Risk Factors for Failing to Recognize Hypoglycemia in a Diabetic

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)