Most attacks occur in the evening and some occur at night. She retains generally good awareness of hypoglycaemic symptoms and can usually take quick corrective action. Over the past year she has noticed unusual stereotyped behaviour displayed by Candy, her 9 year old mongrel bitch, which occurs only before hypoglycaemic episodes. A 47 year old woman has required insulin since type 2 diabetes was diagnosed in 1995. She has up to two hypoglycaemic episodes each week, usually with good warning and characterised by sweating, malaise, and sometimes confusion.
Episodes tend to occur during the afternoon and sometimes at night.
Within the past year her 7 year old mongrel bitch, Susie, has shown peculiar behaviour during the patient's hypoglycaemic attacks. At night she has been nudged awake by Susie and has then found herself to be hypoglycaemic. On other occasions, Susie has refused her favourite chocolate treats and has prevented the patient from leaving the house until she has taken food to correct hypoglycaemia. A 34 year old woman has had type 1 diabetes since 1970, complicated by retinopathy and nephropathy. She currently takes Humulin I and lispro insulin totalling 41 units per day, does not smoke, and drinks very little alcohol.