Answer is A (Autonomic neuropathy): Hypoglycemic unawareness refers to a loss of warning symptoms that ale individuals to the presence of hypoglycemia and prompt them to eat and'abo the episode. Hypoglycemic unawareness can be attributed to two factors : Autonomic neuropathy Loss of catecholamine response to hypoglycemia : This means that patients with repeated attacks of hypoglycemia lose their capacity to release epinephrine and norepinephrine in response to hypoglycemia. (increase release of glucogon in response to hypoglycemia is lost very early in type I Diabetes Thus type I patients overeated with insulin may be unaware of critically low levels of blood glucose because of an adaptive blunting of their alarm systems owing to repeated episodes of hypoglycemia.