Among people who treat diabetes with insulin, hypoglycemia and nighttime hypoglycemia can be common.

People often realize the presence of nighttime hypoglycemia if they wake up from sleep a couple of hours into the night or multiple times during their sleep. Many people cannot remember or know they are suffering from nighttime hypoglycemia if they do not remember waking up at irregular hours during the night.

Diagnosis of nighttime hypoglycemia is important to treat it. And, one must be able to understand the signs and symptoms once they occur.

Tip: We have already covered How to Avoid Nighttime Hypos.

In this article, I will cover about 14 things you may not know about nighttime hypoglycemia but crucial to understanding for your well being.

Written by Shani, an Australia-base Registered Healthcare Practitioner with a Masters qualification from the University of Newcastle (Australia) and with decades of hands-on experience working for hospitals and in aged-care.

1. Waking up with noticeable conditions

The most common symptoms people notice are:

waking up with headaches multiple times during the night,

waking up with bed sheets damp from sweating,

waking up many times during the night and feeling tired.

Having a clammy neck can be one of the indications of hypoglycemia too.

Other symptoms may include a tingling sensation in fingers and mouth, confusion etc.

Tip: Migraine headache symptoms and triggers in Adults are different from children.

2. Reasons for nighttime hypoglycemia

  • Since this disease occurs in diabetic patients (both Type 1 and Type 2), one of the many reasons for having nighttime hypoglycemia is a high level of insulin. Physical activities throughout the day can cause an increase in insulin sensitivity that leads to nighttime hypoglycemia. Usually the same night after the activity, the nighttime hypoglycemia can show-up with visible symptoms.
  • Consuming alcohol can be one of the many and common reasons for nighttime hypoglycemia.
  • People who skip night meals or dinner have a higher chance of suffering from hypoglycemia than in those who take their diabetes-friendly meals regularly.
  • The quantity of basal insulin is usually shuffled for a patient if they suffer from any illness or regular illnesses over time. This change in the amount of insulin, particularly, an increase in the amount, can lead to nighttime hypoglycemia.

3. Treat it yourself

Considering you are a diabetic patient, nighttime hypoglycemia is treated pretty much in the same manner as hypoglycemia is treated.

Doctors and experts demand consumption of 10-15 gm of a snack consisting of sugar.

To prevent a further reaction, a quick-acting carbohydrate snack is taken along, such as bread, etc.

The ‘drill’ is to be aware of these symptoms and assess your condition so you can take prompt action to recover it.

Tip: Diabetes symptoms in men can vary from female and children, depending on whether you have diabetes mellites or diabetes insipidus, Type 1 or Type 2 diabetes, prediabetes or diabetes, or diabetes during pregnancy.

4. Reset your nighttime routine

A key to act quickly is to assess and keep a check on your condition. Diabetes patients usually check their sugar levels
before hitting the bed and after waking up.

If you want to keep a check on your condition during the night, you can test your sugar level at three am in the morning, halfway through the night. This would make a clear picture if the sugar levels are going too low late in the night and if there is a need to increases the insulin dose.

Adjusting the insulin doses should never be done without consulting a good diabetes doctor. You may discuss this with your doctor and inform them about your sleeping pattern and the fluctuating sugar levels, and he/she can guide you regarding the adjustments of your insulin doses.

Another reason why diabetic patients often suffer from nighttime hypoglycemia is skipping night meals. Instead of skipping your dinner, eat a little portion yet heavy in carbohydrates so it could keep your sugar level adjusted during the night.

Always remember to keep a quick-acting carbohydrate snack or two on your bedside. This may save you some precious time, and you can take quick actions if your sugar level drops during the night.

5. A severe hypoglycemic episode can be dangerous

People often ignore the symptoms while other times, they are not aware of the condition and its self-treatment. This enlightenment may lead to severe symptoms and health conditions which include unconsciousness, convulsions and in very rare cases, coma.

6. What causes the sugar imbalance?

A number of things and reasons can cause a sugar imbalance with nighttime hypoglycemia.

Much higher levels of insulin or much lower levels of insulin can cause sugar levels to fluctuate during the night.

In many cases, the acceptable amount of dose given at the wrong time can also lead to hypoglycemia. People diagnosed with diabetes have to be specific regarding their mealtimes. Changing the times of meal or consuming less or too much food can also lead to a decrease in sugar levels.

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Tip: There are many myths about diabetes-friendly food. However, the key to successfully managing diabetes is sticking with the diabetes food list, diabetes gastroparesis food list and reactive hypoglycemia food list based on your symptoms.

7. Nighttime hypoglycemia transfers genetically

People with diabetic family history tend to have more chances of suffering from nighttime hypoglycemia.

Regular checkups can help maintain a healthy and diabetic free lifestyle and keep you safe. People with parents or grandparents diagnosed with diabetes are more likely to establish diabetes and eventually nighttime hypoglycemia symptoms.

The drill is not to ignore the condition and if you sense the suffering from any of these irregular symptoms, consult a doctor.

8. Maintain a blood sugar chart

If you sense some changes in your sleep or eating patterns, start maintaining a chart. Write down what you ate and if you came across any such symptoms which you usually don’t.

Then, take the chart to your doctor and let them provide you with their recommendations.

9. Avoid excessive exercise in late evening or night

Diabetic patients and everyone, in general, is always instructed to exercise, which proves good in maintaining a healthy lifestyle and prevent many diseases from hitting. But extensive exercise a few hours before sleeping is not recommended especially if you have issues with your blood sugar.

Late exercises may cause the sugar level to drop during the night. If your blood sugar level comes out less than 100 mg/dl before bedtime after you have exercised, increase the amount of your orderly bedtime snack to restrain an undesirable dip while you are dozed off.

Tip: Excessive exercise and travels to warm temperatures can lead to heat acclimation. Our popular article about heat acclimation contains some valuable tips on how to manage your body’s adjustment to heat in those scenarios.

10. Be prepared

Low sugar level can hit you any time during the night, and you would not want to panic or rush to cure it.

It is recommended that you always keep snacks rich in sugar and carbohydrates by your bedside. This way, you would save so much time and prevent it from worsening in just the right time.

Tip: A panic attack is different from an anxiety attack.

11. Non-diabetic nighttime hypoglycemia

As much as diabetic patients are prone to hypoglycemia, non-diabetic individuals can develop this condition too, but very rarely.

Two kinds of hypoglycemia could occur:

  • Fasting Hypoglycemia: which results due to fasting for a long period of time or after excessive physical exercise after fasting
  • Reactive Hypoglycemia: which can occur within two to three hours after consuming the meal

Experts are still working out the reason for non-diabetic reactive hypoglycemia. It could be due to a rare enzyme deficiency that makes your body resistant enough to break the food down, or you are at the risk of prediabetes or diabetes.

Tip: Here is the Reactive Hypoglycemia Diet and Food List.

12. Symptoms of non-diabetic nighttime hypoglycemia

The symptoms of non-diabetic nighttime hypoglycemia include the following.

  • Hungry
  • Shaky
  • Sleepy
  • Anxious
  • Dizzy
  • Confused or nervous
  • Sweaty
  • Irritable
  • Syncope
  • Feel weak and
  • Having trouble speaking

Tip: If you struggle to sleep through the night, you must check your blood sugar too.

Tip: There are many differences between Dizziness and Lightheadedness, which you must know.

13. Treating hypoglycemia in non-diabetic patients

For immediate treatment of low levels of glucose in the blood, make sure to consume 10-15 grams carbohydrate in any form including juices, glucose or candies.

Ask an expert or a dietitian, whether there is any need to change your diet.

The following type of diet may help you:

  • Consuming small yet healthy meals and snacks throughout the day
  • Eating a snack or small meal every three hours
  • Having a variety of foods, including meat, bread, vegetable, grains etc.
  • Limiting foods that are high in sugar content

Tip: Here are diabetes food myths.

14. What do you need to ask your doctor?

With the first symptom causing, you need to get checked for the possible conditions. When you visit your doctor, inquire about your condition.

Ask the below questions from your doctor.

  • What are the causes of my hypoglycemia?
  • How do I treat my condition?
  • What and how long will I be treated?
  • Do I need blood tests and blood pressure checkups often?
  • When will I be cured of hypoglycemia?
  • Is there a need to see an Endocrinologist?
  • Is there a need to see a registered Dietitian?

Tip: If ‘hypos’ challenge you, talk to your doctor (also) about going ‘gluten-free’!

Tip: Regular glucose monitoring is important part of avoiding hypos. Always stick with one of the best glucose monitors.