"Although one expects hypoglycemic episodes to be accompanied by the typical symptoms (e.g., tremor, sweating, palpitations, etc.), this is not always the case. When hypoglycemia occurs in the absence of such symptoms, it is called hypoglycemic unawareness. This is especially in people with long standing type 1 diabetes and those who attempt to maintain glucose levels which are closer to normal, hypoglycemic unawareness is common." This is in Wikipedia's entry on Diabetic hypoglycemia.
This looks to be bit uncommonly explained/attended but seems to be very important. If a diabetic patient with previous persisting high glucose levels can get hypoglycemia like symptoms and counterregulations (stress hormone epinephrine) to hypoglycemia and if he tries to get better control by a medication program, can he get such hypoglycemia unawareness or somewhat silent serious conditions especially those related to the autonomous parasympathetic system (may also be silent heart problem)?
During the process of improving your blood sugar, you may experience symptoms of low blood sugars, even when your sugars are not low. That is because your body has accommodated itself to the high sugars and the relative decrease in your sugar looks like a thread to the newly established setpoint. The best way to approach this is with gradual improvement. The symptoms should not be a reason for not improving your blood sugars. Just improving your blood sugars is the best way of trying to prevent neuropathy.
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