Several substances are known to contribute to hypoglycemia unawareness. Beta-blockers, used for managing hypertension and heart conditions, can mask the adrenergic symptoms of hypoglycemia such as tremors and palpitations. Additionally, alcohol consumption can inhibit gluconeogenesis, leading to prolonged hypoglycemia and decreased awareness. Certain toxic heavy metals, like lead and mercury, may also affect glucose metabolism and symptom perception.
