The reliable detection of hypoglycaemia has long been a major preoccupation for diabetic patients and researchers alike Many previous approaches have been barking up the wrong tree. We believe that we have identified a more promising tree. Case 1 A 66 year old woman developed type 2 diabetes in 1971 and was transferred to insulin in 1979. She has no significant diabetic complications or other illness, and drinks very little alcohol. For the past two years she has experienced increasingly frequent hypoglycaemic episodes, with excessive sweating, generalised weakness, anxiety, and irritability.
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.