Who Experiences Nighttime Hypoglycemia & How Can Nighttime Hypoglycemia Be Managed?

Night time sweating can be a symptom of a medical condition. Here’s an informative article to help you understand the relation between diabetes and night time hypoglycemia, better.

An episode of low blood glucose occurs at night. While one is sleeping, the energy need of their body dips, and consequently their liver produces less glucose, the body’s fuel. In non-diabetics, the pancreas responds to the liver’s decreased glucose production by secreting less insulin, for maintaining the balance. But in patients with Type-1 diabetes, it is difficult to maintain this balance since their pancreas no longer secretes insulin. Instead, the required amount of insulin needs to be injected in these people before bedtime for maintaining a normal night time blood glucose level.

Night time hypoglycemia is a common problem affecting people who control their blood glucose intensively through multiple insulin injections during the day. In a study which evaluated the benefits and risks of “tight” blood glucose control, it was found that people on tight control regimes were 3 times more likely to experience an episode of hypoglycemia (low blood sugar) than those on standard regimes, and more than 50% of these episodes occurred while people were sleeping.

Many things can disturb the blood sugar balance in the body of diabetics. Injecting excess insulin or the right amount of insulin, but at the wrong time can lower blood glucose more than desired. Consuming less food than usual during daytime, or eating the evening meal or snack at a different time than usual can affect blood sugar during the night in diabetics. Extreme exercising during the day can also lower blood glucose at night. The signs of low blood glucose mainly include dizziness, shakiness, confusion, light-headedness, irritability, rapid heartbeat, and extreme hunger. These can occur during daytime or at night. Nighttime hypoglycemia can also cause headache, night sweats, nightmares and restless sleep.

Although maintaining tight control on blood glucose levels elevates the risk of night time hypoglycemia, here are some ways through which people can lower their risk of this condition and manage it more effectively.

• Diabetics should consider having a late-night snack to relieve night time falls in blood glucose level and to prevent nighttime hypoglycemia. Several commercial products are available which can also be used to prevent night time hypoglycemia without significantly increasing the blood glucose level in patients with diabetes.
• Diabetic patients, who have a habit of eating dinner late, should ask their doctor about replacing their dinner time regular insulin with rapid-acting insulin like glulisine, aspart, or lispro. These types of insulin start acting within 5 minutes, peak in about 1 hour, and stop decreasing blood glucose after 2 to 4 hours. On the other hand, regular insulin continues to work for 3 to 6 hours.
• The blood glucose should be checked occasionally at 3 AM if possible in diabetics. This will help the diabetes patient understand what is going on in their body in the middle of the night, when they are usually sleeping and helps in preventing night time hypoglycemia. This information can help them make changes in their routine.
• People suffering from diabetes should talk to their doctor about adjusting their insulin regime to prevent nighttime hypoglycemia. NPH taken during dinnertime may peak in the middle of the night, when insulin is least required. Taking NPH at bedtime instead can help to yield better blood glucose control during the night.

Also Read:

• What Causes Low Blood Glucose or Hypoglycemia, Know its Signs, Symptoms, Diagnosis
• Low Blood Glucose or Hypoglycemia: Treatment, Recovery, Prevention, Complications