Nocturnal Hypoglycemia | Hypoglycemia Treatment | Hypoglycemia Unawareness

Nocturnal Hypoglycemia

Nocturnal hypoglycemia is defined as hypoglycemia occurring at night and is commonly known as hypoglycemia while asleep.

It is common in patients with type1 diabetes and is asymptomatic.

A low blood glucose level that occurs when a person is sleeping disrupts sleep and often goes unrecognized.

Nocturnal hyperinsulinemia occurs frequently with insulin therapy and although blood glucose levels are often low during sleep, they are rarely measured regularly.

50% episodes of severe hypoglycemia occur at night during sleep. These episodes cause convulsions and coma and have been involved as an important factor in cardiac arrhythmias resulting in sudden death.

If you have an event of nocturnal hypoglycemia, your mood and well-being are affected. Repeated exposure to nocturnal hypoglycemia decreases cognitive function and leads to the development of “hypoglycemia unawareness”.

Hypoglycemia unawareness:

When a person does not have the early symptoms of low blood glucose, hypoglycemia unawareness occurs. As a result, the person cannot respond in early stages. Severe signs of hypoglycemia are loss of consciousness and seizures.

In patients who tightly control the blood sugar levels with insulin, hypoglycemia and hypoglycemia unawareness occurs frequently. Frequent low blood glucose levels reduce the proportion of the hormones which produce symptoms of low blood glucose.

Hypoglycemia unawareness occurs in patients who take medications that stimulate insulin secretion.

Controlling nocturnal hypoglycemia:

Various techniques can be used to reduce the nocturnal hyperinsulinemia which is associated with many insulin replacement plans.

The frequency of nocturnal hypoglycemia can be reduced by regular glucose monitoring, taking appropriate bedtime snacks, and utilizing short and long acting insulin analogues.

Most nocturnal hypoglycemia episodes occurred with no snacks compared to any snacks. Eating snacks at bedtime is important when you had an exercise in the evening or in the late afternoon. Exercise can result in delayed hypoglycemic events.

Nocturnal hypoglycemia diagnosis:

If you are suffering with nocturnal hypoglycemia, you will be awake at the time of the event and realize that you are low or you may awake later with a severe headache.

The diagnosis can be made by your bed partner. You might be asleep, but sweating profusely and thrashing about.

Unsuspected nocturnal hypoglycemia can be detected by routine checking of blood sugar levels at 3 AM. Use continuous glucose monitoring systems to provide information about glucose levels.

Hypoglycemia treatment:

Blood sugar levels should be tested as soon as possible and the treatment should not be delayed if equipment is not available. You should eat 10 to 15 grams of fast acting carbohydrate such as three to four glucose tablets, half cup fruit juice, and six to eight hard candies.

This amount of food raises blood glucose into a safe range without causing high blood glucose levels called hypoglycemia. Once the blood glucose levels become normal, you can resume with your own activities.

You should speak to the health care provider. This helps to identify the cause of a severely low blood glucose level and adjustments can be made to prevent future reactions.

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