Lactate administration during hypoglycemia suppresses counterregulatory responses, which mimicks the condition of impaired awareness of hypoglycemia (IAH) seen in patients with type 1 diabetes. Lactate can act as an alternative cerebral fuel and/or lactate can drive other brain-protective processes. We examined whether lactate administration affects brain lactate concentrations, as measured with J-difference editing 1H-MRS, during hypoglycemia in patients with normal awareness of hypoglycemia (NAH) and in patients with IAH. Brain lactate concentrations increased modestly upon lactate infusion in both groups. These results suggest that the excess lactate entering the brain is immediately oxidized, which may suppress the hypoglycemic counterregulatory response.