Certain conditions may make it difficult for a diabetic to recognize impending hypoglycemia.

Reasons for failing to recognize:

(1) different symptoms than expected

(2) symptoms less pronounced than usual

(3) incapable of recognizing (intoxication, disturbed consciousness)


Conditions associated with failure to recognize hypoglycemia in a diabetic:

(1) long duration of diabetes

(2) diabetic neuropathy with autonomic dysfunction

(3) beta-blockers or other medications masking hypoglycemic response

(4) change in insulin preparation, especially shift to human recombinant preparations

(5) intensified control (3 or more insulin injections per day)

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