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PMID 35005595

Early warning signs of hypoglycemia may be less obvious in patients with hypoglycemia unawareness which can be due to a long history of diabetes (where deficiencies in the release or response to counter regulatory hormones exist), with autonomic neuropathy, intensified diabetes control, or taking beta-blockers, guanethidine, or reserpine

After the plunger is fully depressed or the pen has delivered the full dose, count to 5 while keeping the needle in place

Liver and kidney markers are reasonable to track in extended high-dose protocols