Impaired hypoglycaemia awareness (IHA) 1 November 2013 IHA means that people do not have symptoms of a hypo or feel the late symptoms of a hypo before they feel the early signs and symptoms. People who have had diabetes for a long time or who have frequent hypos are more at risk of having IHA. If you have had a recent hypo you are at greater risk of having another hypo within 24 hours so you may need to check your Blood Glucose Levels (BGLs) more often during this time. Having IHA increases your risk of having a severe hypo, which requires another person to help you. Can you regain Hypo Awareness? Yes, if you can avoid having low BGLs for at least six weeks you may find you are able to feel early symptoms again. However, you may not have the same symptoms that you did when you were first diagnosed as symptoms can change over time. If you have IHA it is important to talk with your health professional about what changes you may need to make. How do you know if you have IHA? your diabetes health professional can do an assessment to check if you have IHA others notice signs such as appearing pale or vague before your feel symptoms your BGLs are at hypo range only when you check your BGLs e.g. meal times Risk factors for IHA: you have had type 1 diabetes for more than 25 years you are older than 65 years kidney disease alcohol Driving Before driving you should always check your BGL. You need to be above â€™5â€™ to drive. If your BGL is under 5.0mmols but not less than 4.1 mmols, you should have a small snack such as a piece of fruit, some dry biscuits, a small tub of yoghurt or a glass of milk. If your BGL is 4.0mmol/L or less you need to treat it as you would for a hypo. Always carry hypo food in the car. Check your BGL every two hours if driving for a long time. If you have a hypo, pull over, stop the car, treat your hypo and wait at least 30 minutes before driving again. How to help prevent having a hypo: Structured education programs for people with type 1 diabetes such as DAFNE (Dose Adjustment for Normal Eating) have been shown to reduce hypos and improve diabetes management. Aim for slightly higher BGL ranges for five to six weeks to help regain hypo awareness. Treat any BGL 4.0mmol/L or less, even if you have no symptoms. Monitor your BGLs regularly and, more often, after exercise, alcohol and previous hypos.