Watch out for hypoglycemia particularly if you exercise vigorously and take drugs with the potential to cause hypoglycemia, like insulin and sulfonylureas
If you take drugs that can cause hypoglycemia, you need to know about “hypoglycemia unawareness.” (Click for a quick review of diabetes drugs.)
Some people with diabetes, particularly after having the condition for many years, lose the ability to detect hypoglycemia just by the way they feel. This hypoglycemia unawareness is obviously more dangerous than being able to detect and treat hypoglycemia early on. Blood sugar levels may continue to fall and reach a life-threatening degree.
Hypoglycemia unawareness can be caused by impairment of the nervous system (autonomic neuropathy) or by beta blocker drugs prescribed for high blood pressure or heart disease. It’s more common in folks who have had diabetes for many years. People with hypoglycemia unawareness need to check blood sugars more frequently, particularly if driving a car or operating dangerous machinery.
Steve Parker, M.D.
Paleo Diabetic 