Complex sentence: In the absence of epinephrine release, or when it is attenuated (reduced) during hypoglycemia, then patient may not be aware that his/her glucose level is low, therefore, the usual responses of glycogenolysis and gluconeogenesis may also lost or blunted.
Split into simpler sentences: In the absence of epinephrine release, or when it is attenuated (reduced) during hypoglycemia, the patient may not be aware that his/her glucose level is low. The problem is compounded since, in the absence of an appropriate epinephrine response, the usual responses of glycogenolysis and gluconeogenesis may also lost or blunted.