Hypoglycaemia unawareness
When usual hypo signs (tremor, sweating, hunger) stop appearing, that is a medical problem requiring dedicated therapy and obligate CGM use.
What it is
Hypoglycaemia unawareness (impaired awareness of hypoglycaemia, IAH) is reduced or absent perception of hypo symptoms. It affects 20-40% of patients 5-15 years into T1D. Cause: repeated hypos depleting counterregulation (catecholamines, glucagon). The condition is fully reversible with the right approach.
Restoration principles
Two hypo-free weeks
Primary strategy — full avoidance of hypos for 2-3 weeks. Counterregulation recovers; symptoms return.
Temporarily relaxed targets
Pre-meal 6-8 mmol/L during the recovery window instead of the usual 4-6.
CGM with aggressive alerts
Low predictive alert at 5.0 mmol/L — 20 minutes before hypo. For patients without sensitivity, the only reliable signal.
Structured education
DAFNE / BERTIE / HypoCOMPaSS programmes — training to recognise early cues and prevent recurrence.
Syai's role
In IAH, CGM moves from "useful" to "life-critical". Syai offers: 20-minute predictive alerts — time to act. Sharing — a relative receives an SOS notification on urgent low (< 3.1 mmol/L). 14-day continuity — no "blind" gaps between sensors.
Studies
HypoCOMPaSS — structured programme to restore hypoglycaemia awareness
Little S.A. et al. · Diabetes Care · 2014
On requestIN CONTROL — RCT of CGM in impaired awareness of hypoglycaemia
van Beers C.A.J. et al. · The Lancet Diabetes & Endocrinology · 2016
On request
Further reading
More on the manufacturer's site
Syai Health maintains a detailed topic page with clinical cases. Opens in a new tab.