 The near-normalization of glycemic control has become an established treatment goal in diabetes in order to reduce late complications such as nephropathy, neuropathy, retinopathy and cardiovascular disease 1,2. However, the frequency of insulin-induced hypoglycemia increases several-fold during intensified insulin therapy 2,3. Thus, hypoglycemia is the most common acute complication in the treatment of diabetes with insulin. During hypoglycemia the cognitive function is disturbed, and may progress to unconsciousness and seizures. This can lead to high-risk situations, e.g. while driving or operating a machine. Estimates of deaths in patients with type 1 diabetes attributed to hypoglycemia vary between 2 and 6 4,5. Moreover, the risk of hypoglycemia limits everyday activities of diabetic patients decreasing their quality of life. It is therefore not surprising that hypoglycemia is the most feared acute complication of insulin therapy in diabetic patients. This fear of hypoglycemia discourages diabetic subjects from attempting to maintain tight glycemic control, which in turn leads to a higher incidence of late complications and consequently increased mortality rate 1,6,7 In the first years of type 1 diabetes, most patients are able to sense the characteristic symptoms of hypoglycemia, which can then be relieved by consuming appropriate food. The symptoms of hypoglycemia can roughly be classified as autonomic warning symptoms caused by the release of catecholamines, and neuroglycopenic symptoms caused by the lack of glucose in the brain. In many patients symptoms are often compromised at night nocturnal asymptomatic hypoglycemia due to impaired glucose counterregulatory response by adrenaline and glucagon. The chronic form of hypoglycemia unawareness is very common. A quarter of all insulin-treated diabetic patients have some degree of diminished symptomatic awareness, but this proportion increases to almost 50 in patients who have had diabetes for more than 20 years 8. Strict control of diabetes by intensive insulin therapy is associated with increased risk of the hypoglycemia unawareness syndrome with loss of autonomic warning symptoms 2,6,9. This seems to involve diminished hormonal glucose counterregulation due to recurrent hypoglycemic episodes 6,9. 