger and make sure i always carry a snack with me when i am away for long periods of time when my blood sger is too high or to low i cannot even tell i feel fine my suger was down to 74 and i did not even know it then it was 266 and i could not even tell
- candie
November 13, 2012 11:12 p.m.
I have been reading your blog entries because I am experiencing more hypoglcemic episodes lately which scare me. ALSO, I am quite unaware of symptoms at times. I have had episodes where I feel nothing until I get up from bed, at which time I have fallen, almost passed out, & had to crawl to fridge to get cola or juice etc. I take medications for chronic pain daily. These meds can also make me tired, sometimes have headaches, & feel unaware. I am oftentimes alone, & there is nobody who can always be with me. I am only 45 years old & take care of myself regularly. But with these happening more frequently, I am fearful of what will happen if my sugar drops when I am alone if I do pass out. What are strategies for those in my situation where being alone at times is simply unavoidable along with being symptomatically unaware? We have a cat in the household who despite never being trained to do so, awakens my husband when he has a low blood sugar, however, she does not do this with myself & I do not know why, except for possibly that my husband is a brittle diabetic who sweats A LOT on lows, & I do not. Also, Bandit has just always been basically a 1-master pet since a kitten. My cat, Smokey, is just a cat, not a hero, which is fine with me. But I could use some suggestions to the concerns I have touched on here. Thank You in Advance
- Angel
November 9, 2012 8:16 a.m.
Thank you for the suggestions on retraining your body/mind to recognize low blood sugars. I have suffered from Hypoglycemic Unawareness for 15 years. I've had type 1 diabetes for 24 years. I'm retired from law enforcement, after 20 years, due to having suffered several serious injuries while on the job. I have been working rotating shifts the past 5 years, while working in security as a patrol officer with a port authority. The combination of working rotating shifts and suffering with hypoglycemic unawareness has brought significant challenges with glycemic management. I have had a blood sugar of 16, 17, 24 etc on several occasions with absolutely no symptoms. I've lost consciousness on two occasions and during the last episode, I was driving and it took 6 police cars to get me to stop. Not only was this embarrassing, I also lost my drivers license for over 2 months and had to change my diabetes management. I'm now using the Medtronc continuous blood glucose monitor along with my current insulin pump. It is tedious at times but it saved my job and allowed me to drive again. The sensors used to monitor my blood sugars work accurately 75% of the time and alright the remainder. The system is continually getting easier to utilize and as a result, more accurate. I'm grateful to have this tool. I have tried to maintain higher ranges with my blood sugars and avoid eating poor food choices. I would like to do more research and in operate the suggestions you mentioned.
- Mark
December 14, 2011 12:27 p.m.
I'm surprized that setting an alarm to remind you to eat the correct things at the proper intervals is not suggested. But maybe you would learn that at "blood glucose awareness training education programs"?
- Tara
October 5, 2011 11:11 a.m.
I travel for my job, alone, and spend a week at a time in a hotel, alone and have fallen and injured myself due to low BS. I am 7 years post Gastric Bypass and have kept my weight off, but still have diabetes with this new complication. I am completely unaware of when my BS is getting so low. The cost of a service dog is 12 thousand dollars. I have done the research and located a trainer and would love to get a dog. I take Acarbose and eat as directed by my doctor, and still have those low readings...it's horrible. I get so confused and then I start crying, and then the shaking is so bad by the time I realize how low my BS is, I sometimes cannot use my glucometer, or a telephone. And when I am alone, I am so afraid I will die. I am sad and my boss may not accomodate me for my health needs. I have a teenager at home, so at least when I am home, I am not alone.
- Marie
August 25, 2011 10:02 a.m.
I check my bg at least 7 times a day but will still have problems with it going low. Never know it when it is going one. Any way to change this?
- Linda
August 23, 2011 4:16 p.m.
Very concise and educative
- Abideen
August 21, 2011 6:54 p.m.
Lately I have been having episodes of low blood sugar that I don't recognize until I'm so confused, and I know something is wrong but I'm not quite sure what it is. This morning it happened and I thought it might be low blood sugar, so I took it it and it was 30. I did the usual with the glucose tabs , followed by some protein. There have been times when my husband has recognized the symtoms and given me the glucose. I was very glad to read that this is not just me, and that other people are having these symptoms too.
- grace
Share on:


10 comments posted