Will the symptoms be pronounced enough to wake me up | Causes of nocturnal hypoglycemia | Stock in case of nocturnal hypoglycemia | Symptoms
Night hypoglycemia may or may not occur- it depends a lot on our habits. Consider the reasons, actions for stopping and habits that will permanently get rid of this challenge!
Even when we trained to stop hypoglycemia during the day, this condition inspires fear at night. The very idea that such a state will happen when we are most vulnerable leads to a feeling of complete helplessness. The main thoughts on this are next.
Will the symptoms be pronounced enough to wake me up?
Will I have the strength and the ability to get up and quickly deal with this, or will I just lie there, unable to do anything about it?
Most often, our body saves us during nocturnal hypoglycemia. It does this with counter hormones, which makes sugar ricochet in unrealistically high numbers. If you didn’t wake up with a decrease in sugar at night, then in the morning you can understand what happened by the sweat-soaked pajamas and the disappointing result on the meter and CGM. And honestly – this is the best defensive reaction in such circumstances.
But even taking into account the body’s ability to independently respond to low blood glucose and signs that usually warn other family members about the problem, hypoglycemia at night continues to be a source of fear and anxiety for most people with diabetes and their loved ones. The good news is that night hypoglycemia can be completely prevented. Understanding the causes of nightly sugar drops, people with diabetes can use preventative strategies to minimize these episodes.
Causes of nocturnal hypoglycemia
Hypoglycemia is more prone for those who use insulin replacement therapy. However, with an imbalance in the nutrition, activity and intake of oral hypoglycemic agents, people with type 2 diabetes are also at risk. This is especially true for those patients who take hypoglycemic drugs from the sulfonylurea class.
The most common causes of hypoglycemia during sleep are as follows:
- Use of long-acting insulin in the evening. It is important to know when insulin reaches peak action. If the maximum effectiveness of the drug falls during sleep, then the likelihood of hypoglycemia will be higher.
- Too high of a dose of basal insulin. Basal insulin is designed to maintain a constant level of glucose in the blood. If the administered dose is too high or the basal delivery rate in the insulin pump is too high, the blood glucose level will tend to decrease.
- Too large a dose of bolus insulin for dinner or evening snack. In general, it is advisable to establish a food routine (at least in the evening). I mean, you set a time limit for food and select a certain amount of carbohydrates, which is accompanied by an insulin injection. This allows you to hold night and morning sugars more tightly.
- Too large of a bolus to correct glycemia before bedtime or at night. Keep in mind that insulin susceptibility varies at different times of the day. For many people, sensitivity to fast-acting insulin is higher at night than during the day. Track what trend you personally have and select corrective doses accordingly.
- Active insulin + additional injection. Active insulin, which is so difficult to take into account, is another reason to establish an evening meal and injection routine. If you inject a corrective bolus before bedtime, do not forget about the previously entered insulin and the time it unfolds.
- Additional physical activity. After prolonged, intense training, or physical labor, blood glucose levels may decline over many hours. Keep this in mind to avoid delayed hypoglycemia, keep fast carbohydrates with you, and measure your blood sugar more often. If you are not sure how the additional load will affect the blood sugar, set yourself alarms at night and take additional measurements.
- Alcohol consumption. Alcohol is dangerous not only because it increases the risk of hypoglycemia, but also because it masks its symptoms for others, making them think that you are drunk when in fact sugar has critically decreased. Avoid alcohol or take precautions.
- Skipping measurement before bedtime. Forget about the guidelines for well-being. Always measure blood sugar before bedtime. This is the golden and unchangeable law to fight against nocturnal hypoglycemia. This rule also applies to people who take sulfonylurea class oral medications.
Stock in case of nocturnal hypoglycemia
Always have oral glucose at the bedside. It should be close and with easy access. Darkness, fear and a sleepy state do not play into the hands of our coordination. Think it over in advance.
It is better to keep dextrose tablets, which are easy to chew. A few tubes of gel / juice drink or soft glucose sweets are inexpensive, but also the most effective. Whatever you use, remove the wrappers and loosen the lid in advance so that it is very easy to access the contents of the container when you need it.
Get the glucagon! This, unfortunately, is not always easy, but there should be a small amount at least. Even if you never use it (and this is a good option)!
Explain to your family what the symptoms of hypoglycemia are and what you need to do to help you. It is especially important to tell in detail about glucagon, since in an emergency it is quite difficult to understand the details. Regularly check the expiration date of the drug.
Symptoms of nocturnal hypoglycemia
A sudden decrease in blood glucose usually does not lead to serious conditions. However, even a moderate decline that has not been treated for several hours or more can lead to serious consequences. Thus, the key to preventing serious episodes of hypoglycemia (day or night) is early detection and rapid treatment.
Frequent monitoring of blood glucose levels and the use of CGM can be very useful in the early detection and treatment of mild hypoglycemia. However, you and your partner should be aware of even the most subtle signs of low sugar during sleep. Symptoms can vary greatly from person to person, so take the time to think about it and discuss it with your partner. Even insignificant signs can be a warning: unusual dreams, desire to urinate, night twitching and cramps, profuse sweating, more restless behavior than usual.
Follow precautionary rules and analyze your behavior for possible risks. If it seems to you that your therapy increases the likelihood of hypoglycemia, consult your doctor about how to correct it. For example, you can check whether basal insulin is correctly selected, and for oral therapy with hypoglycemic agents, consider another class of drugs.
Be vigilant and your will have very SWEET dreams!