By testing frequently you can see what symptoms you have, if any, when your sugars are in the range of around 60 mg/dL [3.3 mmol/L] and use these, even if atypical, to help you know when you are low. Pay close attention to symptoms, even if they are atypical or subtle, and be sure to treat at the first sign of them especially if you cannot test at that moment to verify the low. For people with nearly-normal A1C, it's even more important to see if there are occasional times when the blood glucose is low without symptoms.

Another important new tool for assessing how often the glucose is low is continuous glucose monitoring.

Treatment is aimed at elimination of episodes of hypoglycemia. There is general agreement that letting glucose levels run a little higher for several weeks may help, allowing the usual symptoms to reappear. Then, gradually lower your targets again, in accordance with your diabetes team's recommendations.

If you have experienced hypoglycemia without warning, seizures, or unconsciousness, be sure to discuss it with your diabetes team as soon as possible. And if possible, bring your spouse or partner to the clinic -- they can share their observations, and they will need to be involved in treatment should another episode occur.