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Tips for Managing Nighttime Hypoglycemia

How to Avoid Low Blood Glucose Overnight

Many people with diabetes (both type 1 diabetes and type 2 diabetes) experience hypoglycemia while sleeping—this is called a nighttime low (as in low blood glucose level).  Many factors contribute to nighttime hypoglycemia. Being familiar with the causes will help you understand the signs and take steps to prevent nighttime lows.

Episodes of hypoglycemia can be uncomfortable and frightening. Severe hypoglycemia can cause seizures and be life-threatening so it's important to recognize the problem and respond appropriately.Read on for tips to help you prevent hypoglycemia.

Recognizing the Signs  

Shakiness and irregular heartbeats can be a sign of approaching hypoglycemia. Symptoms can develop when blood sugar drops below 70 milligrams per deciliter (mg/dl). Eating dinner much later than you normally do, drinking excessive amounts of alcohol or having an unusually active day can contribute to the condition. Sometimes exercising too close to bedtime can trigger it, too. Experts say it's best to avoid exercising within two hours of bedtime.

Nighttime Hypoglycemia
If you frequently wake up with symptoms of hypoglycemia, such as a headache, nausea, restlessness, dry mouth, light-headedness, or sweating, start testing your blood glucose level as soon as you get out of bed. If it's low in the morning on a regular basis —below 70 mg/dL— you and your doctor should take steps to stop the nighttime hypoglycemia.Not everyone experiences symptoms so it's possible (and potentially dangerous) to ignore the problem. To avoid what is known as "hypoglycemia unawareness" routine checking of levels at night and in the morning is vital.

Strategies for Preventing Nighttime Hypoglycemia 

To reduce the risk of nighttime hypoglycemia, you need to come up with a way of ensuring you have more glucose in your body during the last few hours of sleep.Checking your blood sugar before turning in is the best way to ward off sugar trouble during the night. If your blood sugar level is less than 100 mg/dl at bedtime, you may need to double your regular snack. 

Your doctor may also suggest eating a complex carbohydrate before going to bed. Whole wheat bread, black or pinto beans, or a bowl of oatmeal just before bed may give you those slow-burning carbohydrates that you need to make it through the night.

Your diabetes treatment team may also decide to change your insulin regimen (all people with type 1 diabetes use insulin and some people with type 2 diabetes do, too).Trading your long-acting insulin at night with a less short- or moderate-acting insulin may remedy the issue and provide the glucose you need during those final sleeping hours.

A continuous glucose monitor, or CGM, may also help. You can program the CGM to sound an alarm if your blood glucose drops too low during the night. It would wake you so you could take a glucose tablet or eat a snack before dozing off for your final few hours of sleep.

It's possible to experience what's known as "hypoglycemia unawareness," which means you don't recognize or feel the symptoms of low blood sugar. Regularly monitoring your levels and taking steps to prevent nighttime hypoglycemia will help avoid those overnight lows and help get your day off to a better start when you wake up! 

Updated on: July 26, 2017
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