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Type 1 Diabetes Hypoglycemia At Night

Do You Bolt Awake At 3 A.m.? Low Blood Sugar Symptoms May Be To Blame

Do You Bolt Awake At 3 A.m.? Low Blood Sugar Symptoms May Be To Blame

You’re exhausted and you need your eight hours of sleep, but you suddenly bolt awake around 3 or 4 a.m., energy coursing through your veins and mind churning anxiously. What gives? Waking up in the middle of the night is simply one of many low blood sugar symptoms. Why Symptoms of Low Blood Sugar Can Cause You to Be Awake at 3 a.m. Sleeping through the night represents a long period without food when blood sugar can drop too low. This is bad news for the brain, which depends on glucose for energy. The brain is highly active at night, transforming short-term memory into long-term memory,[1] and carrying out repair and regeneration.[2] In response, the adrenal glands, two walnut-shaped glands that sit atop the kidneys, release stress hormones. These stress hormones raise blood sugar back to a safe level. Unfortunately, stress hormones also raise, well, stress. Hence the anxious awakening during night’s darkest hours. Eating at 3 a.m. Can Help You Fall Back to Sleep A quick fix for this and other low blood sugar symptoms (below) can be as simple as eating a small amount of protein—with perhaps some fat thrown in—when you wake up too early. This could a spoonful of nut butter, a few pieces of meat, or a hard-boiled egg. Some find this stabilizes blood sugar levels enough so they fall back asleep. Do not, however, eat something starchy at this time, such as bread or cereal, as it will spike blood sugar levels, causing them to drop too low again. Daytime Tips to Avoid Waking Up at 3 a.m. Every Night Although a quick snack may help you fall back asleep, it’s better to prevent waking up in the first place. If you are waking up regularly at 3 a.m., chances are you suffer from low blood sugar symptoms. Signs of low blood sugar include: Sugar cravings Irritability, light Continue reading >>

Nocturnal Hypoglycemia In Type 1 Diabetes: An Assessment Of Preventive Bedtime Treatments

Nocturnal Hypoglycemia In Type 1 Diabetes: An Assessment Of Preventive Bedtime Treatments

Objective: We assessed four putative bedtime treatments in the prevention of nocturnal hypoglycemia in type 1 diabetes. Research Design and Methods: Plasma glucose concentrations were measured every 15 min from 2200 h through 0700 h in 21 patients with type 1 diabetes (mean ± sd HbA1C = 7.1 ± 1.0%) on five occasions with, in random sequence, bedtime (2200 h) administration of 1) no treatment, 2) a snack, 3) the snack plus the α-glucosidase inhibitor acarbose, 4) an uncooked cornstarch bar, or 5) the β2-adrenergic agonist terbutaline. Results: In the absence of a bedtime treatment, 27% of the measured nocturnal plasma glucose concentrations were less than 70 mg/dl (3.9 mmol/liter) in 12 patients; 16, 6, and 1% were less than 60, less than 50, and less than 40 mg/dl (3.3, 2.8, and 2.2 mmol/liter), respectively. Neither the snack (without or with acarbose) nor cornstarch raised the mean nadir nocturnal glucose concentration or reduced the number of low glucose levels or the number of patients with low levels. Terbutaline raised the mean nadir nocturnal glucose concentration (mean ± se, 127 ± 11 vs. 75 ± 9 mg/dl; P < 0.001), eliminated glucose levels less than 50 mg/dl (P = 0.038), reduced levels less than 60 mg/dl (P = 0.005) to one, and reduced levels less than 70 mg/dl (P = 0.001) to five (four at 2215 h, one at 2230 h). However, it also raised glucose levels the following morning. Conclusions: Nocturnal hypoglycemia is common in aggressively treated type 1 diabetes. Bedtime administration of a conventional snack or of uncooked cornstarch does not prevent it. That of terbutaline prevents nocturnal hypoglycemia but causes hyperglycemia the following morning. The efficacy of a lower dose of terbutaline remains to be determined. Background: GH deficiency (GHD) acquir Continue reading >>

Nighttime Hypoglycemia

Nighttime Hypoglycemia

An episode of low blood glucose occurring at night. During sleep, the body’s energy needs fall, and consequently the liver pumps out less glucose, the body’s fuel. In people without diabetes, the pancreas responds to the liver’s lowered glucose production by secreting less insulin, and in this way, a balance is maintained. In people with Type 1 diabetes, this balance is harder to maintain since the pancreas no longer secretes insulin. Instead, a person must inject just enough insulin — but not too much — before bedtime to maintain a normal nighttime blood glucose level. A number of things can throw off the balance. Injecting too much insulin or injecting the right amount at the wrong time can lower blood glucose more than desired. Eating less food than usual during the day or eating the evening meal or snack at a different time than usual can affect blood sugar during the night. Exercising more than usual during the day can also cause low blood glucose at night. Many of the classic signs of low blood glucose — including shakiness, light-headedness, dizziness, confusion, rapid heartbeat, irritability, and extreme hunger — can occur during the day or at night. Nighttime hypoglycemia has also been known to cause night sweats, headache, restless sleep, and nightmares. Nighttime hypoglycemia is a common problem among people who control their blood glucose intensively through multiple injections of insulin during the day. In the Diabetes Control and Complications Trial, a study that evaluated the benefits and risks of “tight” blood glucose control, people on tight control regimens were three times more likely to have an episode of hypoglycemia than those on standard regimens, and more than half of these episodes occurred while people were sleeping. Although Continue reading >>

A Silent Danger: When Blood Sugar Goes Down While You Were Sleeping

A Silent Danger: When Blood Sugar Goes Down While You Were Sleeping

You've heard it before—how taking a snack at nighttime after dinner may not be such a good idea, what with the weight gain that may come with it. But if you're a diabetic, that nighttime snack may spell the difference between life and death—literally. “The absence of a nighttime snack when one is usually taken is one cause of nocturnal hypoglycemia,” said Dr. Richard Elwyn Fernando, president of Diabetes Philippines and consultant at St. Luke's Medical Center and Capitol Medical Center. Nocturnal hypoglycemia, as the name implies, happens at night. “It occurs when blood glucose levels fall below 4 millimoles per liter (mmol/l) or 72 milligrams per deciliter (mg/dl). At 40 mg/dl or below, a person can be comatose... In rare cases, it may lead to death,” Fernando said during a media briefing organized by pharmaceutical company Novo Nordisk last May 27. What makes it dangerous is that the person, being asleep, is not aware of what is happening and is not able to seek help. This poses a real concern for diabetics and their families, said Fernando. In a previous interview, former Health Secretary Esperanza Cabral said the body needs glucose to function well. “Kailangan ng katawan ang sugar for energy, metabolism,” she told GMA News. When the blood sugar drops to low levels, a person may experience dizziness, weakness and even fainting, Cabral said. There may also be confusion and disorientation. Fernando said hypoglycemia may lead to complications affecting the heart (decreased heart rate, decreased cardiac output, myocardial contractility), blood vessels (stroke, myocardial infarction, acute cardiac failure, ventricular arrythmia), and brain (seizures, convulsions, coma). While hypoglycemia may occur in both diabetics and non-diabetics alike—“kapag gutom Continue reading >>

Tips For Managing Nighttime Hypoglycemia

Tips For Managing Nighttime Hypoglycemia

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. 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 duri Continue reading >>

Hypoglycemia In Children With Type 1 Diabetes

Hypoglycemia In Children With Type 1 Diabetes

Hypoglycemia, or low blood glucose (blood sugar), is a common complication that can occur with diabetes. The challenge for parents of children with type 1 diabetes is to know how to detect the symptoms of hypoglycemia and effectively treat it. This article addresses both those considerations. But first, it's important to have a solid understanding of hypoglycemia. EndocrineWeb has a comprehensive article series on this complication—and we invite you to read them to learn more. Below is a selection of hypoglycemia resources to get you started: Detecting Hypoglycemia Hypoglycemia occurs when your child's blood glucose levels fall below his or her target range. Target ranges are determined by your child's doctor and are unique to each child. For instance, your child may feel fine with a blood glucose reading of 70, but another child could show hypoglycemia symptoms with a reading slightly above 70.1 Knowing your child's target range and ensuring his or her blood glucose level stays within it is the main objective. If hypoglycemia isn't detected early on, it can cause serious problems, such as seizure or loss of consciousness. So what can you do to prevent your child's hypoglycemia from becoming a potentially serious problem? First and foremost, you should understand the symptoms. These include: Sweating Hunger Dizziness and difficulty concentrating Shakiness Headache Fatigue Pale skin Irritability Make sure that you, your family, and your child can identify the most common hypoglycemia symptoms. Treating Hypoglycemia You should talk with your doctor for specific recommendations on how to treat your child if he or she experiences an episode of hypoglycemia. But, generally, if your child has a low blood glucose meter reading and is showing hypoglycemia symptoms, the goal i Continue reading >>

Nocturnal Hypoglycemia

Nocturnal Hypoglycemia

Thanks to the Diabetes Control and Complications Trial (DCCT), it is now well recognized that intensive glycemic control can reduce the risk of diabetes complications. Despite this knowledge, one of the biggest barriers in reaching glycemic targets is the increased risk of hypoglycemia that comes with tighter blood glucose control. Hypoglycemia is often reported to be one of the most feared complications of diabetes. With nocturnal hypoglycemia being especially worrisome for those who live alone or travel alone. It can also be concerning (not to mention disruptive) for a significant other that you share a bed with. What is nocturnal hypoglycemia? Nocturnal hypoglycemia is a low blood sugar that occurs overnight while you are asleep. It is common to sleep through a low blood sugar when it occurs during sleep. How common is nocturnal hypoglycemia? According to a journal article from Medscape General Medicine: During the DCCT 43 percent of all hypoglycemia episodes and 55 percent of severe [hypoglycemic] episodes reported occurred during sleep. Incidence rates vary from 12 to 56 percent, however because 49 to 100 percent of episodes occur without symptoms the actual incidence may be much higher.1 Why is nocturnal hypoglycemia concerning? Nocturnal hypoglycemia can be especially dangerous because an individual is unlikely to recognize symptoms or wake up during an episode. Undetected nocturnal hypoglycemia is a risk factor for hypoglycemia unawareness: Hypoglycemia unawareness is a low blood glucose that occurs without symptoms therefore the person is unaware of the drop in their blood glucose, ultimately delaying treatment. Nocturnal hypoglycemia may also result in physical injury, poor quality of life and possibly impairment in cognitive function. Severe hypoglycemia can Continue reading >>

Sleep Safe & Sound: Avoiding Overnight Low Blood Sugars

Sleep Safe & Sound: Avoiding Overnight Low Blood Sugars

An Essential Blood Glucose Reading Sleep should be restful, yet for people with diabetes it can be stressful. Many factors can affect glucose levels when you sleep. For starters: your body's varied need for insulin, how much glucose the liver produces, what and when you eat before bed, and how much and what type of exercise you've done during the day and near bedtime. It's essential to check blood glucose an hour or so before bedtime. "This is the most important reading of the day," says Gary Scheiner, M.S., CDE, owner and director of Integrated Diabetes Services in Wynnewood, Pennsylvania. "If you take insulin and you check at least three or four hours after dinner, you'll learn how well your dinnertime insulin covered the rise of your blood glucose from dinner." If you eat late, this bedtime reading may really reflect your after-meal level. If your bedtime glucose reading is low, treat the low. If you use insulin as part of your regular blood glucose control, and your blood sugar is high three or more hours after your dinner, you may need to take a few units of rapid-acting insulin. {C} How to Prevent Going Low In addition to monitoring glucose levels right before bedtime, other steps can prevent low blood glucose while you sleep. Snack Smart: If you typically eat a snack before bed to prevent hypoglycemia and keep your blood glucose on an even keel, experiment with different types of snacks. Get a feel for which ones help your blood glucose readings stay within target goals during sleep. Spencer Bond, an active teen PWD type 1, usually eats peanut butter with apple slices or crackers. Because peanut butter contains both protein and fat, it's absorbed and metabolized more slowly than carbohydrate, so it helps to keep his blood glucose stable overnight. "Sometimes I ha Continue reading >>

Nocturnal Hypoglycemia - Night Time Hypo

Nocturnal Hypoglycemia - Night Time Hypo

Tweet Nocturnal hypoglycemia or night time hypos are common in people who treat their diabetes with insulin. Symptoms are usually only realised once waking up from a hypo. Due to their nature, you will usually only find out about having a hypo during the night after waking up from a hypo. Therefore people may not even be aware that they are having night time hypos, so it’s useful to be able to spot the signs and symptoms of when nocturnal hypoglycemia may be taking place. Whilst nocturnal hypoglycemia is most common in insulin users, it can also occur for people who take oral anti-diabetic drugs. Symptoms of night time hypoglycemia Sometimes you may wake during an episode of nocturnal hypoglycemia. However, if you don’t, you may notice one or more of the following indications that hypoglycemia may have occurred whilst you were asleep. Waking with a headache Experiencing seemingly unprovoked sleep disturbance Feeling unusually tired Waking with damp bed clothes and sheets from sweating Having a clammy neck can be a particular indication of night time hypoglycemia. Nocturnal hypoglycemia in children For parents on children with diabetes, nocturnal hypoglycemia can be particularly worrying. Parents of diabetic children may wish to check their child’s neck whilst they are sleeping if they are worried that night time hypoglycemia may be occurring. Causes of nocturnal hypoglycemia The chances of having night time hypos may be increased by the following: Too high a level of basal (background) insulin Physical activity during the day can increase insulin sensitivity which can lead to night time hypoglycemia, particularly for the first night after a sustained session of activity Following alcohol consumption Absence of a night time snack when one is usually taken Missing o Continue reading >>

What You Should Know About Nocturnal Hypoglycemia

What You Should Know About Nocturnal Hypoglycemia

Nighttime hypoglycemia is an episode of low blood sugar during the night; these are common and affect nearly every person with type 1 diabetes and a significant minority of those with type 2 diabetes. How Sleep Affects Glucose Production To understand nighttime hypoglycemia, it's necessary to know how sleep affects glucose production. Normally the body produces two hormones -- glucagon and epinephrine -- that combat low blood glucose levels. However, glucagon production is typically lower at night. In addition, type 1 diabetes impairs glucagon production, which becomes further depressed with each episode of hypoglycemia. Other factors, including longer periods between meals and increased insulin sensitivity, also contribute to hypoglycemia during sleep. Signs While the standard signs of early hypoglycemia include sweating, heart racing, shakiness, hunger and anxiety, nighttime hypoglycemia presents an unusual challenge, as the symptoms of this occurring may not be as apparent during sleep. Keep an eye out for night sweats, poor sleep quality, headache or a tired feeling upon awakening, and higher than normal blood glucose levels in the morning, which is the "rebound" effect in blood sugar levels known as the Somogyi effect. If a person does not awaken during an episode of nighttime hypoglycemia, low blood sugar remains untreated and may progress to more pronounced hypoglycemia, which is characterized by drowsiness and confusion with symptoms that easily can remain masked during sleep. Nighttime hypoglycemia may not be recognized until blood glucose levels are dangerously low, possibly low enough to cause convulsions or coma. Prevention To avoid or prevent nighttime hypoglycemia, it is helpful to maintain a consistent late afternoon and evening routine of diet, activity, Continue reading >>

3 Reasons For Nighttime Hypoglycemia

3 Reasons For Nighttime Hypoglycemia

Many people with diabetes experience low blood sugar levels at night. Recent studies revealed it is more common than most experts thought for people with diabetes to experience hypoglycemia while they sleep. Discover 3 reasons for nighttime hypoglycemia and what you can do about them. When people experience hypoglycemia, their blood sugar levels get too low. Symptoms usually occur when your blood sugar goes below 70 mg/dl. These symptoms may include headaches, perspiring, dizziness, irritability, anxiety, hunger, nightmares, rapid heartbeat, feeling restless or acting erratic. Some people do not get symptoms, which is called “hypoglycemia unawareness”. You may experience heavy perspiration during the night with wet morning bed sheets and not know the cause. You may also have high morning blood sugars due to a “rebound effect”. It can be dangerous as you are less likely to wake up or realize your blood sugar is low. This often happens when there is long standing diabetes. It is important to check your blood sugar level before you go to bed to see if it is too low. Always have a healthy snack of a protein and carbohydrate 30 minutes before you settle in for the night. You should also check it in the morning to see if the levels are low. Make sure to have a healthy breakfast each day. When you sleep, your liver may pump out a lower amount of glucose. The pancreas may not respond to this reduced glucose production when you have diabetes. As a result, the same amount of insulin is secreted and you can experience nighttime hypoglycemia. It can be a challenge to maintain the proper balance. Discuss medications including your insulin dosage with your doctor to make sure you are administering the right amount at the right times. Always talk to your doctor before changing Continue reading >>

How To Treat A Low Blood Sugar At Night

How To Treat A Low Blood Sugar At Night

It’s the worst. The worst! If you are treating your diabetes with insulin, you know what I’m talking about. That feeling when you wake up in the middle of the night soaked in sweat and shaking due to low blood sugar. Your whole body goes into stress mode, and all you can think about is eating! I absolutely hate it, so I wanted to share my approach on how to treat low blood sugar at night with you guys. I hope this can help some of you and I would love to hear your best advice and tricks as well. If you have a smart way of dealing with nightly lows, please write it in the comments below this post so everyone can learn it. So How Do I Treat Low Blood Sugar At Night? What I do is treat it for what it is, a medical emergency. So I test my blood sugar and immediately eat or drink 8-15 grams of carbs in the form of 2 glucose tablets or 125 ml juice. I then assess whether I need a low glycemic carb as well (you can read more about low-glycemic carbs here). The assessment is pretty quick, and for me only involves checking that I didn’t bolus within the last 4 hours. If I did, I might have to cover that with a few rice cakes. The reason why I say 4 hours is because I bolus with Novolog and that stays active in the body for about 4 hours. If it has been more than 4 hours since I took my bolus, I know that just the sugar or juice will get me through the night. My recommendation is to be honest with yourself, and if you can’t go into the kitchen and just have those 15 grams of carbs without emptying the fridge every time, then keep your emergency carbs in the bedroom next to where you sleep (that’s always a good idea anyway). I also recommend that you don’t treat your low with candy or cake. As I said, it’s a medical emergency and you need a carb that will hit your bl Continue reading >>

Hypoglycemia (low Blood Sugar) In People Without Diabetes - Topic Overview

Hypoglycemia (low Blood Sugar) In People Without Diabetes - Topic Overview

Hypoglycemia, or low blood sugar, is most common in people who have diabetes. If you have already been diagnosed with diabetes and need more information about low blood sugar, see the topics: You may have briefly felt the effects of low blood sugar when you've gotten really hungry or exercised hard without eating enough. This happens to nearly everyone from time to time. It's easy to correct and usually nothing to worry about. But low blood sugar, or hypoglycemia, can also be an ongoing problem. It occurs when the level of sugar in your blood drops too low to give your body energy. Ongoing problems with low blood sugar can be caused by: Medicines. Metabolic problems. Alcohol use. Symptoms can be different depending on how low your blood sugar level drops. Mild hypoglycemia can make you feel hungry or like you want to vomit. You could also feel jittery or nervous. Your heart may beat fast. You may sweat. Or your skin might turn cold and clammy. Moderate hypoglycemia often makes people feel short-tempered, nervous, afraid, or confused. Your vision may blur. You could also feel unsteady or have trouble walking. Severe hypoglycemia can cause you to pass out. You could have seizures. It could even cause a coma or death. If you've had hypoglycemia during the night, you may wake up tired or with a headache. And you may have nightmares. Or you may sweat so much during the night that your pajamas or sheets are damp when you wake up. To diagnose hypoglycemia, your doctor will do a physical exam and ask you questions about your health and any medicines you take. You will need blood tests to check your blood sugar levels. Some tests might include not eating (fasting) and watching for symptoms. Other tests might involve eating a meal that could cause symptoms of low blood sugar seve Continue reading >>

Nocturnal Hypoglycemia: The Hidden Killer

Nocturnal Hypoglycemia: The Hidden Killer

Imagine putting you happy, healthy child to sleep and not knowing that they will wake up alive the very next morning. This is the thoughts and fear in the minds of parents of kids with Type 1 Diabetes everywhere. We never know if the next morning we will see our child’s face awake, happy, ALIVE. It is another reason that if you ask about how much sleep a parent with a child with Type 1 diabetes gets, the answer is resoundingly minimal. Why? Because we stay awake to test our sleeping children to ensure they are not dropping too low during the wee hours of the night. Or we set multiple alarms to wake up to test. The title may frighten you, or you may even think it’s a bit over dramatic, but unfortunately for many families around the world, death because of nocturnal hypoglycemia has happen. It is a rare occurrence for the most part, but it can happen. If you are a parent of a kid with type 1 diabetes, or a person with diabetes yourself concerned about this happening, there are steps you can take to help prevent a nighttime low blood sugar from happening. In this article we will discuss how nocturnal hypoglycemia can be avoided at all costs, and how you can get some sleep once again. Learning to Recognize the Symptoms If you do not have diabetes yourself, it can be challenging to learn how to recognize the symptoms of a low blood sugar in your loved one, particularly when they are asleep. Nocturnal hypoglycemia is not all that different from your traditional low blood sugar episodes. Here are the most common symptoms that those with diabetes experience during a nighttime low: Waking up with a headache Feeling of unusual fatigue Waking up drenched and sweating Sleep disturbances A couple of these you can recognize if you are not the one with diabetes. If you happen to s Continue reading >>

Awakening Response To Nocturnal Hypoglycemia In Type 1 Diabetes

Awakening Response To Nocturnal Hypoglycemia In Type 1 Diabetes

Hypoglycemia (low blood sugar) is a frequent complication of insulin-treated diabetes, affecting patients with type 1 diabetes mellitus in particular. In individuals who do not have diabetes, insulin secretion is modified naturally and continuously by the body's own regulatory systems, depending on the blood sugar. However, in diabetes patients there is a lack of natural insulin and so manufactured insulin has to be given by injection after blood sugar testing. Hence, it is not possible for patients with diabetes to modify insulin secretion naturally in response to a change in glucose levels, and so blood glucose levels can rise and fall beyond healthy levels. In individuals who have intensive insulin therapy, hypoglycemia can be a particular problem; each year about 25% of patients on intensive insulin therapy have at least one episode of severe hypoglycemia -- which requires the assistance of another person. When hypoglycemia occurs during the day, diabetes patients can recognize it by a variety of symptoms, e.g., feeling sweaty and lightheaded, and they may either seek help from another person or treat themselves with sugar. Hypoglycemia during sleep may be very common -- it has been observed to occur in up to half of the nights when patients with diabetes were monitored. The particular problem with hypoglycemia occurring during sleep is that diabetes patients may not be aware of it and hence may not be able to treat themselves or to seek assistance. It is believed to contribute to some instances of sudden death during sleep in patients with diabetes. It has not been clear whether there is a certain level of blood glucose below which a signal is triggered that provokes awakening from sleep in either diabetes patients or in individuals who do not have diabetes. The a Continue reading >>

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