With experience, won’t I know what my glucose levels are?

Dr. Jack Merendino, MD
Endocrinology Diabetes & Metabolism
Many people report that they know what their blood sugars are, and many people can distinguish the kinds of symptoms that they get with high blood sugars or low blood sugars, but it’s dangerous to assume that you can tell. I have seen many people who didn’t feel well and thought they were going too high when, in fact, the blood sugar was rapidly falling. And I’ve seen the opposite. And I’ve had many, many patients who can’t really tell at all, even when they are having a severe low. This is a dangerous condition that we call “hypoglycemic unawareness,” and it puts people at risk because they don’t realize they are having a problem until it’s too late for them intervene.

A subtle but important part of the question above is “with experience,” because it is tempting to think that the longer you have diabetes the better you become at knowing what your blood sugars are. But in actual practice the opposite is usually the case: people tend to be less good at knowing what their blood sugars are over time because their bodies become desensitized to the symptoms that result from fluctuating levels. This desensitization is made worse by neuropathy which often accompanies diabetes, and by beta blocker medicines that are frequently used to treat high blood pressure or heart disease in people with diabetes. 

Over time, you will gain confidence in your ability to manage your diabetes. You may think it’s okay to monitor less often. Beware! It’s tempting to think you can tell what your glucose level is by the way you feel. But research shows that most people cannot guess their glucose level reliably. Guessing is dangerous, especially if your blood glucose levels tend to swing with little warning.

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