Question: How can I tell if I have hypoglycemia and can it happen without warning symptoms?
Answer: When blood sugar levels fall below their usual values, the body elicits a hormonal response to try to bring those blood sugar levels back up to normal. Those same hormonal responses also lead to a number of symptoms. Those symptoms include palpitations, rapid heart rate, nervousness, and sweating. For some individuals, the sweating predominates. For other individuals, it's the rapid heart rate and palpitations, but what distinguishes hypoglycemia and the symptoms associated with hypoglycemia from those same symptoms by other causes, is that when you take carbohydrate to bring blood sugar levels back up, the symptoms resolve.
So, we normally understand that patients with hypoglycemia will respond quickly to carbohydrate, and their blood sugar returns to normal. There are a very few individuals who, over time -- and I stress that this is really over time in a very rare number of patients -- the symptoms of hypoglycemia that we just talked about don't occur. In those individuals, blood sugar levels fall to a level where their ability to respond normally to their activities of daily living is impaired. We call that hypoglycemic unawareness.